breast cancer. The major purpose of chemotherapy as an adjuvant is to kill of micro-
metastases that may have been established before surgery. Recently, chemotherapy
has been used before surgery as a neoadjuvant. This therapy has the same effect as
adjuvant chemotherapy but may also shrink a tumour, making it more easily operable.
Many cancers arising from tissues that are hormone dependants are responsive to
hormone manipulation. Other approaches are still being researched for the treatment of
cancer. The most important method for curing cancer though is preventive, for example
stopping tobacco use, better diet, avoiding over-exposure to sunlight and the routine use
of sunscreens, the environment can be improved by the elimination of carcinogenic
chemicals e.g. asbestos. People without symptoms should have a cancer related
check-up every 3 years from the ages 20 to 40 years, and every year from the age 40
years.
The basics of UV sun rays
The sun produces about three types of UV rays:
UVA
UVB
UVC
Ultraviolet Light is harmful to humans. The ozone layer filters out UVC. UVA, however,
has a long wavelength ray, so a certain amount reaches the earth’s surface. UVA is the
predominant ray to reach earth. UVA causes damage to cellular membranes and DNA,
and has been implicated in ageing of the skin and the development of skin cancer.
Scientists believe it is UVB rays that are the paramount cause of premature ageing of
the skin, sunburn, skin cancers and other sun induced skin problems, despite the fact
that UVB rays constitute for only 1% of UV rays that reach our skin.
The difference between suntan and sunburn
Tanning is your body’s response to UV light. Your skin darkens when you tan due to an
increase in the production of melanin. It is a protective reaction to prevent further injury
to your skin by UV rays as melanin absorbs light in the UV range. The complete
physiological response to UV light takes about a week. A suntan is protective, however
they do not prevent skin cancer.
Tanning and burning are two different processes. UVB rays are absorbed by the outer
layers of the skin, causing the blood vessels that run close to the surface of the skin to
swell, preventing the stimulation for tanning, so you burn. Sunburn can start within
several minutes of UV exposure or can continue to occur 24-72 hours after exposure to
the sun. The sunburn you receive now may take 20 years or more to become skin
cancer because it is very slow to develop.
How to care for sunburn
Unless accompanied by severe swelling, fever, or confusion; you can treat a sunburn by
immersing the area in cool water immediately following exposure and then treating the
area with hydrocortisone cream for several days. If blisters form do not purposely pop
them. When they do pop use antibacterial soap to keep them clean. Aspirin will help
mitigate pain and swelling. Moisturising creams and aloe containing products may help
soothe the sunburn and replenish the skin.
Severe sunburn is usually indicated when a person experiences excessive exposure to
the sun. Intemperate swelling, fever, chills, nausea, confusion, or immediate blistering
may indicate that you are suffering with severe sunburn. You should seek medical help.
The sun can dry out your skin so you should keep your skin moist. Moist skin is an
important part of healthy skin. Most over-the-counter skin lubricants are adequate.
Keeping your skin from drying out by applying moisturiser before your skin becomes dry
is better than doing it afterwards. You should pay particular attention to your face, and
especially your lips, to make sure they do not “dry-out” in the extremes of winter and
summer.
Photosensitivity reaction
Photosensitivity reactions are immunological or toxicity reactions which result from the
presence of a photosensitising agent and UV light. Photosensitivity reactions are
characterised by reddish skin with elevated poison ivy like bumps and can occur in
areas that were not exposed to the sun. They rarely produce discomfort, however
phototoxic reactions (another type of photosensitivity reaction) are usually accompanied
by symptoms similar to sunburn.
The long-term effects of exposure to the sun
Exposure to UV rays adds up over time, most people receive approximately 80% of
their lifetime exposure to the sun by the time their 18 years old! UV light and sunburn
can damage your skin, this damage can then lead to skin cancer. Apart from skin
cancer, overexposure to the sun can cause:
* Skin to become dry, wrinkly, thicker, saggy, with splotches of pigmentation,
* Pre-cancerous growths,
* Photosensitivity reactions,
* Cataracts,
* Eyelid cancers,
* Burnt retinas,
* Acute and systematic immune depression,
* Exacerbation of chronic medical conditions,
* Sun exposure can also induce herpes “flair-ups”.
