Melanoma

Note: The information on cancer types on the ACRF website is not designed to provide medical or professional advice and is for information only. If you have any health problems or questions please consult your doctor.

  • What is melanoma?

    Melanoma is a cancer that begins in the melanocytes.  Most melanoma cells still make melanin, and so melanoma tumours are usually brown or black, however some melanomas do not make melanin and can appear pink, tan, or even white.

    Melanoma is much less common than basal cell and squamous cell skin cancers. However it is far more dangerous as it is much more likely to spread to other parts of the body if not caught early.

    The most common locations for melanomas are chest and back for men, and legs for women. The face and neck are also common sites for melanoma, though they can form elsewhere such as the eyes, mouth, genitals and anal area.

  • Melanoma symptoms

    The most important symptom for melanoma is a new spot on the skin or a spot that is changing in size, shape, or colour. Other signs to look for are:

    • One half of a mole or birthmark does not match the other.
    • The edges are irregular, ragged, notched, or blurred.
    • The colour is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white, or blue.
    • The spot is larger than 6mm across, although melanomas can sometimes be smaller than this.
    • The mole is changing in size, shape, or colour.

    Melanomas may not always appear as a spot. Other warning signs include:

    • A sore that does not heal
    • Spread of pigment from the border of a spot to surrounding skin
    • Redness or a new swelling beyond the border
    • Change in sensation – itchiness, tenderness, or pain
    • Change in the surface of a mole – scaliness, oozing, bleeding, or the appearance of a bump or nodule

    It is sometimes hard to tell the difference between melanoma and an ordinary mole, even for doctors, so it’s important to show your doctor any mole that you are unsure of.

  • Melanoma treatment

    Early-stage melanomas can often be treated effectively with surgery alone, but more advanced cancers often require other treatments. Sometimes more than one type of treatment is used.

    Wide excision

    When melanoma is diagnosed by skin biopsy, the site will most likely need to be excised to ensure the cancer has been removed completely. The margin of normal skin that needs to be removed around the site of the tumour increases based on the size of the melanoma and may be altered depending on where the tumour is on the body and other factors.

    This fairly minor surgery will cure most thin melanomas. If the melanoma is on a finger or toe and has grown deeply, amputation of all or part of that digit may be required. If melanoma has spread from the skin to distant organs such as the lungs or brain, the cancer is very unlikely to be curable by surgery alone.

    Lymph node dissection

    Lymph node dissection involves a surgeon removing all of the lymph nodes in the region near the primary melanoma as this is where the cancer is most likely to travel to first.

    Once the diagnosis of melanoma is made from the skin biopsy, the doctor will examine the lymph nodes nearest the melanoma. Depending on the thickness and location of the melanoma, this may be done by physical exam, or by imaging tests to look at nodes that are not near the body surface. If the nearby lymph nodes feel abnormally hard or large, and a biopsy finds melanoma in a node or nodes, a lymph node dissection is usually done.

    If the lymph nodes are not enlarged, a sentinel lymph node biopsy may be done, particularly if the melanoma is thicker than 1 mm. If the sentinel lymph node does not contain cancer, then it is unlikely the melanoma has spread to the lymph nodes and there is no need for a lymph node dissection. If the sentinel lymph node contains cancer cells, removing the remaining lymph nodes in that area with a lymph node dissection is usually advised.

    Targeted therapy

    As research into cancer genomics continues to advance, doctors are developing drugs that specifically attack the gene changes that make melanoma cells. These targeted drugs work differently from standard chemotherapy drugs, which basically attack any quickly dividing cells. Sometimes, targeted drugs work when chemotherapy doesn’t and can also have less severe side effects.

    Chemotherapy

    Chemotherapy, which usually involves drugs being injected into the bloodstream or taken as an oral pill, can be used to treat advanced melanoma. However, it is not often used as the first treatment since newer forms of immunotherapy and targeted drugs have become available. Chemotherapy is usually not as effective in melanoma as it is in some other types of cancer, but it may relieve symptoms or extend survival for some patients.

    Radiation therapy

    Radiation therapy is not usually used to treat the original melanoma, although it is sometimes used after surgery for a type of melanoma known as desmoplastic melanoma. In some cases, it may be given after surgery in the area where lymph nodes were removed, especially if many of the nodes contained cancer cells. This is to try to reduce the chance that the cancer will come back.

    Radiation therapy may also be used to treat melanoma that has recurred, either in the skin or lymph nodes, or to help treat distant spread of the cancer.

    Palliative radiation therapy is often used to relieve symptoms caused by the spread of the melanoma, especially to the brain or bones. It is not expected to cure the cancer, but might help to shrink the cancer for a time to control some of the symptoms.

Cancer Statistics

  • 14,320

    new estimated cases of melanoma skin cancer in 2018

  • 90.4%

    is the estimated 5-year survival rate

  • is the estimated 5-year survival rate

    years is the median age of diagnosis

Together we can change the statistics and
outsmart cancer for good

REFERENCES

Cancer in Australia 2017, Australian Institute of Health and Welfare

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