Melanoma

What is Melanoma?

Melanoma is a cancerous growth of the melanocyte cells in the skin – a common form of skin cancer. New Zealand and Australia have the highest incidence of melanoma in the world. Approximately 2,000 new cases a year of melanoma are diagnosed in New Zealand.

Melanoma can be an aggressive form of skin cancer with potential for metastatic spread throughout the body. It is imperative to diagnose and treat melanoma as early as possible.

Melanoma can develop at any age, but most commonly occurs between the ages of 45-65. In males, the most common places to develop melanoma are the chest and back, while in females the most common place is the legs.

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What Causes Melanoma?

The majority of melanoma cancers are associated with excessive sun exposure. Patterns of sun exposure most likely to cause melanoma are excessive sun burns and excessive sun exposure in childhood years. Sun beds are also a known risk factor for the development of melanoma.

Genetic factors are also important and having a family history of melanoma is a significant risk factor.

Risk factors for developing melanoma.

  1. Family history of melanoma
  2. Past history of melanoma
  3. Large numbers of moles
  4. Presence of atypical moles
  5. Fair skin type
  6. Immunosuppression

Development of melanoma

Melanoma can develop in a pre-existing mole. Less commonly it can develop as a new spot, which develops on previously normal skin. Important signs to look for are:

  • A — Asymmetry
  • B — Borders/irregularity
  • C — Colour variation
  • D –- Diameter over 6mm
  • E –- Elevation/mole becoming more raised

Other less common signs are itching or bleeding of a mole.

Rarely, melanomas can develop internally – e.g. mouth, rectum, the eye or in the scalp.

Any change in a mole should be assessed by a dermatologist to make sure it is not melanoma.

Diagnosis of melanoma

If there is suspicion of melanoma, the area should be completely surgically excised and checked in the lab. Partial biopsy are indicated if total excision of the lesion is not possible.

The biopsy will be reported by a pathologist who will comment on the type of melanoma, its depth and activity.

Melanoma Treatment

The preferred treatment of melanoma is surgical. Depending on the type of melanoma, a lymph node biopsy may be performed to provide further prognostic information. This is normally performed by a plastic surgeon.

For advanced forms of melanoma that have spread to either lymph nodes or internally, exciting new drugs are now available for treatment. These are a major advance in treating more serious melanoma cases. Use of these medications is usually under the care of an oncologist.

Follow Up

All patients who have had melanoma will require regular follow up for up to five years post surgery. This would include regular examination of the scar and lymph nodes. A whole body skin check should be undertaken on a regular basis as the chance of a second melanoma is higher if a person has had a melanoma. Your dermatologist will advise you on the exact frequency and type of follow up that is needed.

Melanoma Summary

Melanoma is a potentially serious skin cancer that has the potential for spreading throughout the body. Early diagnosis and removal is essential. Any changing mole should be examined by your dermatologist. Make an appointment with us now if you have any concerns.

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