The Doctor's Consultation: Melanomas - Are you at risk?
by Dr. Iain Corness
A few months ago I wrote about lumps and bumps on the skin,
that fantastic wrapping that we all need to keep forever, if we are to remain
healthy! And what a wonderful organ our skin really is. It regulates the
passage of water and electrolytes and keeps that internal collection of bones
and organs neatly covered with a self-sealing all enveloping wrapping. We
can’t live without our skin.
Unfortunately we tend to abuse our skin, and I must admit I
am no exception. Sun block is not high on my list of picnic requirements, even
though it should be.
Like all of our other organs, the skin organ can have
problems too, and these range from minor rashes, fungal infections, cysts,
warts and other “lumpy” conditions that we call tumours. Now the very word
‘tumours’ strikes fear in the hearts of many, but this is purely a term to
describe growths on the skin, which may or may not be ‘malignant’. In
fact, most skin tumours are not malignant (called ‘benign’), and even with
the malignant ones, the majority are not going to kill you.
Having said that, it does not mean that you should ignore
skin growths. While most will not kill you, they can make the last few years
very unpleasant if left untreated, like Squamous Cell Carcinomas (SCC’s),
Basal Cell Carcinomas (BCC’s) that eat you away and then the Melanomas that
can be fatal.
Yes, while your skin may keep you alive, it can also kill
you. Melanoma is also much more widespread than you would imagine. And the
statistics can be quite frightening. Take these US statistics - Melanoma
strikes people of all ages, all races, all economic levels and both sexes. It
is already the most common cancer for women 25 to 29 and the second most
common cancer for women 30 to 34 and the incidence of melanoma is increasing
faster than any other cancer. An American’s lifetime risk of developing
melanoma is about 1 in 75.
Now those American statistics are not so bad compared to
some other countries. Two of the worst as far as melanoma statistics are
concerned are Australia and New Zealand. Why? Because these sunny countries
have become inhabited by fair skinned people from the northern hemisphere, a
skin which does not take the sun so well.
So where does that put us Caucasians living in a tropical
country like Thailand? At risk, that’s what. And I am sure you have all been
like me and suffered sunburn from time to time, one of the predisposing
factors in changing seemingly “innocent moles” into malignant Melanomas.
Researchers have also shown that overexposure to the sun as a child can result
in an increased risk of Melanoma as an adult. In my era, children were
actually sent out to play in the sun, because it was ‘healthy’!
The message with the Melanomas is to find the moles before
they change - and that takes a trained and skilled eye and sometimes a biopsy
as well. But it is worth the look. Melanoma can be fatal, remember. These dark
pigmented skin lesions with irregular borders invade the deeper tissues and
can spring up as secondary lesions as well. These are truly tumours that can
kill you. Wide and deep surgical excision is the treatment of choice, that
often leaves a most unattractive scar.
Prevention is much better than cure!
I met a woman at the party last night and I can’t get her out of my
mind. I didn’t get her name as we only briefly saw each other across the
room, before she flitted away, so I haven’t even spoken to her, but
there was that spark of magic there in her eyes promising just so much.
Can you help me find her again? I think I am going mad with desire. She
was wearing a yellow dress, and with her dark hair and dark eyes, the
effect was fantastic. I must find her again.
What sort of a love struck calf are you, my myopic Petal? How would
Hillary know where to find your lady with the bedroom eyes? I wasn’t
even at your party. Or perhaps I was and enjoyed it too much? Oh my
goodness! Perhaps the woman was me? Was I wearing yellow last night? Did
she leave a glass slipper by any chance? Back to reality. Have you had
your hormone levels checked recently? You are not going mad with desire
young man, you are just mad. But to show that Hillary has a heart, I have
published your letter. If any woman answering to your description calls, I
will let you know.
In this Amazing Thailand, with its Amazing ladies, it is amazing that any
young man survives holidays over here. At every turn there is temptation
awaiting the unwary and unknowing. My sister’s son, my nephew, is a shy
young man, and has been told by my sister that he is to come to Thailand
to spend three months with me. She has spoken to me and wishes for me to
oversee this young man blossom into adult life. I believe that the
responsibility she wants me to take is too great. Do you concur with my
opinion on this Miss Hillary?
Without wishing to be seen looking as if I am ‘buttering’ you up,
Marje, I must concur (love using words like that) with your sister. I
think the young man should just be brought over here and Hillary will do
the honours for you, so to speak. By the time he is ready to return to his
mother he will know all about wine, women and song, provided he has been
given a decent sized well filled wallet for his and his tutor’s use.
