Melanoma
Melanoma is an uncommon, but more dangerous type of skin cancer. It starts in the melanocytes (the cells that give your skin its colour) and can be found on any part of the body. Melanomas can also occur in your eye (ocular melanoma) and parts of the body never exposed to sunlight.
Australia has the highest rate of melanoma in the world. Every year, around 16,800 people are diagnosed with melanoma, and around 1,300 Australians die from it.
Fortunately, you can take steps to protect yourself from melanoma.
What does melanoma look like?
Most melanomas are brown or black, but they can also be tan, pink or white. They can be raised or flat and be of different sizes and shapes. The four types of melanoma have different characteristics.
Superficial spreading melanoma — These may be flat or slightly raised. Colours may be tan, brown, black, red/pink, blue or white. They usually looks asymmetrical (the two halves look different) with uneven borders.
Lentigo maligna — These can appear as a blotchy patch that is flat or slightly raised. They’re often blue-black but can vary from tan through to dark brown. They also have uneven borders.
Acral lentiginous melanoma — Acral refers to melanomas that occur at the periphery, in particular on the palms of the hands or soles of the feet. This can include melanoma of the fingernails or toenails.
Nodular melanoma — These are usually blue-black but can also appear as shades of pink to red. They usually look like a bump on the skin. Nodular melanomas may be more aggressive in their behaviour.
Graeme's Story
Graeme grew up in the bush in the 1960’s and 70’s and spent most of his time biking, swimming, fishing and playing sport. Though blue-eyed and fair-skinned, he remembers this as a time where no one really knew about melanoma, and sunscreen use was not commonplace.
Melanoma had affected Graeme’s circle long before his own diagnosis, when two very close family friends died from it. Graeme was “was acutely aware of how nasty it could be,” and began using sun safe habits in the 1980s. Later, in 2010, he found a lump behind his ear. “The specialist said, mate, I’m sure it’s melanoma. I’ll take it out next week.”
After removal, tests confirmed it was advanced, and quite aggressive, melanoma, starting a long and difficult cancer journey.
How can I recognise a melanoma?
It’s recommended you use the ABCDE guidelines when checking for melanoma.
Asymmetry – Are the halves of each mole different?
Borders – Are the edges uneven, notched or scalloped?
Colour – Are there different colour patches?
Diameter – Is the spot greater than 6mm across, or is it smaller but growing?
Evolving – Has the spot changed in any way?
If you answer ‘yes’ to any of the above, there’s a chance it may be melanoma.
What causes melanoma?
The biggest risk factor for melanoma is exposure to ultraviolet (UV) radiation. This can be from the sun or tanning beds and tanning lamps. Limiting your exposure to UV radiation will reduce your risk for melanoma. Other risk factors include:
A history of tanning and sunburn, especially during childhood and adolescence
A family history of melanoma, especially if diagnosed before the age of 40
Already having another type of skin cancer such as basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)
Having lots of moles
Having fair or freckled skin that burns easily
Having red or fair hair, and light-coloured eyes
Carrying a genetic variant that increases your risk for melanoma.
How is melanoma diagnosed?
Melanoma is usually diagnosed via a physical examination. If your doctor or a skin specialist (dermatologist) suspects you have melanoma, they will usually do a biopsy (take a sample of the tissue) when removing the spot. This is taken so it can be examined under a microscope to confirm if it is melanoma.
How is melanoma diagnosed?
Melanoma is usually diagnosed via a physical examination. If your doctor or a skin specialist (dermatologist) suspects you have melanoma, they will usually do a biopsy (take a sample of the tissue) when removing the spot. This is taken so it can be examined under a microscope to confirm if it is melanoma.
What are the stages of melanoma?
Melanoma is usually staged. This is the process of determining how much cancer is in your body, and whether it has spread. Melanoma is usually given a stage of 0-4 (written in Roman numerals).
Stage 0 - The melanoma is confined to the outer layer of the skin, the epidermis.
Stage I - The melanoma is localised (has not progressed past the original or primary site) and is less than 2 mm thick.
Stage II - The melanoma is still localised but at high risk. It’s more than 2mm thick.
