One of the joys of living on your own block of land is being able to spend time outdoors, enjoying what good weather we can find. But this comes with a very real danger: the more we’re outdoors, the more we’re likely to develop a melanoma.
With over 6,000 melanomas diagnosed in New Zealand every year and melanoma accounting for nearly 80% of all skin cancer deaths, it's important to protect yourself.
The bad news is that NZ has the highest rate of melanoma in the world and every year around 300 of us will die from melanoma. The good news is that it is largely preventable and, if caught early, treatable. The great news is that some rural companies are onto this and you may be eligible for free education or discounted scans.
What is melanoma?
Melanoma is a type of skin cancer that develops from melanocytes, which are the cells responsible for producing melanin— the pigment that gives colour to our skin, hair, and eyes. Although there are other factors, melanoma primarily develops when melanocytes undergo mutations, often due to exposure to ultraviolet (UV) radiation. These mutations can cause the melanocytes to grow uncontrollably, leading to the formation of a malignant tumour.
Unlike other skin cancers, melanoma is more aggressive and has a higher potential to spread to other parts of the body if not caught early.
Risk factors
Your risk for developing melanoma increases if you:
- Live in NZ!
- Spend a lot of time outdoors.
- Are over 50 years old.
- Have fair skin that burns easily.
- Have red, blonde, or fair hair.
- Have suffered sunburn, especially when young
- Have previously had skin cancer, especially melanoma.
- Have used a sunbed for tanning (more than 10 sessions).
- Have many or large moles (50+).
- Are immuno-suppressed.
- Have a family history of melanoma.
Prevention
Prevention is the goal - it’s a lot less stressful than treatment and it should begin as early as possible. The more we protect our children, the less damaged their skin will be and therefore they’re less likely to suffer from melanoma later.
We all know about slip, slap, slop (and more recently wrap) from years of advertising. These are still the primary focus but there’s more to it than that.
Firstly, when possible stay out of the sun, especially when the UV index is high. This generally means from 10am-4pm from September to April. Organise your work so that you can be indoors or at least in shade during the high risk times. NIWA monitors the UV index and you can find your local sun protection recommendations here.
Slip
Cover up! It’s natural for most of us to look forward to wearing shorts and sleeveless tops in summer but if you’re out and about it’s much safer to cover up with long pants and long sleeves. Dark fabrics absorb more UV than lighter colours and the more tightly woven the cloth the better protection it provides. Yes, you’ll feel hot…which is why it’s better to be indoors or in the shade. Save the shorts and T-shirts for later in the day when the UV risk is lower.
Even better, you can find clothing with an Ultraviolet Protection Factor (UPF) rating which tells you how protective an item of clothing is from UV radiation.
Slap
- Opt for a broad-spectrum sunscreen that protects against both UVA and UVB rays.
- Choose a sunscreen with an SPF of at least 30. Higher SPF offers more protection but be aware that no sunscreen can block 100% of UV rays.
- For outdoor activities where you might sweat (like many lifestyle farming tasks) or come into contact with water, choose a water-resistant formula.
- Use a generous amount. Most people apply too little.
- Apply sunscreen at least 15-20 minutes before going out into the sun to allow the skin to absorb it.
- Pay attention to commonly missed areas like the back of the neck, ears, and tops of your feet. Remember your face, but avoid the eyes.
- Reapply sunscreen every two hours, or immediately after swimming, sweating, or towel-drying.
- Sunscreen has an expiration date. Using expired sunscreen may result in reduced protection.
Other considerations
- Even if your makeup contains SPF, it's usually not enough for prolonged sun exposure. Always apply sunscreen underneath.
- If you have sensitive skin opt for mineral-based sunscreens that contain zinc oxide or titanium dioxide.
- UV rays can penetrate clouds. Use sunscreen even on cloudy days.
- Sun damage can occur all year around. If you're spending time outside in winter, apply sunscreen to exposed skin.
