Melanoma: What is it and what are the causes and symptoms?

What is melanoma

What is melanoma?

Melanoma is a type of skin cancer which usually occurs on the parts of the body that have been overexposed to the sun. Rare melanomas can occur inside the eye or in parts of the skin or body that have never been exposed to the sun.

Melanoma is the third most common cancer diagnosed in Australia, which along with New Zealand has the world’s highest incidence rate for melanoma. It is more commonly diagnosed in men than women and the risk of being diagnosed with melanoma by age 85 is 1 in 13 for men compared to 1 in 22 for women.1

In 2014, 13,134 new cases of melanoma were diagnosed in Australia, accounting for nearly one in ten cancer diagnoses.

In Australia in 2015, there were 1520 deaths.

Symptoms

Often melanoma has no symptoms, however, the first sign is generally a change in an existing mole or the appearance of a new spot. These changes can include:

  • colour? a mole may change in colour or have different colour shades or become blotchy
  • size? a mole may appear to get bigger
  • shape? a mole may have in irregular border or may increase in height
  • elevation? the mole may develop a raised area
  • itching or bleeding.

Other symptoms include dark areas under nails or on membranes lining the mouth, vagina or anus.

New moles and spots will appear and change during childhood, adolescence and during pregnancy and this is normal. However, adults who develop new spots or moles should have them examined by their doctor.

Causes

Your risk increases with exposure to UV radiation from the sun or other sources such as solariums, particularly with episodes of sunburn (especially during childhood).

Melanoma risk is increased for people who have:

  • unprotected sun exposure
  • a history of childhood tanning and sunburn
  • a pattern of short, intense periods of exposure to UV radiation
  • increased numbers of unusual moles (dysplastic naevi)
  • depressed immune systems
  • a family history of melanoma in a first degree relative
  • fair skin, a tendency to burn rather than tan, freckles, light eye colour, light or red hair colour
  • had a previous melanoma or non-melanoma skin cancer.

Diagnosis

If you have a suspicious spot or mole, your doctor may examine you and use a dermascope (magnifying instrument). The ABCDE method is used to help identify symptoms and make a diagnosis:

  • A – Asymmetry, irregular
  • B – Border, uneven
  • C – Colour
  • D – Diameter (usually over 6mm),
  • E – Evolving (changing and growing).

If the doctor suspects melanoma, a biopsy may be carried out. This may be done by your GP or you may be referred to another specialist.

Treatment

Staging

The most important feature of melanoma in predicting its outcome is its thickness.

  • stage 0 is less than 0.1mm
  • stage I less than 2mm
  • stage II greater than 2mm
  • stage III spread to lymph nodes and
  • stage IV distant spread.

The presence of ulceration also predicts a poor outcome. If distant spread is suspected, CT scans of the chest, abdomen and pelvis are performed. The blood test LDH can sometimes be useful to assess metastatic disease.

Early-stage

Surgery can be curative for thin melanomas and requires that the melanoma be removed with at least 1?2cm of normal skin around it. If the draining lymph nodes are involved they are removed.

If the melanoma has spread to the lymph nodes, you will have a lymph node dissection or lymphadenectomy to remove them. If lymph nodes have been removed, your neck, arm, or leg may swell. This is called lymphoedema.

If there is a risk that the melanoma could come back, you may be offered additional treatments. These can include immunotherapy and targeted therapy.

Advanced

Treatment for advanced melanoma, where the cancer has spread to lymph nodes, internal organs or bones, may include surgery, radiation therapy targeted therapy or immunotherapy.

Surgery may be used to treat metastatic melanoma that involves other parts of the skin. Surgery may also still be possible if the melanoma has spread to other organs but will depend on the part of the body that is affected.

Radiotherapy may be of benefit in treating some forms of melanoma. It may be used:

  • when cancer has spread to the lymph nodes
  • after surgery to prevent the cancer returning
  • in combination with other treatments
  • as palliative treatment

Targeted therapy drugs attack specific genetic changes (mutations) that allow melanomas to grow and spread while minimising harm to healthy cells. It is most commonly used for melanomas that have spread to other organs or if it has come back after treatment.

Immunotherapy uses drugs to stimulate the body’s immune system in order to recognise and fight cancer cells. Ipilimumab, nivolumab and pembrolizumab are three immunotherapy drugs approved for treatment of advanced melanoma.

Palliative care

In some cases, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.

As well as slowing the spread of melanoma, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.

Preventing

Avoid sunburn by minimising sun exposure when the UV Index exceeds 3 and especially in the middle of the day when UV levels are most intense. Seek shade, wear a hat that covers the head, neck and ears, wear sun protective clothing and close-fitting sunglasses, and wear an SPF30+ sunscreen. Avoid using solariums.

If you would like a skin check our General Practitioners at Brighton and Oakleigh are now available.

Book in and get yourself checked today.

 

This post was originally published on the Cancer Council website.

Source: https://www.cancer.org.au/about-cancer/types-of-cancer/skin-cancer/melanoma.html

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