Despite not being known for the sun, one out of every three cancers in Ireland is of the skin, with almost 12,000 new cases annually.
And while most of us are aware of the need to seek shade and wear sunscreen, not everyone knows what the signs of skin cancer look like - which is why Jane Jackson was totally unaware about a mole on her neck until it was pointed out to her at a dental appointment earlier this year.
"When the dental hygienist put the protective cover around my neck, she just casually asked if I knew I had a mole there," says the 45-year old, who has one daughter, Susie (7). "She said I should get it checked out as due to its location at the base of my neck, neither I nor anyone else had noticed it.
"I was concerned enough to ask my husband, Roy, to look at it when I got home and he said it looked like a normal mole so we agreed to leave it alone but keep an eye on it."
Jane, who works as a chartered tax advisor, did nothing about the mole for several months until her husband suggested that she should go to the doctor to have it examined.
"About five months later, Roy checked the mole and said it looked as though it had changed," she says. "This did concern me, so I called the GP and asked for an appointment. It was in the early days of lockdown, so I didn't expect to be seen straight away, but I was told to come in on the same day.
"The doctor closely examined the mole and the rest of my body and advised that I see a dermatologist to have it removed and analysed. I still wasn't very concerned but as I have medical insurance, she gave me the number of a private doctor and I left feeling positive that some action was being taken."
The mother of one, who lives in Meath, called the dermatologist and was advised that due to the Covid-19 crisis, the practice was not currently seeing patients, but she would be in touch when it reopened.
She then called her GP to inform her of the situation and thinking she would hear nothing until restrictions had been lifted, was surprised to get a call from her doctor informing her that she had referred her to the dermatology department at the local hospital.
"I expected this to be in a few weeks' time, but they called me that same day and said to go in on Friday afternoon, exactly a week after I had first seen the GP," she says. "I was now getting a little anxious about how seriously the GP was taking this, and I was also very worried about going to the hospital in the middle of the health crisis.
"But I went to the appointment and it was agreed that the mole should be removed there and then. I had one internal stitch and 11 external ones - then the wound was dressed, and I was sent home. This procedure had taken just under an hour."
Jane was reassured that the mole was gone and while waiting to receive notification of results, was advised to visit her GP to have the stitches removed. But before this scheduled appointment, she was called back to the hospital for the possible removal of more skin.
"I was very anxious, my emotions were high causing me to be tearful when I would normally deal with things much better," she admits. "The consultant told me that the mole had been cancerous and that I had Stage 1b skin cancer - and I cried when she told me, as I think the word cancer was what hit me the most.
"She was so kind, apologising for her mask and that social distancing meant she wasn't able to comfort me and I couldn't have someone with me. But she gave me some literature and phone numbers and said I would be referred to Beaumont Hospital to have further skin removed and my lymph nodes checked.
"Once I left the hospital, I burst into tears but had to pull myself together as Susie was with Roy in the car and I didn't want to frighten her. When we got home, myself and Roy talked about the diagnosis and I talked on the phone to some friends and my family. Then we made cookies and watched a Disney film. It's funny how there is comfort in wanting things to be the same as usual."
A few weeks later, Jane had a lengthy hospital appointment where her entire body was checked and she was advised that several other moles would need to be removed. She was also scheduled for a sentinel lymph node biopsy and a wide excision of skin from the back of her neck.
After a 'painful' injection of radioactive dye, she underwent a scan which would check if the cancer had reached the lymph nodes before the required surgery.
"The point of this is to find out which lymph nodes had been affected by the melanoma, so they could remove the sentinel [main] ones," she says. "The dye - injected into the spot where the melanoma had been - would travel to the lymph nodes and would show up as blue.
"After this, Roy took me to St Joseph's Hospital where they removed the wide excision of skin and also a lymph node from the base of my neck at the side and another from under my arm. I was in a lot of pain after the operation, but now that a few weeks have passed, this is easing and I am healing well. But I did have swelling to the back of my neck and shoulders and deep bruising to the right side of my body - my right breast was purple.
"I returned to hospital a week after the operation and they removed the dressings and reassured me that I was healing well. And I will return to the consultant this month to get the biopsy results."
Jane has five moles on her stomach and one on her back which will be removed and now that she is 'in the system' will be checked every few months. She is extremely fortunate that her dental hygienist spotted the cancerous mole and advises everyone else to inform themselves of the guidelines and stay protected from harmful rays.
"I am fairly sallow and always tanned well so I thought I would have been the last person to get skin cancer," she says. "I would not have used sun cream in Ireland, but I rarely sunbathe here and did use it when abroad. But when I was younger, I had bad acne, and the medical advice at the time was to use sunbeds to help with this and I also sunbathed without sunscreen, so, I think this is when the damage occurred.
"My advice now would be to wear a good, high factor sunscreen, to cover up and to stay in the shade. The sun is so dangerous to our skin and most people are completely unaware of this. This and the casual attitude to moles and skin cancer, is really worrying.
"I have found that people are laid back about the removal of a mole and a skin cancer diagnosis because they believe it to be trivial so wait to get them checked out as skin cancer does not seem to carry the same dread as another cancer would.
"If I had known that use of a sunbed or lack of sunscreen would lead me to this much pain, emotional distress and anxiety, I would certainly have behaved differently. As it stands, I am still waiting to find out if I need further treatment or surgery."
While skin cancer is very prevalent in Ireland, Kevin O'Hagan, Cancer Prevention Manager with the ICS, says risks can be minimised if detected early.
"Catching cancers early is key and can mean the difference between life and death in some cases," he says.
"This is very much the case for certain types of skin cancers, with five-year survival rates ranging between 90pc and 20pc, depending on the stage of detection.
"Changes to look out for include the appearance of a new mole or an existing mole that has changed shape, size or colour, or other unusual spots or lumps. Anyone who is concerned needs to contact a GP for investigation."
⬤ Skin cancers account for one in three cancers diagnosed every year Ireland, with almost 12,000 cases annually. The incidence of skin cancer is expected to treble over the next 20 years.
⬤ This risk is particularly acute among outdoor workers who receive up to eight times more exposure to UV radiation than indoor workers.
⬤ People also need to be aware of any changes to their skin and contact their GP if they spot anything unusual.
⬤ Risks can be reduced by seeking shade between 11am and 3pm, applying sunscreen with SPF 30 or higher and UVA/UVB protection on all exposed area of the body every two hours, covering up with a long sleeved collared shirt, a hat and sunglasses with full UV protection. cancer.ie