In this patient story, Giles shares his skin health journey through the decades and how he felt when a suspicious lump on his left temple led him to experience AI for skin cancer detection.
Early childhood health struggles
I was born an apparently healthy 8+lb baby in 1944, living in the Bristol area until we moved to Birmingham when I was about 8 years old. Now this was a time of crippling yellow smogs in the city; I became thin, underweight and prone to any sickness that was around. The GP at the time prescribed Sun Ray treatment, so I was marched off to the local hospital – the smell of rubber remains with me today, presumably the rubber goggles!
Whether this exposure to Flash Gordon type light apparatus did me any good I cannot remember, but as I grew a bit older, I didn’t improve. After X-rays on my chest revealed a shadow on my left lung, the physician advised my parents that we should relocate to the country i.e. right out of Birmingham.
The suspicion was tuberculosis. However, this diagnosis was later not confirmed. After we had moved to the countryside, I was able to participate in activities and enjoy the fresh air – particularly in the sun – which had not been possible in the foul, heavily polluted city of Birmingham. It seems this move was exactly what I needed to get back to a normal weight and health.
Early relationship with sun exposure
Growing up, I always enjoyed being outside, particularly when the sun made an appearance. I loved feeling its rays on my skin and I remember thinking it was really doing me good. In those early years, there was no advice on sun protection and the harm it can do.
Nowadays of course, high UV warnings and instructions to use sun protection are accessible and given out with weather forecasts. I’ve experienced a definite culture shift too; certainly the way men view the application of sunscreen has moved on from ‘not for me’ to rightly embracing it.
First holidays and overexposure to the sun
After getting married and in our early twenties, our first foray into the sun’s power occurred in 1969 when we travelled to southern France on a camping holiday. My wife and I, along with our baby son, soaked up the UV and IR to our heart’s content. This often led to me suffering terrible discomfort at night time from over exposure; red and sore skin, which of course sloughed off immensely. Somehow, this was no deterrent as the aim was to go golden brown! My wife always used sunscreen on her skin and of course for our young son, but I hated it.
The first warning signs
The first sign of skin trouble was in our thirties during a holiday in Corfu. A large burn appeared on my upper right chest, which became a nasty, crusty scab and then of course healed. Two years later, I had to have a lesion removed from that same site. After that episode, I started to care more about my skin health and rarely went bare chested, often opting to wear a T-shirt in an outdoor pool or the sea.
For several years following there were no more skin issues; I’d started using sunscreen and increased the level of SPF.
A serious skin cancer scare
But then came that particular holiday in Spain where my and my wife’s initial introduction to truly serious dermatological anomalies began. I was walking barefoot behind my wife at the water’s edge on a totally deserted beach, only a 5-minute walk from our house in the south east of Spain. It was a beautiful day, and this 1½-mile-long beach sits in a nature reserve with not a single building to be seen – only a few eucalyptus trees and warm, golden sands. This idyllically painted picture was, and still is, the backdrop to what became a painful and frightening experience in 1992. On this beautiful walk, I noticed that a mark on my wife’s right upper calf was dark brown and larger than the last time I’d looked at the back of her legs.
A decision was made to investigate this upon our return from holiday, as we had private insurance at the time and knew we could get an appointment without having to wait. After assessment, a follow-up appointment was necessary for removal and a biopsy. At the next visit for results, my wife came back with an ashen face, trembling with the diagnosis of melanoma – which, fortunately, had been caught early. The worrying aspect was that she’d been told if the cancer grows into the dermis by more than 1.6 mm, the cells can spread to other areas of the body. She needed a further and deeper excision, which was completed successfully with no additional visits planned other than routine follow-ups.
After this scare, we enjoyed our sunshine holidays but with much greater care and attention to protecting our vulnerable skin.
AI for skin cancer diagnosis today
Fast forward to 2024, I noticed a small lump develop on my left temple, which became harder, thicker, and scaly. Given my history of sun exposure and my wife’s earlier scare, I wasted no time in contacting our GP surgery for an appointment. A practice nurse saw me and explained that a new system for examining and diagnosing skin concerns was in place, asking if I would be agreeable to trying it. It involved a short description from me on how the ‘mole’ had developed, followed by photographs taken on a mobile phone. These images would be assessed and evaluated by an AI system, and I would be advised accordingly.
As I recall, I was told I would be contacted in 2-3 days by telephone with the result. In fact, I was called the next day by a consultant dermatologist from our local major hospital, who advised me that it was a benign lesion. I was instantly put at ease by the information delivered in his empathetic, friendly manner.
The lesion quietened down, flattened out after a few weeks, and is no longer visible. Receiving reassurance this quickly meant this was an almost trouble-free and worry-free experience, occupying little of my time and, presumably and more importantly, serving as a huge time-saving exercise for the NHS.
Looking forward
Compared to our previous skin scares, this was by far the easiest and best in terms of examination, assessment, and result communication. Based on this recent experience, should anyone mention a worrying mole or mark on their skin, I would have absolutely no hesitation in recommending the use of AI for dermatology.