Stage III - Also known as a regional melanoma, it has spread to the lymph nodes near the primary site to nearby skin and tissues.
Stage IV - This is advanced or metastatic melanoma. This means it has spread to other parts of the body such as the lungs, liver, brain, bone or distant lymph nodes.
How do you treat melanoma?
If the melanoma is found early, treatment is via surgical removal. Usually, it’s not necessary to remove lymph nodes during early-stage melanoma.
If the melanoma is advanced (i.e. it has spread), treatment may involve surgery, radiation therapy, targeted therapy or immunotherapy. In some cases, treatment may involve palliative care. This treatment is designed to slow the spread of melanoma and improve the quality of your life by reducing pain and other related symptoms, rather than treating the cancer itself.
When should you see your doctor?
It’s important to visit your doctor or dermatologist if you notice any new changes to your skin. In particular, you should look for:
Spots that look or feel different from other spots
Spots that have changed in colour, texture, size or shape
Sores that don’t heal after a couple of weeks
Sores that are itchy or bleed.
You should also talk to your doctor if you’re concerned about your risk for melanoma. They will be able to advise whether you should undergo more regular and formal skin checks with a skin specialist.
When should you see your doctor?
It’s important to visit your doctor or dermatologist if you notice any new changes to your skin. In particular, you should look for:
Spots that look or feel different from other spots
Spots that have changed in colour, texture, size or shape
Sores that don’t heal after a couple of weeks
Sores that are itchy or bleed.
You should also talk to your doctor if you’re concerned about your risk for melanoma. They will be able to advise whether you should undergo more regular and formal skin checks with a skin specialist.
Can you prevent melanoma?
The good news is that you can significantly reduce your risk of developing melanoma by protecting your skin from UV radiation.
When the UV level is 3 or above, it’s recommended you:
Slip – Slip on sun-protective clothing that covers your skin.
Slop – Slop on a broad-spectrum, water-resistant, SPF30+ sunscreen. You should apply this 20 minutes before heading outside and every two hours after that.
Slap – Slap on a hat.
Seek – Seek shade where possible.
Slide – Slide on sunglasses that meet Australian standards.
Graeme’s tips to help protect your skin
Today counts – Whether continuing sun safe habits or beginning for the first time, today matters
Know your skin – Remember, melanoma can appear anywhere; if something changes, get it checked
Regular skin checks – These are essential to keep track of changes which may occur between appointments
Wide-brimmed hat – “I wear very unattractive and unfashionable wide-brimmed hats,” quips Graeme
Sunscreen as routine – For kids, establish the culture that sunscreen is simply part of going outside
Long pants and long-sleeved shirts – Use a lighter fabric during summer to keep cool
Can you prevent melanoma?
The good news is that you can significantly reduce your risk of developing melanoma by protecting your skin from UV radiation.
When the UV level is 3 or above, it’s recommended you:
Slip – Slip on sun-protective clothing that covers your skin.
Slop – Slop on a broad-spectrum, water-resistant, SPF30+ sunscreen. You should apply this 20 minutes before heading outside and every two hours after that.
Slap – Slap on a hat.
Seek – Seek shade where possible.
Slide – Slide on sunglasses that meet Australian standards.
Graeme’s tips to help protect your skin
Today counts – Whether continuing sun safe habits or beginning for the first time, today matters
Know your skin – Remember, melanoma can appear anywhere; if something changes, get it checked
Regular skin checks – These are essential to keep track of changes which may occur between appointments
Wide-brimmed hat – “I wear very unattractive and unfashionable wide-brimmed hats,” quips Graeme
Sunscreen as routine – For kids, establish the culture that sunscreen is simply part of going outside
Long pants and long-sleeved shirts – Use a lighter fabric during summer to keep cool
You can find the UV index on the weather page of all Australian daily newspapers and the Bureau of Meteorology website. The free SunSmart app is also a great way to check the UV index when you’re out and about.
You should also avoid using tanning beds or tanning lights. Commercial solariums are illegal in Australia due to the associated risk of skin cancer and melanoma.
Your local MediADVICE pharmacist is available to help you manage your health. We can provide advice on the right sun protection products for you and your family. We can also refer you to a doctor if necessary.
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