Oooh, Hillary is quite looking forward to this. I’ll teach him all about
French champagne and Belgian chocolates and onwards and upwards from
there. When does he arrive?
Our driver had an accident in our car, which he took without our
permission one night, and was taken into custody by the police. Apparently
he attempted to flee the scene, but was caught. He now has to stay in jail
until there is settlement and agreement between our insurance company and
the rider of the motorcycle he crashed into. Is this the usual thing in
these instances or should we have intervened?
Firstly, never intervene on your own, no matter how well intentioned that
intervention might be. Thai law grinds along in its own sweet way, without
any need for ‘help’ from others. Just take the advice of a good and
trusted Thai lawyer. Your husband’s work will be able to supply you with
some names. Unfortunately, you will be without the car until everything is
settled, but that’s just tough luck, I’m afraid. Next time make sure
your driver can’t get the keys. Be prepared for the fact that you may
have to rescue your driver financially too.
I have a 24 year old Thai girlfriend who I met over here in the UK and we
have been together now for almost two years and we have always managed to
get along well, despite differences in our ages (I am sixteen years older
than she is). We have been having a sticky patch recently but now she has
decided she wants to go back home to Thailand and leave me in the UK. What
can I do to stop her leaving? She says she will go at the end of July. I
have told her the weather will be hot and how different she will find
Thailand compared to the UK (she left Thailand 4 years ago), but she is
adamant. I don’t feel our problems are so bad that we can’t get over
them. Hillary, what do you suggest?
That’s not a very old head on your 40 year old shoulders, is it? If your
girlfriend has decided to leave, then you must go with her decision, my
Petal. She is 24 years old and sounds reasonably mature I would assume
from your letter (sorry I had to shorten it, but it was a little too long
for publication), although the fact that she has lived with you for two
years might put a question mark over this. You can ask why she came to the
conclusion, (and it is a conclusion, isn’t it Petal) but her decision is
her decision - not yours. Sorry. Better luck in the future. Get an older
girlfriend next time, or lie about your age.
Camera Class: A new way!
by Harry Flashman
photographers are very often ones who have discovered a “different” way of
seeing the subjects they (and you and I) photograph. One such photographer was
He was an artist who used both paints and pictures to express
his dreams and fantasies. “I paint what cannot be photographed. I photograph
what I do not wish to paint.” With that aim in mind, Man Ray went on and broke
just about every ‘rule’ of photography that was ever thought up.
Man Ray rejected the ‘usual’, even his own name! Born
Emmanuel Radnitsky in Philadelphia in 1890, he adopted the name Man Ray. He
bought his first camera in 1914 expressly to photograph his own paintings for
collectors or galleries, but then came to explore the artistic possibilities
that this new medium could offer.
In 1921, at the urging of fellow Dadaists Marcel Duchamp and
Francis Picabia, Man Ray moved to Paris to join the growing cultural avant-garde
movement. There he worked in painting and photography while supporting himself
through portrait commissions and fashion photography, which appeared regularly
in such magazines as Harper’s Bazaar and Vogue during the 1930s.
However, by this time he had gone past Dadaism and into
Surrealism. Man Ray sought to create a Surrealist vision of the female form and
began to utilize such photographic techniques as solarization (originating from
a dark-room accident), dynamic cropping, over enlargement and over development
in an effort to create this. His use of what he called “Rayographs” where he
placed objects directly on the photographic paper to get the image, was just
another of these.
After the Germans invaded Paris in 1940, Man Ray returned to
the United States, settling in Hollywood with the intention of pursuing
filmmaking, but this did not really hold him, and in 1951 he returned to Paris,
where he lived and worked until his death on November 18, 1976.
Now I am not suggesting that you rush out and place unexposed
film on your foreheads in a dark room and ‘think’ the images, print the
results and call it ‘art’. (It has been done already, by the way.) What I am
suggesting is that you should stop for a while and consider something unusual,
compared to your “standard” way of taking shots.
Everyone gets into the habit of taking photographs in one
particular way. And habits certainly do die hard, even if it is just always
taking shots in the horizontal (landscape) format.
What I am suggesting this weekend is to devote one complete
roll of film to some new or different ways of doing things. Many times it is
impossible to predict what the final result may be. You may have discovered a
radical new approach, a highly individualistic way of presentation. The end
result may not be to everyone’s taste, but you will never know till you try.
And what is a roll of film worth compared to the fun (and fame and fortune,
perhaps) that this weekend could produce for you.
