| |
Melanoma is the most dangerous type of skin cancer. It may appear as a new spot or as a change in an existing mole or freckle. If caught early, most melanomas can be cured. The biggest risk factor for developing melanoma is overexposure to UV radiation from the sun or artificial sources like solariums.
There are three major types of skin cancer, each named after the type of cell they start from. These are squamous cell carcinoma, basal cell carcinoma and melanoma. Melanoma is the most dangerous. If untreated, melanoma can spread to other parts of the body and may not be curable.
Australia has one of the highest rates of skin cancer in the world. Melanoma is the fourth most common cancer in Australia, with over 2,100 people in Victoria alone diagnosed each year. Melanoma is usually diagnosed in people aged 55 and over – however, young adults, teenagers and even children can be affected. In fact, Australian adolescents have, by far, the highest incidence of malignant melanoma in the world, compared with adolescents from other countries.
Symptoms
The first sign of melanoma is usually a new spot or an existing mole or freckle that changes in appearance. Some of the changes might be:
- The spot may grow larger.
- The edges of the spot may look irregular, rather than smooth.
- The spot may be mottled with a range of colours such as brown, black, blue, red, white or light grey.
- The spot may be itchy or bleed.
The change usually happens over weeks or months, not days.
UV radiation and other risk factors
Overexposure to UV radiation from the sun and other sources is the major cause of melanoma. Repeated bouts of sunburn, particularly during childhood, greatly increase the chance of getting melanoma. Some people are more prone to melanoma because of inherited factors. Adults with fair skin and a large number of moles on their body are at higher risk of melanoma.
The melanin in naturally dark skin offers some protection against the damaging effects of UV radiation and the risk of skin cancer is lower. However, when skin cancer is detected in people with naturally dark skin, it is often found at a later, more dangerous stage when the risk of death is much higher. It is recommended that everyone checks their skin regularly, at least every three months.
While melanoma usually occurs on parts of the body that have been sunburned, it can sometimes start in parts of the skin or other parts of the body that have never been exposed to the sun. Melanomas on the arms and legs are usually detected earlier and have a better chance of cure than melanomas on the body, neck or head (which are usually detected at a later stage).
Once melanoma is diagnosed and treated, regular skin checks are advised, since there is an increased risk of further melanomas developing.
Diagnosis
Melanoma is diagnosed by:
- Physical examination – including medical history.
- Biopsy – under local anaesthetic, the suspected melanoma and some of the surrounding skin is removed. The sample will be examined in a laboratory for signs of cancer.
Further tests
If melanoma is diagnosed, further tests may be needed if surgery is planned or to see if the cancer has spread to other areas of the body. These tests may include:
- Blood tests
- Chest x-ray
- Ultrasound scan
- Magnetic resonance imaging (MRI) scan
- Computed tomography (CT) scan
- Bone scan
- Lymph node biopsy.
Treatment
Most people with melanoma need to have surgery. In some cases, melanoma may be treated by radiotherapy, chemotherapy and other drugs.
Your doctor will advise you on the best treatment for your cancer. This will depend on the type of cancer you have, where it is and how far it has spread, your general health and what you want.
Surgery
Melanomas are usually removed by surgery (except when the melanoma is too advanced). The surgery also removes some normal-looking skin around the melanoma. This is to get rid of any cancer cells in the surrounding skin and prevent the melanoma from growing back at the same site. Most people will be able to have their skin sewn up with normal stitches. If the surgeon needs to take some extra tissue to close the wound, a skin graft or flap may be required.
Radiotherapy
Radiotherapy treats cancer by using radiation to destroy or injure cancer cells. The radiation can be targeted onto cancer sites in your body. Treatment is carefully planned to do as little harm as possible to your normal body tissue. You will probably have radiotherapy once a day from Monday to Friday over several weeks, with a break on the weekends.
The number of visits you need to make will depend on the size and type of the cancer and on your general health. The treatment itself only takes a few minutes.
Chemotherapy
Chemotherapy is the treatment of cancer with anti-cancer drugs. The aim is to destroy cancer cells while doing the least possible damage to normal cells. The drugs work by stopping cancer cells from growing and reproducing and are usually given by injecting the drugs into a vein (intravenous treatment).
In melanoma, chemotherapy is used as palliative treatment to try to control the growth of the cancer. Chemotherapy usually does not cure melanoma.
Complementary and alternative treatments
It’s common for people with cancer to seek out complementary or alternative treatments. Complementary therapies include massage, meditation and other relaxation methods that are used along with medical treatments. Alternative therapies, including some herbal and dietary remedies that are used instead of medical treatment, may be unproven remedies. Some of these have been tested scientifically and found to be ineffective or even harmful.
Before choosing any remedy, discuss it with your doctor or a cancer nurse at the Cancer Council Helpline on 13 11 20. It is important to tell all your health care professionals about any complementary medicines you are taking and never abandon your conventional treatment without consulting your doctor first.
Long-term outlook
More than 85 per cent of people diagnosed 15 years ago with melanoma are alive and well today, with no sign of the disease. This percentage has grown steadily over the years with early detection and treatment, so more people can expect to be cured.
Your medical history is unique, so you will need to discuss with your doctor what you can expect and the treatment options that are best for you.
When cancer can’t be cured
If your cancer has spread and it is not possible to cure it by surgery, your doctor may still recommend treatment. In this case, treatment may help relieve any symptoms, can make you feel better and may allow you to live longer.
Whether or not you choose to have anti-cancer treatment, symptoms can still be controlled. For example, if you have pain, there are effective treatments for this.
General practitioners, specialists and palliative care teams in hospitals all play important roles in helping people with cancer.
Risk of further melanomas
Most people treated for early melanoma do not have further trouble with the disease. However, when there is a chance that the melanoma may have spread to other parts of your body, you will need regular check-ups. Your doctor will decide how often you will need check-ups – everyone is different. They will become less frequent if you have no further problems.
Look after your skin and always take precautions in the sun. If you develop any changes in your skin or enlarged lymph glands near to where you had the cancer, you should see your specialist as soon as possible.
Where to get help
Things to remember
- Melanoma is the most dangerous type of skin cancer.
- A melanoma may appear as a new spot or as a change in the appearance of an existing mole or freckle.
- Treatment depends on whether or not the cancer has spread to other areas of the body and may include surgery, chemotherapy, immunotherapy and radiotherapy.
You might also be interested in:
Cancer.
Cancer - exercise to help you cope.
Cancer and food.
Cancer and heredity.
Cancer pain management.
Cancer treatments - chemotherapy.
Cancer treatments - radiotherapy.
Skin cancer - children.
Skin cancer - prevention and early detection.
Skin cancer - protecting outdoor workers.
Skin cancer - risk factors.
Skin care - tanning.
Want to know more?
Go to More information for support groups, related links and references.
|  |
|
