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Melanoma is a type of skin cancer that occurs when melanocytes, the cells that produce pigment in the skin, become cancerous.
These cancerous cells can develop on any part of the body, as most non melanoma skin cancers but they most commonly occur on areas that have been exposed to the sun, such as the face, arms, and legs.
Malignant melanoma is the most dangerous form of skin cancer and can spread to other parts of the body if left untreated. However, when detected early, advanced melanoma, can be effectively treated and even cured.
In this blog post, we will explore what melanoma is, its causes, symptoms, and treatment options, and how you can reduce your risk of developing this deadly disease.
the disease
What causes melanoma Skin Cancer?
Melanoma is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources such as tanning beds. When healthy skin that is exposed to UV radiation, it damages the DNA in skin cells, which can lead to the development of cancer.
However, there are also other factors that can increase your risk of skin cancers, including:
Family history of malignant or nodular melanoma or non melanoma skin cancer
Having a large number of moles on your body
Having fair skin that burns easily
Weakened immune system
Previous history of skin cancer
It is important to note that anyone can develop melanoma, regardless of their skin colour or ethnicity.
Skin cancer do not discriminate
Overview
How common is melanoma?
Australia has one of the highest rates of melanoma and non melanoma skin cancers in the world, due in large part to its location and climate.
According to the Australian Institute of Health and Welfare and Cancer Council Australia, melanoma is the third most commonly diagnosed cancer in Australia, accounting for approximately 10% of all cancer diagnoses.
In 2020, an estimated 16,221 Australians were diagnosed with melanoma, and it is malignant component is responsible for approximately 1,300 deaths each year. Melanoma is more common in men than women in Australia, and its incidence increases with age.
The high incidence of melanoma and skin cancers in Australia has led to extensive public health campaigns promoting sun safety and skin cancer awareness.
The message is clear: taking steps to protect your skin from the sun’s harmful UV rays, including wearing protective clothing and using sunscreen, is crucial for preventing melanoma and other types of skin cancer.
Melanoma signs and symptoms
The most common symptom of developing melanoma is the development of a new or changing mole on the skin. However, not all melanomas develop from moles, and some metastatic melanoma may appear as a dark spot or blemish on the skin.
To help identify possible melanomas, use the “ABCDE” rule:
A: Asymmetry
One half of the mole or spot does not match the other half
B: Border
The edges of the mole or spot are uneven or blurry
C: Color
The mole or spot has multiple colours or is unevenly coloured
D: Diameter
The mole or spot is larger than the size of a pencil eraser
E: Evolving
The mole or spot is changing in shape, size, or colour
If you notice any of these signs, it is important to see a dermatologist or a skin cancer doctor as soon as possible.
the disease
How is melanoma diagnosed?
Melanoma is typically diagnosed through a combination of physical examination and biopsy like most skin cancers. A dermatologist or a skin cancer doctor will examine the suspicious area of skin, the surrounding skin and any existing mole, taking note of its size, shape, colour, and any other features that may indicate melanoma or a non melanoma skin cancer.The doctor will assess the risk factors of potential skin cancers, your level sun exposure and any skin damage. They may also examine nearby lymph nodes to determine if the cancer has spread.
If your doctor suspects melanoma, a biopsy will be performed. During a biopsy, a small sample of the suspicious skin or tissue is removed and sent to a laboratory for analysis. The type of biopsy will depend on the size and location of the suspicious area, but may include a punch biopsy, excisional biopsy, or incisional biopsy.
In some cases, imaging tests such as a CT scan or PET scan may be ordered to determine if the skin cancer has spread to other parts of the body, such as the lymph nodes, lungs, or liver.
It is important to note that not all moles or other skin changes that look abnormal are melanoma. Some may be benign growths or other types of skin cancer such as squamous cell carcinoma, basal cell carcinoma or other skin cancers. It is important to see a dermatologist or a skin cancer doctor for regular skin checks and to report any new or changing existing moles or other skin changes promptly to your doctor.
