Every year over 1500 Australians die from melanoma of the skin. This is a tragedy as these potentially deadly tumours are in plain view on the skin and are completely curable when caught early enough. Though very rare, it is also possible for melanomas to develop in the eye, mouth, intestine and genital areas making early diagnosis much more difficult.
Melanoma is the fourth most common cancer in Australia with 1 in 14 men and 1 in 23 women developing melanoma in their lifetime. The likelihood of a melanoma causing death is closely linked to how thick it is at the time of surgery. Early detection of melanomas is therefore crucial to prevent loss of life.
Melanomas may grow in longstanding moles but are more likely to just appear and grow in normal looking skin.
They are often brown or black but can be tan, pink, grey, red, blue or even skin coloured. They can be perfectly flat or raised with a smooth, crusted or look like an ulcer that won;t heal. Though melanomas are sometimes itchy, more frequently they are not itchy or painful especially early on when they are still curable.
The hallmark of melanoma is change in colour, size or symmetry over weeks or months.
This can easily be missed especially if the tumour is growing on a part of your body that you don’t look at closely or you have a large numbers of moles.
Even though almost all melanomas arise in plain sight on the skin, many are subtle and tricky to diagnose. A visit to a doctor trained in skin cancer medicine who uses a dermatoscope helps dramatically with early detection.
A dermatoscope is a specialised instrument that makes the surface of the skin transparent allowing a trained doctor to clearly see pigment and structures within the skin that will allow her to flag a melanoma early if she has had adequate training. This is much like polarising sun glasses cutting surface reflection on the ocean allowing you to clearly see rocks and fish below.
Adequate surgical excision can be lifesaving if you develop a melanoma.
Often the diagnosis of melanoma is missed with punch biopsy sampling.
If your skin cancer doctor thinks melanoma is at all possible they will do a small excision or shave of the entire suspect spot with a narrow margin of normal skin. Once a diagnosis of melanoma is confirmed, a second excision is undertaken with a margin of normal skin. The width and depth of this margin of normal skin will depend on the thickness of the original melanoma. For thicker melanomas your doctor may also need to discuss lymph node sampling with you.
Having had one melanoma increases the risk of developing others.
We cannot over-stress the importance of ongoing regular skin checks for early detection. Additionally it is important that you do your own skin checks on a monthly basis specifically looking for new or changing spots remembering of course that any future melanoma you develop could look completely different to the first one. A set of close up views of your body (total body photography) will assist you and your skin cancer doctor greatly in detecting a new or changing spot that could be an early melanoma.