Slop
A broad-brimmed hat can protect your scalp, ears, neck and face, all areas that can be susceptible to sunburn. Again, dark colours are more effective.
If you choose a baseball cap then make sure your ears and neck get a lot of sunscreen!
Wrap
Close-fitting or wraparound sunglasses can protect your eyes. Wear polarised glasses, particularly when on or near water, snow or other light-reflective surfaces like glass or concrete.
Detection
Note any new moles or skin lesions and monitor existing ones.
It’s important to understand that melanoma can be found in many places on the body, including places that are not generally exposed to sunlight so check everywhere. In men the most common place to find a melanoma is on the back; in women it’s on the legs.
Assess any lesion using the ABCDEFG method. Signs to look for are:
A - Asymmetry: Uneven moles where one half doesn't mirror the other.
B - Border: Irregular or ragged edges in moles.
C - Colour: Moles that have multiple colours.
D - Diameter: Moles larger than 6mm.
E - Evolution: Any change in a mole's appearance over time.
F - Firm: A mole that is firm to the touch
G - Growing: Moles that keep growing
You can take advantage of Melanoma NZ’s spot check van which travels around NZ carrying out free spot checks. See the van’s schedule here. If you are concerned about a lesion, don’t wait for the van to get to your area, see your usual doctor at once.
Get help
See your doctor immediately if:
- A mole has started to change size, shape or colour or is bleeding or itchy.
- You find a new mole or lesion.
- You notice an odd-looking lesion.
- You have a sore that doesn’t heal.
- The earlier a diagnosis is made, the more likely it is that a melanoma can be treated.
Myth busting
MYTH: Skin cancer isn't dangerous: FACT: Melanoma is a killer, especially here in NZ.
MYTH: Melanoma is only a problem for older people: FACT: Young adults get it too.
MYTH: Darker skin protects from melanoma: FACT: While the rates of melanoma drop as skin pigmentation increases, melanoma can affect anyone.
MYTH: Having a base tan protects you: FACT: Any tan signals skin damage, increasing risk.
MYTH: You only need protection if you’re going to be exposed for a long time: FACT: Skin damage can happen in as little as 12 minutes.
MYTH: Melanoma is only on the skin: FACT: It can hit eyes, nails, and more.
MYTH: Melanomas are always dark coloured: FACT: They come in various colours.
MYTH: It takes years of sun damage to get melanoma: FACT: Even one childhood sunburn can spike your risk.
MYTH: Cloudy days are safe: FACT: 80% of UV rays penetrate clouds.
MYTH: My makeup is enough: FACT: Most makeup lacks adequate SPF.
MYTH: Tanning beds are safe: FACT: They boost your melanoma risk with each session.
What does all this mean for lifestyle farmers?
Just by virtue of being a NZ lifestyle farmer your risk, and the risk to your family, is relatively high. A survey back in 2006 by MoleMap found that 25% of farmers in NZ get skin cancer.
What can you do? Firstly, take it seriously. It’s so easy to go out and think ‘I won’t be out long,’ or ‘It’s not too sunny,I’ll be fine’ or ‘I’ll do it later,’ so make it easy on yourself. Put your sun-safe clothing, hat, sunglasses and sunscreen by the door and use them.
It’s unlikely you’ll be able to stay indoors, even if you wanted to, so think about shade on your block. If there are places where you regularly work during the middle of the day then think about how you can create shade. Anything from a shade sail to a leafy tree will help.
Practical help
If you are a client of FMG (the specialist rural insurer) you can get free access to Melanoma NZ’s online education. See here for more details.
Farmlands rural supply company offer their card holders a discount in certain MoleMap clinics. See here for more details.
Finally
Knowing the risks and taking steps for early detection and prevention can make all the difference. Melanoma is a serious concern, especially for NZ lifestyle farmers who enjoy being out on their land, but it's a risk that can be managed.
I want to emphasise that it’s usually an accumulation of sun damage that increases risk so please make sure your young family members are protected.
