Stay aware of melanoma – in all its guises

Dr Antonia Pritchard and Dr Sharon Hutchison

Melanoma. It is one of those softsounding words that disguises a harsh reality. Also sometimes hidden – behind common misconception – is that it is a killer that does not always appear on the skin. As May is both melanoma awareness month and cancer research month, it is a timely opportunity for us to introduce ourselves to our new community and home in the north of Scotland.

We have recently set up a melanoma research group at the Highlands and Islands University in Inverness, thanks to funding support from Highlands and Islands Enterprise.

Here are a few important facts to help give an insight into the work we are doing:

Melanoma is Scotland’s sixth most common cancer – arising from the melanocyte cell which produces pigment (colour) in your body.

Not all melanoma is caused by exposure to the sun and ultraviolet radiation.

Your immune system is capable of killing cancer cells.

The type of melanoma you have likely heard most about appears on the skin – the sort that makes it important that we keep an eye on our moles or appearance of new skin lesions.

It is often identified by changes such as the appearance of a new mole or a transformation in an existing one that progressively changes in shape, size and/or colour.

These can be remembered as the A (asymmetry), B (borders that are uneven), C (colour changes), D (diameter changes) of mole alterations to look out for.

This type of melanoma occurs after exposure of the skin to too much ultraviolet radiation from the sun. In the UK, almost nine in 10

cases of melanoma could be prevented by using high factor sunscreen, limiting the time you are exposed to ultraviolet radiation, including sunbeds, and covering up your skin when in the sun – an important thing to remember during your summer holiday, particularly as the Highlands was hotter and sunnier than Rome or Athens last week.

If you see any changes on your skin or to your moles, please visit your GP who will examine them. This is a quick and easy thing to do and the earlier a melanoma is detected, the more likely it will be cured, so it is good to be cautious.

But did you know that melanoma does not only appear on the skin?

Melanoma can develop in the eye (known as uveal melanoma), under the fingernails or on the palms of hands/soles of feet (known as acral melanoma) or from an internal mucosal surface, such as gums, nose or rectum (known as mucosal melanoma).

These rare types of melanoma are not usually influenced by ultraviolet radiation in the same way as skin melanoma and are often detected at a more advanced stage due to their locations.

Unfortunately, once melanoma has spread, it is one of the hardest cancers to cure. That is something we are working hard to remedy – both in the sense of raising awareness and in terms of finding treatment targets in melanoma that has spread.

One way we achieve this is to study the DNA of people with melanoma to identify changes that might have made them more likely to develop the disease. There can be alterations in DNA that make it more likely that multiple members of the same family develop melanoma. If these are identified, a proactive screening programme can be started to spot melanomas early in these families.

Another aspect of our work is the study of how the immune system can recognise cancer cells as being “foreign” to the body. This occurs in a way that is similar to how it recognises viruses and bacteria as not belonging there. But, once a cancer has developed, it has managed to evade the immune defences. We are trying to find ways to re-stimulate the immune system to recognise and kill cancer cells. Ultimately, we want to be able to identify new immune targets for treatment of melanoma.

We are excited to be able to bring our work to the university and the community and to be part of the teams continuing to put the Highlands on the map as a place to perform life-changing medical research.

Can you help with our research? Absolutely! If you have been diagnosed with any type of melanoma at any time, we have a project you are eligible to join, so get in touch by emailing melanoma.research@uhi.ac.uk

You can spread the word that we are researching melanoma and that lots of different types of medical research is happening in Inverness – we love to talk about our work!

Want more information? We recommend the patient support network Melanoma UK - www.melanomauk.org.uk – and the NHS information pages contain a lot of important material about all types of melanoma.

Finally, the university’s Institute of Health Research and Innovation has a Twitter account – @IoHRI_UHI – to keep everyone up to date on our medical health research.

Dr Antonia Pritchard is a senior lecturer and Dr Sharon Hutchison a post-doctoral researcher at the University of the Highlands and Islands