To get you going, try these. Take photographs of everyday
things, cars, houses or even people, while lying on the floor looking up. A
baby’s eye view. It would certainly be worth re-viewing some items from this
very low viewpoint. OK, I know you will end up looking up people’s noses - but
it just might work. You won’t know till you get the pictures back.
Other possibilities are taking shots with your car’s
headlights as the source of light. (Yes, it has been done before too, and the
end results were spectacular.) Put a red filter over the flash on your camera
and see what you get, taking photographs in the daylight.
Can you see where this week’s column (and Man Ray) is
taking you? Into the realms of the unknown, because it is from there, that true
‘art’ photography comes. I do not mean great technical expertise. Just art.
Let your imagination run wild and try it this weekend. You never know! The
ladies out there could even change their name to “WoMan Ray”!
Money Matters: Investment structure
MBMG International Ltd.
One of the basic problems with many of the consistently top
performing investment funds is that originally they were not set up to accept
investments from retail investors and therefore they are almost invariably
structured as non-distributing offshore funds (roll-up funds).
This means that, for UK investors, while income can roll up
gross when the capital remains invested, a charge to income tax arises on
disposal of units. A disposal for tax purposes includes encashment of units,
switching between funds, and assigning units to someone else, for example to
children or into trust.
The fact that gains are subject to income tax makes such
funds unattractive on purely tax grounds in comparison to authorized unit trusts
and offshore distributor funds, as gains on these funds can be reduced by CGT
taper relief and they can be offset against the annual CGT exemption.
Whilst you retain your UK residence, one way of sheltering
such funds is to invest through a tax free ISA. There are several kinds of fund
plans on the market which qualify as ISAs. The problem with this route, however,
is that the type of individual who will understand fully investment in such
funds will tend to be wealthy. Such funds also generally have high minimum entry
levels, usually between GBP 50,000 and GBP 100,000, so the GBP 7,000 ISA limit
restricts choice and the level of return that is tax sheltered. Also most of our
readers have already given up their UK residence and therefore are ineligible to
invest in ISAs.
An alternative for investors is to invest via an offshore
bond wrapper. Most funds are capable of qualifying as investment links within
non-personal collective investment bonds. The tax-efficient bond wrapper can add
considerable value to the overall investment story. The tax treatments of
encashments of funds held within offshore bonds can produce attractive results
through the use of the 5% withdrawal allowance, top slicing and time
However, even leaving the ability to encash tax efficiently,
returns can be improved by investing in roll-up funds via a bond wrapper because
of the benefit to tax-free switching. This is an important, as sooner or later
almost all investors either want or need to switch funds, whether because of
changes in economic conditions, a change of fund manager, better alternatives or
simply changed investment objectives.
It’s doubtful whether direct investments into funds can be
effected as cheaply as via the institutional terms passed on to investors
through bonds, but for the purposes of this article, let’s assume that somehow
the investor manages to negotiate institutional terms for himself and thereby
saves the bond company’s charges of around 1% upfront and ฃ600 p.a.
To illustrate this point, let us assume an investment of GBP
500,000 and a return of 7% pa after fund charges. After five years, the return
before tax but after charges would be ฃ690,723 for the bond and ฃ701,276
for the direct holding in the fund. The difference is due to the
‘additional’ bond wrapper charges.
However, if one assumes that a fund switch occurs in year
five, and the client is a 40% taxpayer, then the picture changes significantly.
The amount available for re-investment through the bond remains at GBP 690,723
as no tax is payable.
However, the amount available for reinvestment on the direct
holding drops to GBP 620,766 because over GBP 80,000 income tax is payable at
the time the switch occurs.
Carry this example forward for a 25 year term, and assume
full fund turnover every five years, and the net returns after tax would be GBP
1,788,589 for the bond, and GBP 1,474,884 for the direct holding. A total
difference in return of GBP 313,705, solely as a result of the ability to switch
tax free within the bond wrapper.
Part of our job at MBMG International is to devise exit
strategies from the bond to further increase net returns for our clients by, for
example, utilising the 5% per year exemption, timing withdrawals to avoid/reduce
UK tax, or assignment to a spouse or children who may be in lower tax bands.
Remember that UK nationals fall out of the income tax net as
soon as they become non-resident (effectively as soon as they go overseas if
they remain there for a complete tax year or more) whereas the Capital Gains net
still applies until they’ve been overseas for 5 complete tax years.
The above data and research was compiled from sources
believed to be reliable. However, neither MBMG International Ltd nor its
officers can accept any liability for any errors or omissions in the above
article nor bear any responsibility for any losses achieved as a result of any
actions taken or not taken as a consequence of reading the above article. For
more information please contact Graham Macdonald on [email protected] ter na