How many people are affected by sun induced skin
problems
Incidence and mortality rates for skin cancer have risen steeply in the UK during the past
few decades. Scientists estimate that 1 in 5 people will develop skin cancer during their
lifetime. The sun is responsible for more than 90% of all skin cancers. Serious sunburn
once in your life can increase the risk by as much as 50%.
Tanning beds and lights
Exposure to the radiation of a tanning booth may be more risky than exposure to the
sun. UVA can cause “direct” injury to underlying blood vessels, collagen breakdown,
reduced skin elasticity, inflammation of the stratum corneum, retinal damage, a
decreased amount of Langerhans’ cell (immunological cells). UVA rays, which are the
main rays tanning beds and lights emit, compound the damage of UVB rays. Prolonged
exposure to UVA by itself can cause skin cancer.
Tanning creams
Tanning pills or oral compounds that claim to brown the skin are dangerous, most of
them have been removed from the market, however beware of any “pills” that claim to
darken the skin.
Most tanning creams are skin dyes or cosmetics. They do not stimulate melanin
production and therefore do not provide any protection against UV rays.
Skin cancer
The skin has two main layers, the epidermis and the dermis, and several kinds of cells.
The epidermis is the top layer of skin. It contains three types of cells: squamous cells
(flat, scaly cells on the surface), basal cells (round cells), and melanocytes (which give
your skin colour). If you have skin cancer the skin cells become malignant. There are
three main types of cancer: Basal cell carcinoma, Squamous cell carcinoma and
melanoma.
Major risk factors for getting skin cancers
The effect UV light has on your skin is dependent both upon the intensity and the
duration of your exposure. How your skin reacts to the amount of exposure received is
related to your genetic background. Even if you rarely sunburn you should still protect
the sensitive areas such as your lips, nose, and the palms of your hands.
If there is a history of skin cancer in your family, you are probably at higher risk. About 1
in every 10 patients diagnosed with melanoma has a family member with a history of the
disease. Lighter coloured skin puts individuals at a higher risk for some types of skin
cancers. People with a large number of moles or freckling have a higher risk for getting
skin cancers. A history of sunburns increases your risk - one study showed that 6+
sunburns during a lifetime doubles a persons risk of malignant melanoma. The more
UV exposure the greater the chance of getting sun induced skin damage.
The level of UV light today is higher than 50 years ago, which was higher than 100 years
ago. With less atmospheric ozone, a higher level of UV light reaches the earth’s
surface. The reduction of the ozone layer is not the only influencing environmental facto,
elevation, latitude, and cloud cover have an effect. UV light is stronger as elevation
increases. The thinner atmosphere at higher altitudes cannot filter UV as effectively as it
can at sea level. The rays of the sun are also strongest near the equator. Cloud cover
helps to reduce UV; the density of the clouds affects the amount of UV filtered out.
Skin types and their response to the sun
Skin type
Sunburn and Tanning history
I
Always burns; Never tans (“Celtic”)
II
Burns easily; Tans minimally
III
Burns moderately; Tans gradually to
light brown (average Caucasian)
IV
Burns minimally; Always tans well to
moderately brown (olive skin)
V
Rarely burns; Tans profusely to dark
(brown skin)
VI
Very rarely burns; Deeply pigmented
(black skin)
Sunscreens
Sunscreens are chemically formulated oils, lotions or creams applied to the skin. They
absorb and filter out UV rays before they penetrate your skin, unlike sun blockers that
reflect UV rays before they reach it. From a functional standpoint, sunscreens protect
the skin like the natural pigment melanin. Sunscreens are formulated to protect against
UVA rays, UVB rays or both. Those that protect against both contain at least two active
ingredients. Most are water resistant. Sunscreens do not interfere with the body’s
production of vitamin D.
There are 4 main classes of sunscreens:
1. PABA - absorbs and filters out UVB rays. May cause minor skin irritation.
2. Cinnamates - provide protection from UVB rays. They have a SPF of 15. They may
cause contact dermatitis, especially in people who are sensitive to products with
cinnamon.
