In this personal account, Stevan shares his experience of AI for skin cancer detection following extensive exposure to the sun during time in the Service and mountaineering.
I never imagined I’d end up in the Royal Navy or facing skin cancer concerns in my 70s, but life has a way of surprising you. At 71, having survived academic failure and homelessness in my youth, I can look back on a life that’s been anything but predictable.
In 1973, I joined the Royal Navy as a medic. People said it was the “easiest job on board” – half an hour’s work in the morning with the rest of the day off. Anyone who said that had clearly never been a medic! Despite my earlier vow to never join the military, I found the structure, discipline, and framework of the Service exactly what I needed.
My naval career spanned 35 years, eventually rising to Captain working in the Ministry of Defence. During those years, I received extensive sun exposure, particularly working on aircraft carrier flight decks. Like many servicemen, I didn’t think twice about stripping off layers to catch some rays. Compounding this, during my deployment, I developed a keen passion for mountaineering which brings its own extreme weather challenges…
Mountains and Extremes Conditions
I’ve tackled some of the world’s hardest routes. Only 2 British expeditions have reached the summit of Kangchenjunga, the world’s third-highest mountain at 8,586 meters, by the South West-Face and in 2000, I led the British expedition that achieved this. In 1987, I slept on the summits of Mount Kenya with Kilimanjaro visible in the distance and vice-versa. In 2006, I was involved with the British expedition to climb Everest’s West Ridge, a route no Brit has ever completed.
How is this relevant to my skin concerns I hear you ask?
At high altitude, the sun is both your best friend and worst enemy with temperatures swinging from -30°C at night to over 40°C during the day. You welcome its warmth, stripping off layers for comfort, but it quickly melts the snow you’re relying on to continue the climb safely.
As you can probably decipher, from my early career to mountaineering adventures, I’ve had extensive exposure to the sun.
The Suspicious Spot
After leaving the Service in 2007, I moved into leadership roles, including working at a hospice in the West Midlands, along with coaching and mentoring. When you’ve spent the majority of your life outdoors, skin concerns become almost inevitable, but these can be particularly challenging when they develop on areas on the body you can’t easily see.
Despite being happily married for 50 years, I sleep alone due to sleep apnoea, so my wife doesn’t regularly see my back – and naturally, neither do I. Years ago, while weight training, I caught sight of something unusual in the mirror but thought nothing of it. When I saw it again much later, it had changed. It looked black and concerning.
I asked my wife to take a photo with my phone, which I sent to my local GP surgery. Within 48 hours, they asked me to come to the Kidderminster Medical Centre to see the dermatology lead, where I was invited to an imaging appointment and advised my images would be taken and then analysed by AI.
AI for skin cancer detection
I’ve always been supportive of AI – it has a million uses and is essentially “the new computer” if you like. Everyone was scared of computers when they first appeared but they are now unquestionably part of our every day and I consider the evolution to AI much the same.
After being invited in to have my mole analysed, I was curious to understand the wait times for dermatology services in Worcestershire. For non-urgent cases, which I hoped mine was, the wait time was approximately 17 weeks – pretty hefty. I wasn’t at the stage of an urgent cancer referral where wait times are usually much less, however the prospect of 17 weeks was still disconcerting.
At the imaging appointment, the staff explained that following image capture of my skin lesion, my photos would be uploaded to a platform where regulated medical-grade AI would assess, classify and triage my condition, and a consultant would review the results. If I needed to be seen, I’d receive an appointment.
Thankfully, the process was extremely quick! They got back to me within days with the good news that the lesion on my back was in fact benign (harmless).
This experience felt like a perfect use of AI; using it for skin cancer detection, especially given the shortage of dermatologists within the NHS. The amount of information provided was good, I was put at ease and overall, I was very comfortable with AI as a screening tool.
Changed perception
Despite being open to innovation and technology, before this recent experience, I hadn’t seen many examples of AI in professional healthcare contexts. This experience genuinely changed my perception – it opened my eyes to how AI can speed up processes while outperforming junior doctors and performing on par with experienced dermatologists.
My view of AI has changed very positively. I would absolutely recommend this approach to family and friends. In fact, I’d go as far as encouraging patients to ask, “Is AI being used in dermatology services near me? And if not, why not?”
If my medical background has taught me anything, it’s that it is important to consider the evidence behind medical devices – or anything being used within healthcare for that matter. While my case involved clinical review following the AI’s benign analysis, having reviewed suitable clinical research, peer-reviewed papers and real-word evidence, I would be comfortable with regulated AI assessing and discharging a lesion of mine that it deemed to be benign. It all boils down to evidence. If the AI had only analysed 10 cases, then I’d be nervous, but when we’re talking thousands and statistically significant data, that’s a lot more reassuring.
I must also confess that I count myself among the “worried well.” If technology like this can address the demand of people like me yet still provide accurate diagnosis and quicker access to care for those in greatest need, then surely it’s a no brainer.