Melanoma

Melanoma is the most well-known and most serious type of skin cancer. Melanoma arises from changes in melanocytes, the skin cells that produce the pigment (melanin) which gives skin and moles their colour. Though it is less common than other types of skin cancer, it is also more aggressive. Most deaths from skin cancer are caused by melanoma. It is therefore essential to understand how to identify a lesion that could be a melanoma and seek a professional diagnosis from a dermatologist.

What Causes Melanoma?

Evidence suggests that almost all melanomas are caused by sun exposure. Childhood sun exposure is a particularly important contributing factor. Anyone can develop skin cancer, but you are at greater risk if you have:

• A history of repeated sunburns and blistering
• A history of close family members that have had melanoma
• Unusual looking moles or a larger number of moles
• Fair skin that easily burns and never tans

What Does Melanoma Look Like?

Melanoma can take many forms. As a general rule, most melanomas appear as a new spot. A smaller number arise from existing lesions. Melanomas often look like a mole at first, but grow larger at a rapid rate and change in shape or colour to become increasingly irregular. The ABCDE guide is one way to identify the warning signs associated with melanomas:

• Asymmetry: spots that lack symmetry and appear randomly shaped
• Border: spots with irregular edges that are ragged, notched or blurred
• Colour: blotchy spots with several colours (brown, black, blue, red, white, grey)
• Diameter: spots that are larger than 5 millimetres across
• Evolving: spots that change in colour, size or shape

Please refer to our self-skin examination guide for more information about identifying melanomas.

How Is Melanoma Diagnosed?

If you believe a spot may be a melanoma, schedule an appointment with your doctor and explain why you are concerned. Your doctor will excise the suspicious lesion or refer you to a dermatologist for an urgent assessment if necessary. Do not hesitate to share your concerns or question your doctor’s opinion if you have good reason to suspect the spot is a melanoma. Any lesion that may be a melanoma should be removed completely and sent to a pathologist for assessment. A partial biopsy is usually avoided, but may be considered for large lesions.

The pathologist will evaluate the depth of the melanoma to determine the level of risk attached to it. When the pathology report is back, you will be told the result and your doctor will explain the treatment options.

How Is Melanoma Treated?

Appropriate treatment will be determined based on how deeply the melanoma has grown into the skin and whether it has spread to other areas of the body. All melanomas are treated surgically by excising the melanoma and a margin of healthy skin around it. The width of the margin will depend on the depth of the melanoma.

Medical researchers are developing new methods, including targeted therapy and checkpoint inhibitors, to treat more advanced melanoma. Targeted therapy uses medication to slow or stop the growth of melanoma cells. Checkpoint inhibitors enhance the immune response and help the body deal more effectively with melanoma. These treatments have resulted in improved survival for patients with evidence of spread of melanoma.

What Is the Outlook for Melanoma?

With early discovery and treatment, melanoma has a high cure rate. Anyone with strong risk factors for melanoma or a previous melanoma should conduct routine self-skin checks and be assessed regularly by a dermatologist. Call Northside Dermatology on 03 8582 8688 to book an examination.