Lymphatic system
Checking lymph nodes
Checking lymph nodes is an important part of the diagnostic process for melanoma, as the cancer can spread to other parts of the body.
During a physical exam, a healthcare provider will typically check the lymph nodes near the area of suspected melanoma for any signs of enlargement or firmness, which may indicate the presence of cancer cells.
If melanoma is diagnosed, a biopsy of the nearby lymph nodes may be recommended to determine if the cancer has spread beyond the skin. This is typically done through a procedure called a sentinel lymph node biopsy (SLNB).
During a SNLB, a radioactive tracer and/or blue dye is injected near the site of the melanoma. The tracer or dye will then travel to the sentinel lymph node, which is the first lymph node that cancer cells are likely to spread to from the primary tumor. The sentinel lymph node is then removed and examined for the presence of cancer cells.
If cancer cells are found in the sentinel lymph node, additional excision in the area may also be done. This information is important in determining the stage of the melanoma and guiding treatment decisions.
It is important to note that not all melanomas will spread to nearby lymph nodes, and not all melanomas that have spread to lymph nodes will have symptoms or signs of enlargement.
Regular skin checks and prompt reporting of any new or changing moles or skin changes can help detect melanoma in its early stages, when it is most easily treated.
Skin cancer do not discriminate
Tests and treatment
How is melanoma treated?
If melanoma is detected early, it can often be treated with surgery to remove the cancerous cells. In some cases, additional treatments such as radiation therapy or immunotherapy may be recommended.
If the melanoma has spread to other parts of the body, treatment options may include:
Chemotherapy
Targeted therapy
Immunotherapy
Radiation therapy
Surgery
Palliative treatment
The treatment plan will depend on the stage of the cancer, the location of the other melanoma cells, and the patient’s overall health.
What tests are used to stage melanoma?
Staging is the process of determining how much cancer is present in the body and how far it has spread. The stage of melanoma is important in guiding treatment decisions and predicting outcomes. The staging process for melanoma typically involves a combination of imaging tests, biopsies, and physical exams. The tests used to stage melanoma may include:
Physical examination:
A healthcare provider will examine the skin and lymph nodes for signs of melanoma, including the size, shape, and colour of the lesion, and the presence of any symptoms such as itching or bleeding.
Biopsy:
A biopsy of the melanoma may be performed to determine the type and extent of the cancer.
Imaging tests:
Imaging tests such as CT scans, MRI, PET scans, or X-rays may be used to determine if the cancer has spread beyond the skin. These tests can also help identify the location and size of any tumors that may have developed.
Blood tests:
Blood tests may be used to check for elevated levels of certain enzymes that can indicate the presence of cancer, such as lactate dehydrogenase (LDH).
Sentinel lymph node biopsy:
A sentinel lymph node biopsy may be performed to determine if the melanoma has spread.
Once all the necessary tests have been completed, the stage of the melanoma can be determined. The stages of melanoma range from 0 (early, non-invasive cancer) to IV (advanced cancer that has spread to distant parts of the body). The stage of melanoma is an important factor in determining the best treatment options and predicting outcomes.
Can Melanoma skin cancer be prevented?
The best way to prevent most melanomas is to protect your skin from UV radiation. Here are some tips to reduce your risk of getting skin cancers:
Use sunscreen with an SPF of 30 or higher, and apply it 20-30 minutes before going outside to reduce the impact of UV radiation.
Wear sun protective clothing such as long-sleeved shirts, pants, and hats to prevent blistering sunburns.
Seek shade during peak hours of sunlight (10am-4pm).
Avoid tanning beds.
Examine your skin regularly for any changes or new moles/spots.
It is also important to talk to your healthcare provider about any concerns you have regarding your skin or general health too, especially if you have a family history of melanoma or other types of skin cancer.
the risks of skin cancer treatment
Are there complications of skin cancer treatment?
