Malignant Melanoma is the least common but, frighteningly, the most dangerous of all the skin cancers. Melanoma accounts for the majority of skin cancer deaths, but fortunately, it is the rarest of skin cancers. It is nearly always curable if diagnosed early.
Melanoma does not always develop from a pre-existing mole. Overall, this occurs only 50% of the time (more likely in younger patients approximately 2/3 under the age of 30, it is less likely in older patients, approximately 1/3 over the age of 50).
You must be on the lookout for a change in a mole, but also be highly suspicious of any newly appearing spot on your skin, especially if it is dark in colour and seems to stand out from surrounding skin spots.
Melanoma can occur at any age, though is very rare before puberty. We have certainly treated melanomas in teenagers.
Melanoma does have a strong genetic tendency, so family history is important. Indeed some families are extremely prone.
It is not restricted to the sun-exposed areas only as sometimes it occurs in areas that have never seen the sun.
What should I look out for?
Melanoma should be suspected in the following situations:
- Sudden or recent change in a mole
- The recent appearance of a new dark spot or “freckle”, especially if it is enlarging and looks different to nearby spots.
- The recent appearance of a spot of any colour for which there is no reasonable explanation, especially if it is continuing to grow.
The ABC of Melanoma
The following are features suggestive of Malignant Melanoma:
A Asymmetry – Does the mole or spot have an irregular shape with two parts that look very different?
B Border – Is the border jagged or irregular?
C Colour – Is the colour uneven?
D Diameter over 6mm (the size of a pea)
E Evolving – Has the mole or spot changed during the past few weeks or months?
Diagnosis and Treatment
Melanoma is diagnosed with a skin biopsy and subsequent microscopic examination by a pathologist.
Treatment always involves surgery, but the degree of surgery required varies according to the melanoma in question. In general, though, early melanomas do not require radical surgery.
Early melanomas do not require any further treatment or investigative workup. Patients with more advanced melanoma will frequently require further tests to see if the melanoma has spread beyond the skin and may well require additional surgery, radiotherapy or chemotherapy.
Remember, virtually all melanomas diagnosed early can be cured, however, delay in diagnosis is the major reason why melanomas become advanced. Very advanced melanomas are rarely curable.