3. Benzophenones - protect against UVA. Not effective against UVB. Provide good
protection in snow, high altitudes and against reflected light. If used with PABA
esters they are effective in humid climates because they do not wash off easily.
4. Anthranilates - provide moderate protection against UVA and UVB rays.
It is best to look for a sunscreen that protects from both UVA and UVB rays.
SPF stands for ‘Sun Protection Factor’. It indicates how long you can safely stay in the
sun before you burn when using the product than when not using any sunscreen at all-
that is if you use the product correctly (studies have shown that people only apply about
half the amount of sunscreen that the FDA uses to determine SPF).
How to choose a sunscreen
It is best to choose a sunscreen that has an SPF of 15. If you are fair skinned or plan to
be outdoors for a long period of time, choose a sunscreen with a higher SPF. Consider
buying a ‘broad spectrum’ sunscreen that contains 2 or more UV-absorbing compounds
--> a combination of cinnamates and benzophenones. You should apply sunscreen at
least 30-45 minutes before you expose yourself to the sun, so that your skin has time to
absorb the product. For maximum protection apply sunscreen before you get dressed
in case your clothing slips, and you’ll have up to the edges of your clothes. It is best to
reapply sunscreen every 2 hours (even on cloudy days) and after swimming and
perspiring. You should try and choose a sunscreen that is waterproof.
You should partly choose your sunscreens based on time and environment. The suns
rays are strongest between 10am and 4pm, and UV rays become more intense as you
get higher in elevation and nearer the equator. Do not assume that if your skin is not
red, that you are not sunburned, sunburn becomes more evident 6-24 hours after
exposure to the sun.
Sunglasses
Sunglasses protect eyes against UV radiation and decrease the amount of bright light
that enters the eye. Not using sunglasses can lead to snow-blindness, a temporary but
painful condition that results in inflammation to the eyes, due to UV ray exposure.
Symptoms include:
* Light sensitivity
* Feeling grit in the eyes
* Reddening of the eyelids
Excessive exposure of the eyes to UV rays can lead to cancers of the eyelids. UVB
rays are a major factor in age-related cataracts.
When buying sunglasses you should consider:
* UV filtering - you should buy sunglasses that block at least 95% of UV rays.
* Lens colour - you should select a tint based on what activities you will be doing.
Some tints work better for some activities and weather conditions than others.
Consult a salesperson for which tints are best in which situations. For general use
you should choose a tint that blocks 80% of transmissible light. They must not block
more than 90-92% of transmissible light or the sunglasses might significantly affect
your ability to see! Dark sunglasses that do not have adequate UV filtering can
cause the pupils to dilate (open), which allow more instead of less UV radiation to
pass into the eye. Polarisation (which effectively reduces ‘glare’) is also another
factor to consider when buying sunglasses.
* Comfort
* Price - Buy your sunglasses from a reputable store. If you find a pair of sunglasses
which are normally very expensive at a phenomenally low price then you can feel
confident that they are most likely a counterfeit, look-alikes, or stolen! In which case
they probably will not provide the same protection. Less expensive sunglasses do
not mean less protection.
The sunglasses whether glass or plastic, must also be impact resistant. All sunglasses
must meet FDA requirements for impact resistance.
Self-examination
What to look for: Look for a new growth or any skin change.
What you'll need: a bright light; a full-length mirror; a hand mirror; two chairs or stools;
a hair-dryer.
* Examine head and face, using one or both mirrors. Use hair-dryer to inspect scalp.
* Check hands, including nails. In full-length mirror, examine elbows, arms, and
underarms.
* Focus on neck, chest, and torso. Women: Check under breasts.
* With back to the mirror, use hand mirror to inspect back of neck, shoulders, upper
arms, back, buttocks, legs.
* Sitting down, check legs and feet, including soles, heels, and nails. Use hand mirror
to examine genitals.
The Skin Cancer Foundation advises people to perform a total body skin examination at
least once every 3 months. They also advise that you have a total body skin exam by a
qualified skin specialist at regular intervals. The physician will suggest the correct time
frame for follow-up visits, depending on your specific risk factors, such as skin type and
history of sun exposure.
