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Melanomas 2017-11-08T06:50:33+00:00

MELANOMAS

Why Get a Melanoma Check?

Not all skin cancers are the same. There are three common types:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Melanoma

How common are they?

Fortunately melanomas are the least common type of skin cancer as they are the most dangerous. However over 10,000 Australians are diagnosed with melanoma each year and there are around 1300 annual deaths due to melanoma. They can occur at any age but are rare in childhood and adolescence. They become more and more common with increasing age. 1 in 29 Australians will develop a melanoma in their lifetime.

What are they?

They are tumours of the body’s melanin pigment producing cells. The vast majority of melanomas occur on the skin but rarely they can occur in other sites such as the eye. The most common sites are the face, back & lower legs. Only 25% of melanomas arise in pre existing moles. The majority appear on previously normal looking skin. A newly appearing mole above the age of 25 is definitely a cause for concern.

Who is affected?

Melanoma can affect anyone from childhood onwards but the following people are most at risk:

Family History

A first degree relative (parents, brother, sister, children) with melanoma increases risk

Ethnic Group

People with North West European ancestry are most at risk, with Southern Europeans, Middle Eastern and North Indian people at less risk. Asians have a lower risk again and dark skinned Southern Indians, black Africans and Australian aborigines are at least risk.

Skin type

People with red or pale blonde hair who sunburn, don’t tan and freckle easily are most at risk. Those with more olive complexions are by no means immune however.

Multiple moles

The more moles on the skin surface the higher the lifetime risk of melanoma. The average person has between 5 and 20 significant moles. Very ‘moley’ people with over 100 significant moles have up to a 10 times increased risk of melanoma.

UV exposure

The more UV light that hits the skin in a lifetime the higher the melanoma risk. Outdoor workers in farming, construction, regular surfers & beach goers are all high risk groups. UV exposure can also occur in sun bed use, welding or medical treatment of skin conditions such as psoriasis.

History of previous skin cancers

a history of previous melanoma increases the risk of another one. History of a previous non melanoma skin cancer (basal cell carcinoma or squamous cell carcinoma) also increases risk.

Age

The older you are the more likely you are to get a melanoma. Children and adolescents fortunately have a very low risk. Melanomas start to become more common from the 20s onwards.

How dangerous are they?

Melanomas are very aggressive cancers. They can metastasise (i.e. spread to lymph glands or distant organs such as the liver or lungs) when still small. The thinner a melanoma at diagnosis the less chance it has spread and the better the outcome. The formal measurement of melanoma under the microscope is called ‘Breslow thickness’. If this is less than 1mm at diagnosis 5 year survival is over 95%. This rate sharply declines if melanomas are thicker at diagnosis.

What types are there?

Melanoma in situ

The thinnest and least dangerous melanomas are confined to the top layer of skin – the epidermis. They are most common on the face and can develop slowly over several years.

Superficial Spreading Melanoma

These melanomas grow slowly outwards and can reach a diameter of several centimetres at diagnosis. Typically they are asymmetrical, multiple shades of brown/ black and may bleed intermittently.

Nodular Melanoma

the most dangerous sub type of melanoma is called ‘nodular melanoma’. These can grow to well over 1mm thick in a matter of weeks and metastasise very early. Fortunately they are less common than other melanoma types. They typically present as a dark nodule which can often ulcerate early. Sometimes they are pink rather than dark – so called ‘amelanotic melanomas’.

How can I tell if I have one? Be concerned if:

  • A new mole appears where you never had one before
  • An existing mole changes colour (especially if it darkens) or seems to spread outwards or bleeds
  • Any nodule or ulcer appears on your skin and fails to heal
  • If someone comments on a skin lesion in a place you can’t see yourself (especially the back)

If in doubt see a doctor sooner rather than later.

What is the treatment?

The only current effective treatment of early melanoma is surgical excision from 5 to 10mm wide & deep margins from the edge of the cancer. The thicker the melanoma at diagnosis the wider the excision needs to be. This can leave disfiguring scars but is life saving. The majority of surgery is done under local anaesthetic.

Early Detection

This is the main weapon we have against melanoma. It is recommended every adult over 18 should have a regular melanoma check and annual whole body skin check, especially those in any of the high risk groups listed above. If you have a history of skin cancer, a paler skin type or heavy sun damage to your skin, the doctor may recommend more frequent checkups.

How do I prevent them?

The risk of melanoma is very much increased by high UV exposure. The less UV that falls on the skin the better. This is particularly true for those who have already had a skin cancer. Don’t ever take the attitude “Well the damage is done now so there’s no point wearing sun block “. Seek the shade like people in other sunny countries do. Cover up with a broad brimmed hat, wear clothing with as fine a weave as possible (Lycra is especially protective). If it is not possible to cover up with clothing apply a good quality SPF30+ sun block to exposed skin. Apply it before going outdoors and re apply it often during the day (every 2-3 hours). This advice is particularly important for children and young adults, but parents please don’t just protect your kids and neglect yourselves.

See a doctor if

  • A new mole appears where you never had one before
  • An existing mole changes colour (especially if it darkens) or seems to spread outwards or bleeds
  • Any nodule or ulcer appears on your skin and fails to heal
  • If someone comments on a skin lesion in a place you can’t see yourself (especially the back)