As Australians begin to embark on another long, sunshine filled summer, it’s important we all make sure we understand the dangers of melanoma – the third most commonly diagnosed cancer in Australia. Here, we take a look at risk factors, symptoms and treatment of the deadly skin cancer.
Melanoma is a type of skin cancer that develops when melanocytes (the cells that give skin its colour) start to grow out of control. Along with New Zealand, Australia has the highest incidence rate for melanoma in the world. It is primarily caused by excessive exposure to UV radiation from the sun, which can trigger the abnormal growth of cells and the development of cancer
People with pale skin types are more vulnerable to skin cancer.
Through migration, Australia has been populated by many people with fair skin whose ancestors come from much less sunny climates. Most Australians have the wrong type of skin for their environment. Lack of protective pigmentation leaves skin cells especially vulnerable to the DNA-damaging rays from the sun.
Melanin, which pigments the skin, protects against UV radiation. Melanoma rates are far lower in people with pigmented skin such as Aboriginal people, but not non-existent.
Over 16,220 people are estimated to be diagnosed with melanoma in Australia this year alone. Around 58% of these will be male. Approximately 1,375 people in Australia will die from melanoma in 2020.
Risk Factors for Developing Melanoma
Understanding the causes and risks of developing melanoma could help prevention or early detection of the disease. The earlier a cancer is found, the better the chances of a positive outcome. Factors that increase your risk include:
- Unprotected or excessive exposure to the sun/UV rays
- Weakened immune system
- Numerous moles, particularly large or atypical
- Fair skin
- A personal history of skin cancer
- Family history of skin cancers
Symptoms of Melanoma
Melanomas can develop anywhere on your body. They are most common in areas that have had exposure to the sun such as your back, legs, arms and face.
Common symptoms of melanoma include:
- A new pigmented or unusual-looking growth on your skin
- A change in an existing mole
Normal moles are usually small and oval/round. They are tan, brown or black in colour with a distinct border separating the mole from surrounding skin. Most moles begin in childhood. By the time they are adults, most people have between 10 and 40 moles. Moles may change in appearance over time and some may disappear with age.
Moles with irregular shapes or borders, changes in colour, shape or sensation (eg itching or bleeding), and/or large diameters, should be checked out by a doctor.
Melanomas can also occur in areas that don't receive much sun exposure, such as the soles of feet, palms of hands, fingernail beds, spaces between toes, scalp or genitals. These hidden melanomas are more common in people with darker skin.
You should make an appointment with your doctor if you notice skin changes anywhere on your body that seem unusual.
If you have concerns about any melanoma symptoms, the first thing your doctor will do is examine the suspicious spot or mole, and any other moles on your body. If the doctor feels it is necessary, he will refer you to a pathologist who will remove the spot on your skin for examination. This is called an excision biopsy and provides information about the thickness of the melanoma and how deeply into the skin the cancer cells have grown.
Your doctor will also check the nearby lymph nodes to work out if the melanoma has spread to other parts of the body, and at what stage the cancer is at. Melanoma is staged from 0 – IV. Early melanoma is classed as 0-II.
How is melanoma treated?
Melanoma that is found early can generally be treated successfully with surgery to remove the mole. This may be the only treatment needed.
Following an excision biopsy to diagnose melanoma, a doctor or surgeon may also do a procedure called wide local excision to remove skin from around the melanoma (wider margin). This reduces the risk of it recurring at that site.
Most people will be able to have the wound closed with stitches, leaving a scar that will become less noticeable with time. If a large area of skin is removed, skin and fatty tissue can be lifted and moved over the wound and stitched, or a layer of skin can be taken from another part of your body (usually the thigh or neck) and placed over the area where the melanoma was removed (a skin graft). The skin will grow back within a few weeks.
If the melanoma has spread to your lymph nodes, you may be offered immunotherapy. If melanoma has spread to lymph nodes and caused a lump, the lymph nodes will be removed. Usually only the lymph nodes near the melanoma are removed.
When melanoma has spread to distant lymph nodes or other internal organs or bones (stage IV), it is known as advanced melanoma or metastatic melanoma.
Treatment may include surgery, systemic treatment with immunotherapy or targeted therapy, and radiation therapy. Since the development of more effective treatments, chemotherapy is rarely used to treat melanoma.
In some cases of advanced melanoma, the medical team may talk to you about palliative treatment, which aims to manage symptoms without trying to cure the disease.
It’s important to make sure you stay protected from the sun throughout the year. Make sure you wear a hat and apply sunscreen regularly. It could save your life.
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If you’ve noticed a change to the shape of a mole or a growth on your skin, schedule an appointment with your doctor to have it checked out. It may be nothing but it’s always better to be safe than sorry. The fastest and easiest way to search for and book healthcare appointments online is through MyHealth1st.