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Melanoma symptoms: Sydney recruitment agent Kate Doube reveals how black spot was skin cancer

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A recruitment agent who grew up playing under the hot Australian sun has been left with an eight centimetre scar after a tiny cancerous spot no larger than a freckle was removed from her leg. 

Kate Doube never paid much heed to sun safety until she noticed a ‘black dot the size of a pin head’ on the front of her right shin in January 2020.

The 27-year-old from Sydney’s northern beaches, who regularly sunbaked and rarely wore sunscreen, had only been for two skin checks in her life before spotting the innocent-looking ink-like mark.

But despite its apparent insignificance, Ms Doube struggled to shake a ‘gut instinct’ that something more sinister was lurking on her leg and two months later on March 12, she visited a clinic on her lunch break to have it examined. 

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That instinct was razor sharp and just days later, an otherwise fit and healthy Ms Doube was diagnosed with melanoma in-situ – the earliest form of skin cancer which sits on top of the skin but has not yet penetrated the surface.

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Sydney recruitment agent Kate Doube (pictured) never paid much heed to sun safety until she noticed a ‘black dot the size of a pin head’ on the front of her right shin in January 2020

This innocent ink-like mark circled on Ms Doube's right shin is melanoma in-situ - the earliest form of skin cancer which sits on top of the skin but has not yet penetrated the surface

This innocent ink-like mark circled on Ms Doube’s right shin is melanoma in-situ – the earliest form of skin cancer which sits on top of the skin but has not yet penetrated the surface

‘The doctor could tell just by looking at it. I felt so sick, I had to go straight back to work and it was really traumatic,’ Ms Doube told Daily Mail Australia.

At home reeling from the news, she poured over photos and realised the spot had been growing on her leg for at least a year, without getting bigger but darkening in colour.

Ms Doube was lucky to have caught her melanoma when she did and a simple procedure was all that was needed to remove the growth.

The incision has left a scar stretching eight centimetres up her leg which serves as a sobering reminder about the importance of sun safety, regardless of skin type. 

Since her diagnosis, Ms Doube (pictured with her fiance James) says her attitude to sun safety has 'completely changed'

Since her diagnosis, Ms Doube (pictured with her fiance James) says her attitude to sun safety has ‘completely changed’

Kate Doube is just one of more than 13,000 Australians diagnosed with the condition every year.

Australia and New Zealand have the highest rates of melanoma in the world, with one in 13 men and one in 22 women diagnosed before the age of 85, according to figures from the Australian Cancer Council.

Anyone can develop melanoma, but the risk is heightened in those who have unprotected exposure to the sun, a history of childhood tanning and sunburn, more than 10 moles above the elbow and more than 100 on the body, pale, fair or freckled skin, and a strong family history of melanoma.

The appearance of melanoma varies dramatically from person to person, but the first sign is often a new spot or a change in the shape or texture of an existing mole.

Moles may become increasingly blotchy with different shades of colour – brown, black, red, white, pink and even blue – as well as increasing in height, developing a scaly surface, becoming itchy and bleeding. 

What are the warning signs of melanoma?

The first five letters of the alphabet are a guide to help you recognise the warning signs of melanoma.

A is for Asymmetry. Most melanomas are asymmetrical. If you draw a line through the middle of the lesion, the two halves don’t match, so it looks different from a round to oval and symmetrical common mole.

B is for Border. Melanoma borders tend to be uneven and may have scalloped or notched edges, while common moles tend to have smoother, more even borders.

C is for Colour. Multiple colours are a warning sign. While benign moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. As it grows, the colours red, white or blue may also appear.

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D is for Diameter or Dark. While it’s ideal to detect a melanoma when it is small, it’s a warning sign if a lesion is the size of a pencil eraser (about 6 mm, or ¼ inch in diameter) or larger. Some experts say it is also important to look for any lesion, no matter what size, that is darker than others. Rare, amelanotic melanomas are colourless.

E is for Evolving. Any change in size, shape, colour or elevation of a spot on your skin, or any new symptom in it, such as bleeding, itching or crusting, may be a warning sign of melanoma.

Source: Skincancer.org 

The warning signs come as Australian residents swelter through the ‘worst’ heatwave of the year so far, with the mercury set to rise to 50C in the south east states.

Bureau of Meteorology forecaster Jonathan How said the heatwave will ‘impact millions of people and create dangerous fire weather conditions for multiple states’.

In addition to causing bushfires, Mr How warned the heatwave itself will be ‘a huge silent killer’ as it causes hyperthermia, dehydration and skin cancer.

‘The hot days and warm nights will make it difficult to recover, especially for vulnerable people,’ Mr How said.

‘People are hospitalised and it’s really dangerous so it’s important to take note of the heat and be careful.’

Ms Doube says her attitude to sun safety has ‘completely changed’ since her diagnosis.

‘To be perfectly honest, when sun safety ads came on TV when I was growing up, I used to hit mute,’ she said. ‘Now I realise how silly and naive I was.’

These days she never leaves the house without applying SPF 50, never sunbakes and always wears a hat to protect her now ‘high risk’ skin, which must be checked every six months and vigilantly monitored for the rest of her life.

Ms Doube has had a further two moles removed from her back in the eight months since her diagnosis, though thankfully neither were cancerous. 

Dr David Lim, who works out of Cutis Clinic in Brisbane, Queensland, shared a video on the importance of sunscreen application, saying that your face and neck alone should be swiped with five grams – or a teaspoon full of sunscreen – for it to be effective.

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The average-sized adult will also need a teaspoon of sunscreen for each limb, as well as for the front and back of their torso, equal to 35ml in total.

Tips for choosing the optimal sunscreen: 

 1. Pick a sunscreen that is cosmetically elegant. This means that you are going to enjoy using it. Skin is as individual as you are, so I cannot recommend one particular brand. In general Invisible Zinc is cosmetically elegant and favoured by many. So are sunscreens from La Roche Posay. 

2. Always use a hat or physical barrier as adjunctive sun protection. Even the best sunscreens do not protect against long, long wave UVA and visible light. 

3. Apply frequently, twice a day if possible. Even more if you are going to the beach, surfing, or exercising outdoors. 

4. Use the correct amount. Five grams is needed to cover the face, ears, neck and part of your décolletage. Physical sunscreen offers immediate protection, while chemical sunscreens require application 20 minutes before UV exposure.

Source: Dr Davin Lim 

Ms Doube believes the Australian government could increase investment into social media campaigns to raise awareness about sun safety, working with popular influencers to get the message across to impressionable young teens.

‘Sun damage happens when you’re young – the impact affects you later in life, but to damage happens early,’ Ms Doube said.

‘I upload stuff on Instagram whenever I go for checks, and a lot of people have reached out to me saying “I get my skin checked because of you”.

‘If posting about it helps one other person to avoid getting melanoma, I feel good about it.’

For more information on melanoma and warning signs to watch for, please visit Melanoma Patients Australia or the Australian Cancer Council.

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