Cancer where the sun doesn’t shine
Skin cancer is cropping up in the strangest of places at alarming rates.
Lesions of the genitals, eyelids, inside of mouths and ear canals aren’t uncommon.
In 2016 18 male genital organs and 67 female were diagnosed with skin cancer, according to Ministry of Health figures. This led to two excisions of the vulva, according to material released under the Official Information Act.
And last year 211 publicly funded excisions were performed on the subcutaneous tissue of the finger, along with seven amputations.
Sun exposure is clearly the biggest risk factor for skin cancer, Hamilton dermatologist Amanda Oakley said.
‘‘But that sun exposure can be quite minor. There are other factors that come into it as well.’’
Genetics, viruses, certain medicines and environmental toxins – especially smoking – can also play a role.
New Zealand has the highest skin cancer rates in the world. It’s the most common form of cancer, costing the country around $57 million each year, according to Cancer Society.
Nearly all skin cancers are on exposed sites such as the face, the arms and the lower legs, Oakley said.
‘‘But we do see surprises.’’
Publicly funded excisions – including both full wedge and lesion excisions – of the lip amounted to 614 altogether last year, according to material supplied under the Official Information Act.
And eyelid excisions topped that with 1023.
Some lip and genital skin cancers are more likely to occur in smokers, Oakley said.
‘‘Immune suppression comes into it too,’’ Oakley said.
‘‘If you had a kidney implant you would be given drugs to stop you rejecting someone else’s kidney, otherwise it wouldn’t work.
‘‘They have to take this [immunosuppressant] drug. But they have a down side and one of the most common downsides is the susceptibility to skin cancer.
‘‘It has been reported that 25 per cent of deaths in organ transplant recipients are actually due to skin cancer.’’
But sometimes there’s no explanation.
‘‘This week I saw one in an armpit, so, that wasn’t due to the sun. But it would be one of those random mutations.’’
For older people, odd spots or lesions can be especially hard to spot, Melanoma NZ nursing adviser Sinda Hall said. And it’s even harder when they crop in unexpected places, such as the genitals.
‘‘You can get melanoma of the toenail, that’s what Bob Marley died of.’’ But allied health professionals, hairdressers and most types of therapists can help, Hall said. They’re being encouraged to train to spot abnormal skin spots on clients, in places that may otherwise be missed.
Single people could be more at risk, Hall said.
‘‘Some research came out last week about married couples having a higher awareness uptake. Because somebody would see them with no clothes on and say ‘oh what’s that’?’’
Surprisingly to many, people start producing skin cancers the day they’re born, Oakley said.
‘‘But our immune systems rushes around clobbering them. So, we don’t know that we have skin cancers from babyhood because we don’t see them. We only see them as we’re getting older and our immune systems are starting to run out.’’
‘‘You can get melanoma of the toenail, that’s what Bob Marley died of.’’
Sinda Hall