Precautions
* Minimise sun exposure between the hours of 10:00 a.m. and 3:00 p.m.
* When outdoors apply sunscreens rated SPF-15 or higher to all areas of the body
exposed to the sun.
* Apply sunscreens liberally, uniformly and frequently. Reapply sunscreen every 2
hours, even on cloudy days, and after swimming or perspiring.
* When exposed to sunlight wear protective clothing that covers your body and shades
your face e.g. long trousers, long sleeved shirt, broad brimmed hats and UV-
protective sunglasses.
* Avoid artificial tanning devices such as sunlamps and tanning parlours.
* Teach your children good sun protection habits from an early age. Keep them from
excessive sun exposure when the sun is strongest and apply sunscreen liberally and
frequently to children aged 6 months + (Do not use sunscreen on children under
6 months of age-if your child is under 6 months you should severely limit their sun
exposure).
* Examine your skin, head to toe, at least once every 3 months.
Precancerous conditions - Actinic Keratosis
Actinic keratosis (also known as solar keratosis) can be the first step in the
development of skin cancer - a precursor of cancer/precancer. Anyone who spends time
in the sun runs a high risk of developing one or more.
An actin keratosis is a scaly or crusty bump that arises on the skin surface. The base
may be light or dark, tan, pink, red, or a combination of these, or sometimes even the
same colour as your skin. The scale or crust is horny, dry, and rough, and is often
recognised by touch rather than sight. Occasionally it itches or produces a pricking or
tender sensation. The skin abnormality/lesion develops slowly to reach a size that is
most often from an eighth to a quarter of an inch. It may disappear only to reappear
later. You will often see several actin keratoses at a time. A keratosis is most likely to
appear on the face, ears, bald scalp, and neck, backs of hands and forearms, and lips.
It tends to lie flat against the skin of the head and neck and be elevated on arms and
hands.
Up to 10% of active lesions, which are redder and tenderer than the rest, will progress to
squamous cell carcinomas. They are not usually life-threatening, provided they are
detected and treated in the early stages, if not they can grow large and invade the
surrounding tissue, and, on rare occasions, metastasise. The most aggressive form of
keratosis, actin cheilitis, appears on the lips and can evolve into squamous cell
carcinomas. About 1/5 of these carcinomas metastasise. Actin keratoses can develop
into any kind of skin cancer - not just squamous cell carcinoma.
1 in 6 people, it is estimated, will develop an actin keratosis in the course of a lifetime.
Older people are more likely to have an actin keratosis due to cumulative sun exposure
over the years. People who have fair skin, blonde or red hair, blue, green, or grey eyes
are at greater risk also because their skin has less protective pigment (melanin), and
they are the most susceptible to sunburn. However even those darker skinned may
develop actin keratoses if they expose themselves to the sun without protection.
You can prevent developing actin keratoses by following the normal sun safety
procedures. There are a number of effective treatments for removing actin keratoses,
however not all keratoses need to be removed, the decision whether to remove a
keratosis, or what treatment to use, is based on the nature of the lesion, your age and
your health.
Treatment
* Curettage and Electrodessication
It is the most commonly used treatment. The physician scrapes the lesion and
takes a biopsy specimen to be tested for malignancy. Bleeding is controlled by
electrocutery - heat produced by an electric needle.
* Shave Removal
Utilizes a scalpel to shave the keratosis and obtain a specimen for testing. The
base of the lesion is destroyed, and the bleeding is stopped by cauterisation.
Cryosurgery freezes off the lesions through application of liquid nitrogen with a
special spray device or cotton-tipped applicator. It does not require anaesthesia
and produces no bleeding, but white spots sometimes result.
* Dermabrasion
Removes the upper layers of the skin by sanding or using a fine wire brush
operating at 20-25,000 revolutions per minute. Redness and soreness usually
disappear after a few days.
* Topical Medications
Two medicated creams are effective in removing keratoses, particularly when
lesions are numerous. The patient twice daily applies the medication, with
progress checked by a physician. 5-Fluorouracil (5-FU) cream is used for three
to five weeks. Treatment leaves the affected area temporarily reddened and may
cause some discomfort resulting from skin breakdown. Masoprocol cream, 10%,
the newest topical treatment, is applied for 28 days. Redness and flaking are the
most common side effects; most reactions are usually reported as mild to
moderate.
