Fishing and factor 50
Trout-angler Dr Frank Conroy offers some essential skin-care advice
Trout-fisher Dr Frank Conroy sends us to the pharmacy
“If a lesion has suddenly appeared or changed and hasn’t settled after 4-6 weeks, seek medical advice”
WHEN FISHING from bank or boat we are exposed to the sun and its harmful effects. UVA and UVB rays will happily penetrate our pale, freckly, European skins and ravage the building blocks of our genetic makeup, potentially giving rise to the formation of skin cancer. Skin cancer is an umbrella term that encompasses two distinct groups of skin malignancies: very serious malignant melanoma and less serious nonmelanoma. In 2014 (latest figures) in the UK, there were 15,000 new cases of malignant melanoma reported and 131,000 new cases of non-melanoma skin cancer (thought to be a huge underestimate).
Malignant melanoma has quadrupled in incidence over the last 30 years – faster than any other cancer. In the UK, seven deaths each day occur due to malignant melanoma and it is the 17th most common cause of cancer death. The main risk factor is chronic, intermittent exposure to high-intensity sunlight with episodes of sunburn, a phenomenon all fly-fishermen will have experienced. Melanoma can arise from existing moles or from new lesions and while we all assume melanoma appears as a brown, pigmented spot, it can occur in its amelanotic form containing no pigment and as such go ignored. Melanoma can spread through the lymphatic system and extensive surgery can be needed if evidence of metastasis is found. Vigilance and self-examination are the keys to early detection. The British Association of Dermatologists advocates the ABCDE method of self-examination of moles:
Asymmetry: the two halves of the area may differ in shape. Border: edges of the area may be irregular or blurred, and sometimes show notches. Colour: may be uneven. Different shades of black, brown and pink may be seen. Diameter: most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor. Expert: if in doubt, check it out. If your GP is concerned about your skin, make sure you see a consultant dermatologist or consultant plastic surgeon. Your GP can refer you via the NHS.
NON-MELANOMA SKIN CANCER
Far more common than melanoma, nonmelanoma is thankfully much easier to treat and mortality is low. Basal cell carcinoma and squamous cell carcinoma are the commonest types and while locally invasive, they rarely spread around the body. The development of BCC/SCC is directly attributable to sun exposure and a recent study examining the incidence of outdoor workers developing these skin cancers showed they face a 43 per cent higher risk of developing BCC and a massive 77 per cent increased risk of developing SCC. Professional fishing guides should be running to the chemist for sunscreen having read this. Treatment of BCC/SCC is relatively straightforward, with surgery the mainstay of treatment, though if caught early they can be amenable to LASER treatment, cryotherapy or even a simple ointment.
We all enjoy being out in the sun and need sunlight for the body to make certain vitamins and I would never suggest it should be completely avoided; but it must be respected. Reaching for sun-cream is often the last thing we think of while spellbound by the sight of a 3lb wild brownie sipping down spent mayfly as our fly fast approaches, however, simple, regular application of a high SPF (greater than 50) waterproof sun cream, donning your favourite hat (preferably wide-brimmed) and polaroids may prevent an unpleasant visit to your friendly dermatologist or plastic surgeon.
A malignant melanoma: asymmetric with an irregular border and non-uniform colour.
A classic BCC: note the pearly appearance, tiny blood vessels running through it and the scabbed centre.