Melanoma is a type of skin cancer which usually occurs on the parts of the body that have been overexposed to the sun. Rare melanomas can occur inside the eye or in parts of the skin or body that have never been exposed to the sun.
Melanoma is the third most common cancer diagnosed in Australia, which along with New Zealand has the world’s highest incidence rate for melanoma. It is more commonly diagnosed in men than women and the risk of being diagnosed with melanoma by age 85 is 1 in 13 for men compared to 1 in 22 for women.1
In 2014, 13,134 new cases of melanoma were diagnosed in Australia, accounting for nearly one in ten cancer diagnoses.
In Australia in 2015, there were 1520 deaths.
Often melanoma has no symptoms, however, the first sign is generally a change in an existing mole or the appearance of a new spot. These changes can include:
Other symptoms include dark areas under nails or on membranes lining the mouth, vagina or anus.
New moles and spots will appear and change during childhood, adolescence and during pregnancy and this is normal. However, adults who develop new spots or moles should have them examined by their doctor.
Your risk increases with exposure to UV radiation from the sun or other sources such as solariums, particularly with episodes of sunburn (especially during childhood).
Melanoma risk is increased for people who have:
If you have a suspicious spot or mole, your doctor may examine you and use a dermascope (magnifying instrument). The ABCDE method is used to help identify symptoms and make a diagnosis:
If the doctor suspects melanoma, a biopsy may be carried out. This may be done by your GP or you may be referred to another specialist.
The most important feature of melanoma in predicting its outcome is its thickness.
The presence of ulceration also predicts a poor outcome. If distant spread is suspected, CT scans of the chest, abdomen and pelvis are performed. The blood test LDH can sometimes be useful to assess metastatic disease.
Surgery can be curative for thin melanomas and requires that the melanoma be removed with at least 1?2cm of normal skin around it. If the draining lymph nodes are involved they are removed.
If the melanoma has spread to the lymph nodes, you will have a lymph node dissection or lymphadenectomy to remove them. If lymph nodes have been removed, your neck, arm, or leg may swell. This is called lymphoedema.
Treatment for advanced melanoma, where the cancer has spread to lymph nodes, internal organs or bones, may include surgery, radiation therapy targeted therapy or immunotherapy.
Surgery may be used to treat metastatic melanoma that involves other parts of the skin. Surgery may also still be possible if the melanoma has spread to other organs but will depend on the part of the body that is affected.
Radiotherapy may be of benefit in treating some forms of melanoma. It may be used:
Targeted therapy drugs attack specific genetic changes (mutations) that allow melanomas to grow and spread while minimising harm to healthy cells. It is most commonly used for melanomas that have spread to other organs or if it has come back after treatment.
Immunotherapy uses drugs to stimulate the body’s immune system in order to recognise and fight cancer cells. Ipilimumab, nivolumab and pembrolizumab are three immunotherapy drugs approved for treatment of advanced melanoma.
In some cases, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.
As well as slowing the spread of melanoma, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.
Avoid sunburn by minimising sun exposure when the UV Index exceeds 3 and especially in the middle of the day when UV levels are most intense. Seek shade, wear a hat that covers the head, neck and ears, wear sun protective clothing and close-fitting sunglasses, and wear an SPF30+ sunscreen. Avoid using solariums.
Book in and get yourself checked today.
This post was originally published on the Cancer Council website.