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What is melanoma and what are the symptoms of skin cancer? Duchess of York is diagnosed

The Duchess of York, Sarah Ferguson, has been diagnosed with a malignant melanoma following the removal of a cancerous mole during treatment for breast cancer.

Prince Andrew's former wife, who is 64, remains "in good spirits" as doctors work to establish the stage the cancer is at.

A spokesman announced: "Following her diagnosis with an early form of breast cancer this summer, Sarah, Duchess of York has now been diagnosed with malignant melanoma.

"Her dermatologist asked that several moles were removed and analysed at the same time as the duchess was undergoing reconstructive surgery following her mastectomy, and one of these has been identified as cancerous."

Her diagnosis follows Loose Women star Coleen Nolan revealing last July that she had been diagnosed with skin cancer.

Cancer Research UK has said cases of the disease were at a record high in the UK across all age groups, particularly adults aged 55 and over, with 17,500 new diagnoses a year. The boom in cheap package holidays in the 1960s has been linked to the rise.

Sarah Ferguson was also diagnosed with breast cancer last summer (AFP via Getty Images)
Sarah Ferguson was also diagnosed with breast cancer last summer (AFP via Getty Images)

What is skin cancer?

The NHS says there are two types – melanoma and non-melanoma.

Melanoma

A new mole or a change in the appearance of an existing mole is frequently the first indication of skin cancer. Normal moles are typically round or oval, have a smooth edge, and have a diameter of no more than 6mm. However, size alone does not always indicate skin cancer. A cancerous mole can have a diameter of less than 6mm, and a healthy mole can be larger than this.

Signs to look out for include a mole that is:

  • getting bigger

  • changing shape

  • changing colour

  • bleeding or becoming crusty

  • itchy or sore

It can appear anywhere on your body. But it most commonly appears on the back in men and on the legs in women. It can also appear in the mouth, on the bottom of the foot, under the nail or in the vaginal region but these melanomas are uncommon.

Non-melanoma

The term non-melanoma distinguishes these more common types of skin cancer from the less common type known as melanoma, which can be more serious.

The first sign of non-melanoma skin cancer is usually the appearance of a lump or discoloured patch on the skin that persists after a few weeks and slowly progresses over months or sometimes years. This is the cancer or tumour.

Coleen Nolan was diagnosed aged 55 (PA Archive)
Coleen Nolan was diagnosed aged 55 (PA Archive)

How does skin cancer start?

Overexposure to ultraviolet (UV) light is the main cause of both melanoma and non-melanoma skin cancer. UV light comes from the sun, as well as from artificial tanning sunbeds and sunlamps.

Other risk factors that can increase your chances of developing non-melanoma skin cancer include: a previous non-melanoma skin cancer; a family history; pale skin that burns easily; a large number of moles or freckles; taking medicine that suppresses your immune system; and a co-existing medical condition that suppresses your immune system.

How and why have rates increased?

Case rates among adults aged over 55 have risen by 195 per cent since the 1990s – between 1993 and 1995 21.3 people aged 55 and over were diagnosed with melanoma out of every 100,000, this rose to 62.9 cases per 100,000 in 2017-2019.

“The rise in rates in over-55s is likely to be linked to trends to have tanned skin and the cheap package holiday boom dating from the 1960s before people became more aware of skin cancer,” Cancer Research UK said.

The charity has estimated that across all age groups, melanoma skin cancer cases could increase by around 50% over the next 20 years, hitting a record 26,500 a year by 2040.

But despite the rise in cases, deaths from the disease are decreasing, it said.

Is skin cancer curable?

A GP can examine your skin for signs of cancer. They may refer you to a dermatologist or a specialist plastic surgeon if they’re unsure or suspect skin cancer. The treatment you have will depend on where the cancer is, if it has spread and your general health. Surgery is the main treatment for melanoma. Radiotherapy, medicines and chemotherapy are also sometimes used.

It can be challenging to stop or shrink advanced melanoma. Treatment in this case will focus on reducing the cancer and its symptoms while also extending life.

What is the skin cancer survival rate in the UK?

Cancer Research UK said almost all (98.2 per cent) of people diagnosed with melanoma skin cancer in England survived their disease for one year or more between 2013 and 2017.

Also in this period, around nine in 10 (91.3 per cent) of people diagnosed in England survive their disease for five years or more.