* Chemical Peeling
Makes use of trichloroacetic acid or phenol applied while the patient is under
light sedation. The top layers of the skin slough off and are usually replaced within
seven days by growth of new epidermis.
* Laser Surgery
Focuses the beam from a carbon dioxide laser onto the lesion. This treatment is
rarely used, but can be effective, particularly for keratoses on the lips.
Basal Cell Carcinoma (BCC)
These cancers arise in the basal cells. Basal cell carcinoma is not only the most
common form of skin cancer, but also the most common type of all cancers. One out of
every three new cancers is a skin cancer, and the vast majority are basal cell
carcinomas. The number of new cases has increased sharply each year in the last few
decades; the average age of onset of the disease has steadily decreased.
The Major Cause
Tumours rarely develop on non-exposed areas. Basal Cell Carcinoma is caused mainly
by chronic exposure to sunlight so tumours occur most frequently on exposed parts of
the body e.g. the face, ears, neck, scalp, shoulders, and back. In a few cases, contact
with arsenic, exposure to radiation, and complications of burns, scars, vaccinations, or
even tattoos are contributing factors.
Who Gets It
Anyone with a history of frequent sun exposure can develop basal cell carcinoma. But
people who have fair skin, light hair, and blue, green, or grey eyes are at highest risk.
People who spend extensive time in the sun are in particular jeopardy. Dark-skinned
individuals are far less likely than fair-skinned to develop skin cancer, but there is still a
risk.
What to Look For
An Open Sore that bleeds, oozes, or crusts and remains
open for three or more weeks. A persistent, non-healing
sore is a very common sign of an early basal cell
carcinoma.
A Reddish Patch or irritated area, frequently occurring on
the chest, shoulders, arms, or legs. Sometimes the patch
crusts. It may also itch or hurt. At other times, it persists
with no noticeable discomfort.
A Shiny Bump or nodule, that is pearly or translucent and
is often pink, red, or white. The bump can also be tan,
black, or brown, especially in dark-haired people, and can
be confused with a mole.
A Pink Growth with a slightly elevated rolled border and a
crusted indentation in the centre. As the growth slowly
enlarges, tiny blood vessels may develop on the surface.
A Scar-like Area that is white, yellow or waxy, and often
has poorly defined borders. The skin itself appears shiny
and taut. Although a less frequent sign, it can indicate the
presence of an aggressive tumour.
Frequently, two or more features are present in one tumour. In addition, basal cell
carcinoma sometimes resembles non-cancerous skin conditions such as psoriasis or
eczema. Only a trained physician, usually a specialist in diseases of the skin, can
decide for sure. Learn the signs of basal cell carcinoma, and examine your skin regularly
(as often as once a month if you are at high risk). If you observe any of the warning signs
or some other change in your skin, consult your physician immediately.
Squamous Cell Carcinoma
Squamous cell carcinoma is the second most common skin cancer. It arises from the
epidermis and resembles the squamous cells that comprise most of the upper layers of
skin. Squamous cell cancers may occur on all areas of the body including the mucous
membranes, but are most common in areas exposed to the sun.
Although squamous cell carcinomas usually remain confined to the epidermis for some
time, they eventually penetrate the underlying tissues if not treated. In a small percentage
of cases, they spread (metastasise) to distant tissues and organs. When this happens,
they can be fatal. Squamous cell carcinomas that metastasise most often arise on sites
of chronic inflammatory skin conditions or on the mucous membranes or lips.
More than two-thirds of the skin cancers that darker skinned individuals develop are
squamous cell carcinomas, usually arising on the sites of pre-existing inflammatory skin
conditions or burn injuries.
The Major Cause
Chronic exposure to sunlight causes most cases of squamous cell carcinoma. That is
why tumours appear most frequently on sun-exposed parts of the body: the face, neck,
bald scalp, hands, shoulders, arms, and back. The rim of the ear and the lower lip are
especially vulnerable to the development of these cancers.