Like any medical procedure, there are potential complications associated with melanoma treatment. The type and severity of complications will depend on the specific treatment approach used, the stage and location of the melanoma, and the overall health of the patient.
Surgical treatments, such as excisional biopsies, may be associated with complications such as bleeding, infection, scarring, or nerve damage. Sentinel lymph node biopsies and lymph node dissections may be associated with complications such as infection, pain, numbness, or lymphoedema (swelling in the arm or leg).
Radiation therapy may cause skin irritation, fatigue, nausea, or changes in skin pigmentation. Systemic treatments prevent skin cancer, such as chemotherapy or immunotherapy, may cause side effects such as fatigue, nausea, hair loss, and increased risk of infection.
It is important to note that while complications can occur, they are generally rare and can often be managed with proper medical care. Patients undergoing melanoma treatment should be sure to discuss the potential risks and benefits of each treatment approach with their healthcare provider, and report any new or worsening symptoms promptly.
In addition to physical complications, many patients undergoing melanoma treatment may also experience emotional and psychological distress. Support from loved ones, support groups, or mental health professionals can be helpful in managing the stress and anxiety associated with cancer diagnosis and treatment.
In conclusion, melanoma is a serious form of skin cancer that can be life-threatening if left untreated. It is important to be aware of the symptoms and risk factors associated with melanoma, as well as to practice safe sun habits and seek medical attention promptly if you notice any changes in your skin. Early diagnosis and treatment are key to improving outcomes and preventing the spread of the cancer. Treatment for melanoma may involve a combination of surgery, radiation therapy, chemotherapy, and immunotherapy, depending on the stage and severity of the cancer. With proper care and management, it is possible to successfully treat melanoma and achieve a good quality of life. If you have concerns about your skin health or have been diagnosed with melanoma, it is important to work closely with your healthcare provider to develop a personalised treatment plan that meets your needs and goals.
Melanoma, the most dangerous form of skin cancer, can often be detected by looking for five tell-tale traits: asymmetry in shape or coloration; a ragged border; varying hues within a single spot; diameters greater than six millimeters and changes in size over time. Heeding such warnings could help to save lives.
The 5-year survival rate for melanoma in Australia is around 90%, with higher rates for those with localised cancer and lower rates for those with more advanced disease. The high incidence of melanoma in Australia underscores the importance of regular skin checks and sun protection measures for early detection and prevention.
Yes, early stage melanoma is often curable with prompt and appropriate treatment. The chances of a cure are highest when melanoma is detected and treated in its early stages, before it has a chance to spread to other parts of the body. It is important to monitor your skin regularly for changes and report any concerns to your healthcare provider for evaluation.
Yes, moles can turn into other signs of skin cancer, specifically melanoma. While most moles are harmless, some may develop into melanoma, which is a type of skin cancer that can be deadly if not detected and treated early. It is important to monitor any moles or skin lesions for changes and report any concerns to your healthcare provider for evaluation.
Melanoma can be a fast-spreading cancer, especially if it is not detected and treated early. The rate of spread depends on the thickness and depth of the melanoma, as well as other factors such as the patient’s age and overall health. In general, early detection and treatment developing skin cancer are important for improving outcomes and reducing the risk of complications.
Yes, melanoma is a type of skin cancer that can be deadly if not detected and treated early. Melanoma develops in melanocytes, which are the skin cells called melanocytes that produce pigment in the skin. While most moles and skin lesions are harmless, some may develop into melanoma, so it is important to monitor any changes in your skin and report any concerns to your healthcare provider.
You should worry about a mole if it exhibits any signs of the “ABCDE” rule: asymmetry, irregular border, varied colors, larger than 6 mm in diameter, or evolving in size, shape, color, or texture. Additionally, if you have a new or changing mole that looks different from other moles on your body, or a mole that is growing rapidly, you should consult with a dermatologist or healthcare provider for evaluation. Regular self-exams and prompt reporting of any concerns are important for early detection and treatment of melanoma.