Patients presenting to skin clinic earlier than to other hospitals

PATIENTS WITH melanomas or malignant skin cancers are presenting at a rapid access clinic at the South Infirmary Victoria University…

PATIENTS WITH melanomas or malignant skin cancers are presenting at a rapid access clinic at the South Infirmary Victoria University Hospital in Cork at an earlier stage than at other hospitals around the State, a study carried out by the hospital has found.

According to consultant dermatologist at the Pigmented Lesion Clinic at the South Infirmary Victoria, Dr Johnny Bourke, early presentation at the rapid access clinic is crucial as early diagnosis increases the chances of melanoma being cured.

Dr Bourke said the melanoma clinic, which was established at the South Infirmary Victoria in 2003, carried out a major comparative study of trends in melanoma treatment which highlighted the importance of early diagnosis.

The findings were presented to the Royal College of Surgeons at the agm of the Irish Association of Plastic Surgeons at the weekend. It highlighted the importance of making the public aware of the risk of skin cancers, he said.

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Some 65 per cent of melanoma tumours treated at the rapid access clinic at the South Infirmary Victoria were in the early stage compared with 56 per cent for other hospitals in Cork and a national average of 61 per cent, the study found.

The study found that while men tend to present later than women, the South Infirmary Victoria also performed well in this regard with 65.1 per cent of men presenting at an early stage compared with 43 per cent elsewhere in Cork city and county and 51 per cent nationally.

When elderly people developed skin cancer, they tended to present late for treatment, but by targeting the older population, the clinic had achieved striking results among over-70s with 56.4 per cent presenting early compared with 32.4 elsewhere in Cork and 43.7 nationally.

"The fact that we're getting patients in earlier suggests the Pigmented Lesion Clinic is working. Our percentage of early-stage tumours is high across the board. It shows GPs are sending patients to us earlier and that's what we're trying to encourage," said Dr Bourke.

"Because malignant skin cancer is very difficult to treat, the key is catching it early. With early diagnosis, we get a very high cure rate.

"Cancer caught when a melanoma is 0.7mm thick, measured as skin depth, results in a 99 per cent cure. Until we find a chemotherapeutic agent which works, catching them early and removing them is our best hope," he added.

Of 678 melanoma patients countrywide last year, 110 were in Cork and 56 of these (more than 50 per cent) were treated at the South Infirmary Victoria compared to the situation in 1998 when the hospital treated about 20 per cent of melanomas in Cork city and county.

Dr Bourke attributes the success of the clinic to the fact that every patient is seen and diagnosed by a consultant dermatologist, the on-site availability of plastic surgery beside the clinic and regular advertising in the media highlighting the dangers of melanomas.

"As a result, we're getting a higher proportion of early-stage melanomas presenting at the clinic than in the rest of Cork city and county, or in the country as a whole," he said. "If something is suspicious, it's removed under local anaesthetic straight away or inside a week at the latest.

"We try to see every patient within two weeks. If a melanoma has spread further, our melanoma multi-disciplinary team advises on treatment," said Dr Bourke, adding that follow-up care was vital.

Barry Roche

Barry Roche

Barry Roche is Southern Correspondent of The Irish Times