Squamous cell carcinomas may also occur where skin has suffered certain kinds of
injury: burns, scars, long-standing sores, sites previously exposed to X-rays, or certain
chemicals (such as arsenic and petroleum by-products). In addition, chronic skin
inflammation or medical conditions that suppress the immune system over an extended
period of time may encourage development of squamous cell carcinoma.
Occasionally, squamous cell carcinoma arises spontaneously on what appears to be
normal, healthy, undamaged skin. Some researchers believe that a tendency to develop
this cancer may be inherited.
Some precursor conditions may lead to squamous cell carcinoma such as:
* Actinic, or solar, keratosis. Actinic keratoses are rough, scaly, slightly raised
growths that range in colour from brown to red and may be up to one inch in
diameter. They appear most often in older people.
* Actinic cheilitis. A type of actinic keratosis occurring on the lips, it causes them to
become dry, cracked, scaly, and pale or white. It mainly affects the lower lip,
which typically receives more sun exposure than the upper lip.
* Leukoplakia. These white patches on the tongue or inside of the mouth have the
potential to develop into squamous cell carcinoma.
* Bowen's disease. This is now generally considered to be a superficial squamous
cell cancer that has not yet spread. It appears as a persistent red-brown, scaly
patch that may resemble psoriasis or eczema. If untreated, it may invade deeper
structures.
Who Gets It
Anyone with a substantial history of sun exposure can develop squamous cell
carcinoma. But people who have fair skin, light hair, and blue, green, or grey eyes are at
highest risk. Those whose occupations require long hour’s outdoors or who spend
extensive leisure time in the sun are in particular jeopardy. Dark-skinned individuals of
African descent are far less likely than fair-skinned individuals to develop skin cancer.
More than two thirds of the skin cancers that they do develop, however, are squamous
cell carcinomas, usually arising on the sites of pre-existing inflammatory skin conditions
or burn injuries.
What to Look For
A wart-like growth that crusts and occasionally bleeds.
A persistent, scaly red patch with irregular borders that sometimes
crusts or bleeds.
An open sore that bleeds and crusts and persists for weeks.
An elevated growth with a central depression that occasionally bleeds.
A growth of this type may rapidly increase in size.
Treatment for basal cell carcinoma and squamous cell
carcinoma
* Excisional Surgery
The physician removes the entire growth and an additional border of normal skin as a
"safety margin." The surgical site is then closed with stitches, and the tissue is sent to
the laboratory for microscopic examination to determine if all the malignant cells have
been removed.
* Curettage and Electrodessication
Cancerous tissue is scraped from the skin with a curette (a sharp, ring-shaped
instrument). The heat produced by an electric needle destroys residual tumour and
controls bleeding. This technique may be repeated twice to ensure complete
removal.
* Cryosurgery
Freezing with liquid nitrogen destroys tumour tissue. This procedure may be repeated
to guarantee total destruction of malignant cells. Easy to administer, cryosurgery is
effective for the most common tumours and is the treatment of choice for patients who
have bleeding disorders or an intolerance to anaesthesia.
* Radiation Therapy
X-ray beams are directed at the malignant cells. Total tumour destruction generally
requires a series of treatments, usually several times a week for a few weeks.
Radiation may be used for tumours that are hard to manage surgically and for those
in elderly patients whose health is poor.
* Mohs Micrographic Surgery
The physician removes very thin layers of the malignancy, layer by layer, checking
each one thoroughly under a microscope. The excision is repeated until the site is
free. This method saves the greatest amount of healthy tissue and has the highest
cure rate. It is frequently used for tumours that recur and for tumours in difficult
locations (the nose, ears, mouth, and around the eyes).
Melanoma
Melanoma is the most serious form of skin cancer.
The ABCD’s of Melanoma
Asymmetry
Most early melanomas are asymmetrical: a line through the middle would not create
matching halves. Common moles are round and symmetrical.
Border
The borders of early melanomas are often uneven and may have scalloped or
notched edges. Common moles have smoother, more even borders.
Colour
Common moles usually are a single shade of brown. Varied shades of brown, tan, or
black are often the first sign of melanoma. As melanomas progress, the colours red,
white and blue may appear.
