Michael Pilaar was diagnosed with melanoma when he was just 17. Photo / Supplied
"Don't worry Mum, I've already had a good life."
Those are the powerful words Elizabeth Pilaar holds close when thinking of her son, Michael.
He was 17 when diagnosed with melanoma after a large and rather "ugly" mole on his calf gave Elizabeth some concerns.
It had been there for years before she realised, in 2015, it had grown bigger.
"I will always regret not having acted earlier."
Michael had the mole removed but it was after testing doctors realised the gravity of the situation and he was soon diagnosed with melanoma.
Operations to remove the cancerous cells from his leg and small deposits around his groin were quickly done. The prognosis appeared good and come Christmas, he thought he was in the clear.
"It was shocking, but ignorance is bliss and I didn't appreciate the seriousness."
However, as Easter came around Michael started complaining of a sore back. It was nothing at first, Elizabeth remembers, but in the early hours of a morning in May, he was rushed to Rotorua Hospital.
"They did some more scans and discovered that the cancer was in a number of parts of his body.
"He really was determined to be positive ... He said to me a couple of months in, 'I wake up in the morning, and I decide I'm going to smile. The first 10 minutes are hard enough that it's okay'."
But it wasn't. Michael took his last breath in June of 2017. He was 19 years old.
Three years later, Elizabeth still misses her eldest son's hugs.
Hope was a large factor of Michael's journey but now Elizabeth has turned her hope to others.
"I want to empower young people to take control and be aware or be responsible for their own bodies and that life is worth living.
"People would say, 'Oh, he's young, therefore he's got a chance' but it's actually the opposite. If you're older, you have a better chance because cancer is quickly developing cells and for young people, their cells divide more quickly. You put those two things together, and you have dynamite."
Twenty-one people from the Lakes DHB presented at the hospital with a principal diagnosis of melanoma in 2020.
The Cancer Registry was only able to provide "the most up-to-date" data for the Lakes area, which showed there were nine deaths in 2016 compared to 29 in the Bay of Plenty District Health Board area.
Seventeen people in Whakatāne and one person in Kawerau and Ōpotiki respectively were also diagnosed in 2016 as well as 35 in Taupō. Across all areas, the number of males with melanoma was overwhelmingly higher than women.
New Zealand has the highest rate of melanoma in the world; more than 4000 New Zealanders are diagnosed with melanoma each year and more than 300 people die from melanoma each year in New Zealand, Melanoma New Zealand says.
Dr Rosalie Stephens, medical oncologist and Melanoma New Zealand board trustee, said New Zealanders' complacency was part of the problem.
"There is a range of factors that contribute to our high melanoma rates. Our UV radiation intensities in New Zealand are high because of our environment.
"We have less ozone than elsewhere, we have clean air and the sun orbits closest to the Earth during our southern hemisphere summer.
"That, combined with New Zealanders' love of an outdoor lifestyle and our complacency when it comes to protecting our skin from the sun, contribute to our very high melanoma rates."
Typically, melanoma is caused by sun exposure in people with a fair skin type, however, everyone is at risk.
Those who have a personal or family history of melanoma are more at risk, Stephens said, and so are those who use sunbeds.
However, thinking you are safe because of your olive skin will not work. Stephens said those with olive or darker complexions can still get melanoma.
"Melanoma is a problem for Māori, who have a disproportionately high death rate from melanoma, compared to the rate of diagnosis."
The aggressive melanomas usually present as a new spot on the skin, so Stephens advised getting a GP or specialist to check a skin lesion that hasn't been noticed before.
If there is a change in an existing freckle or mole, such as a change in colour, change in shape or size, bleeding, or itching, that also needs immediate attention as not doing so could be fatal.
"The melanoma cells have the ability to survive and spread to lymph nodes and other parts of the body through the blood stream.
"Melanoma can spread from the skin to the brain, lungs, and liver and once that has happened it is difficult to cure it."
Te Aho o Te Kahu Cancer Control Agency chief executive Professor Diana Sarfati said as the summer months are here, being sun smart should be a priority.
"In regions like Bay of Plenty which have high sunshine hours, it is vital people take being sun smart seriously.
"Skin cancer is New Zealand's most common form of cancer, estimated to make up approximately 80 per cent of all new cancer diagnoses each year."
New Zealand performs poorly against other comparable countries when it comes to skin cancer. It is second only to Australia in skin cancer diagnosis, according to the World Health Organisation.
Melanoma is largely preventable if we practise sun smart behaviour and avoid getting sunburnt, especially in childhood and young adulthood. Sunscreen is very effective at doing this if applied liberally and frequently.
• Sunscreen should be at least SPF30, broad spectrum which means it protects you against both UVA and UVB rays, and water-resistant
• Check the packaging for the expiry date and that it meets the Australian New Zealand Standard
• Sunscreen should be applied 20 minutes before going outside and reapplied every two hours, or more frequently after swimming, towel drying or sweating
• Nine teaspoons of sunscreen for should be used for an average adult on each application
It also helps to avoid sun exposure in the middle part of the day and/or from September to April, especially between 10am and 4pm.
Street view at Tikitapu (Blue Lake): Do you wear sunscreen?
Not very often, I put sunscreen on the kids and my face.
Laura Brownless, 25
Matata
I always wear sunscreen and always apply it 20 minutes before exposure to the sun.
Katarina Haverkamp, 20
Rotorua
I normally wear sunscreen for protection from skin cancer.
Shamos Hunter, 45
Rotorua
Yes, daily on my face to protect from aging and if the sun is out to protect from skin cancer.
Kathryn Wilburn, 31
Rotorua
Yes to protect from skin cancer and aging.
Nicole Loper, 31
Rotorua
Yes I wear sunscreen every day I go out in the sunshine.
Ava Ahping, 12
Auckland
It's in my make up so there's always sunscreen on my face.
Aimee Storie, 19
Hamilton
Yes all the time, sunburn and cancer are no good.
Jason Marshall, 26
Rotorua
The 19-year-old disappeared without her wallet or mobile phone.