Diameter
Early melanomas tend to grow larger than common moles - generally to at least the
size of a pencil eraser (about 6mm, or 1/4 inch, in diameter).
Coping with Melanoma
Accept your doubts, fears, and anxiety as normal reactions to cancer. Do not keep
these feelings to yourself. Speak first of all to your physician who is in a position to allay
many fears and to put others into perspective. Make a list of the questions you want to
ask and take it to the doctor’s office. Check it before leaving so as to be sure that
everything troubling you has been discussed.
Rather than retreating into solitude, reveal your feelings and concerns to family and
friends. When appropriate, let them participate in the decisions being made. Welcome
their support and interest in you. Marriages and other relationships are frequently
strengthened when people face an illness together.
Use the telephone to connect you to family and friends who are far away; consider
talking with a colleague, teacher or religious leader. On the Internet you can “meet”
people who share your concerns and interests.
Relaxation is a tried and true method of relieving stress and everyone can benefit from
it. Many tapes that give relaxation techniques are available.
Give some time each day to positive imagery - the recollection of any thought that gives
you pleasure e.g. the face of a loved one, beautiful scenery, or a humorous moment.
Humour can help create an upbeat feeling; you can look in books, cartoons, or on
television.
Exercise does more than keep you fit: it releases endorphins (the feel good hormone).
Consult your physician to find out what exercise is best for you.
Keep up your appearance - it helps to keep up your spirits. Do not cease wearing
cosmetics, shaving, or dressing in a way where you know you look good. If therapy may
cause hair loss you may want to consider buying a wig in advance.
Be good to yourself. Accept the fact that you may tire more rapidly than you did before.
If you do not feel your best, do not drive yourself to perform al your former duties. Instead
concentrate on doing things you enjoy. Get involved in living. Look ahead to vacations,
career plans, or special occasions.
Support groups may help. They will help you to achieve a positive outlook, and talking to
other patients with cancer will help you realise that you are not alone in fighting the battle
against melanoma. Many hospitals or medical centres have support groups for their
patients, a number of national organisations also provide support services.
The skin cancer foundation
The Skin Cancer Foundation is the only national and international organisation that is
concerned exclusively with the world’s most common malignancy - skin cancer. The Skin
Cancer Foundation is a non-profit foundation. It aims to:
* To control the epidemic.
* To prevent skin cancers through public education campaigns about the need for sun
protection all year round from birth to old age.
* To change public attitudes towards tanning and sun exposure.
* To encourage detection of skin cancers at the earliest stage when they are almost
always curable.
* To improve skin cancer care by offering physician education and training programs.
* To support research into new diagnostic techniques and therapies.
* To focus attention on melanoma, the most life threatening of the skin cancers.
* To teach children and their caregivers about the sun
* To encourage community action
* To stimulate public education programs abroad.
The Skin Cancer Foundation achieves its aims through nationwide public and
professional education programs.
The Macmillan Butterfly Centre
The centre offers information, support, and practical help to any person affected by
cancer, whether patient, family member, carer or friend. The centre aims:
* To provide a comfortable setting for individuals to discuss their needs with staff, in a
friendly relaxed atmosphere.
* To provide a full range of relevant information on cancer and to make specialist
referrals where needed.
* To raise awareness about cancer and listen to the views and concerns of those
affected.
The centre offers a relaxed and friendly atmosphere with quite areas for reading. There
are also areas for outpatients and chemotherapy treatment. As the service develops
they plan to offer counselling and complementary therapies. There are opportunities to
join various support groups and talk to other people with cancer.
An experienced professional team, supported by trained volunteers, staffs the centre.
The centre has a comprehensive library with leaflets, books, tapes, as well as access to
the Internet so you can look up information at your own pace.
The Macmillan Butterfly Centre has been developed as a joint venture between
Macmillan Cancer Relief and Epsom and St.Helier NHS Trust. The centre is open
between 10am-12pm Monday to Friday if you would like to drop in for a coffee and a
chat (no need to make an appointment). The centre is set out to help people with
cancer, people who know people with cancer and people who have a fear of cancer.
2
Vicky Goddin – X09
1