Melanoma Patient Information - what you need to know

What is melanoma?

Melanoma is a type of skin cancer that happens when the cells in your skin that make color (called melanocytes) start to become cancerous. This can cause a dark, irregular spot on your skin that may be itchy or bleed. It's important to protect your skin from the sun's harmful rays to help prevent melanoma. In fact, Australia has the highest rates of melanoma in the world, so it's especially important to be sun-safe here.

Melanoma can develop anywhere on your skin, but it's more likely to occur in areas that get a lot of sun exposure, like your face, neck, arms, and legs. However, it's important to note that melanoma can also occur in other areas of the body that are not exposed to the sun, such as the palms of the hands, soles of the feet, and nails.

What are the signs of melanoma?

Melanoma can appear as a new spot on your skin or as a change in an existing mole. Some of the signs to look out for include:

• A mole or spot that is asymmetrical (one half looks different from the other half)

• A mole or spot with an irregular border (the edges are not smooth)

• A mole or spot that is multicolored (it has different shades of brown, black, or red)

• A mole or spot that is larger than a pencil eraser

• A mole or spot that is changing in size, shape, or color, or is bleeding spontaneously

How can melanoma be prevented?

The best way to prevent melanoma is to protect your skin from the sun. You can do this by:

• Wearing protective clothing, like a long-sleeved shirt, pants, and a wide-brimmed hat

• Applying broad-spectrum SPF 50+ to all exposed skin, and reapplying every 4 hours or after swimming or sweating

• Seeking shade when the sun is strongest, between 10 a.m. and 4 p.m.

What are the different types of melanoma?

There are several types of melanoma, which are classified based on how deeply they have grown into the skin:

1. Melanoma in situ: This is the earliest stage of melanoma, where the cancer cells are only in the top layer of the skin. It's also called stage 0 melanoma and has a very high cure rate. The five-year survival rate for melanoma in situ is nearly 100%. Melanoma in situ is usually not life-threatening, but it can become invasive if left untreated.

2. Lentigo maligna: This is a type of melanoma that usually affects older people who have spent a lot of time in the sun. It typically starts as a flat, dark spot on the face, neck, or other sun-exposed area, and slowly grows over several years. It is highly curable if caught early and treated. 

3. Invasive melanoma: This is the most serious type of melanoma, where the cancer cells have grown deeper into the skin and can spread to other parts of the body. Invasive melanoma can be life-threatening if not detected and treated early. The prognosis for invasive melanoma depends on the stage of the cancer. If it's caught early, when the cancer cells have not spread from the original tumor, the five-year survival rate is around 95%. However, if it has spread to other parts of the body, the prognosis is much worse.

How is melanoma treated?

The treatment of melanoma is highly dependent on the type of melanoma and the stage. The treatments for the different types of melanoma include:

1. Melanoma in situ: The standard treatment for melanoma in situ is wide local excision, which involves removing the entire lesion and a margin of normal-looking skin around it. In some cases, a flap or skin graft may be needed to cover the area where the skin was removed.

2. Lentigo maligna: The treatment for lentigo maligna depends on the size and location of the lesion. It is usually also treated with a wide local excision. In some cases, the lesion may be too large or too difficult to remove with surgery. In these cases, a topical cream called imiquimod may be used. Imiquimod is a type of immune system stimulant that helps the body's own defenses to attack the cancer cells. The cream is applied to the affected area for several weeks or months, and may cause redness and irritation.

3. Invasive melanoma: The treatment for invasive melanoma will depend on the stage and location of the cancer. In most cases, surgery is the main treatment, and may involve a wide local excision to remove the tumor and surrounding tissue. In some cases, lymph nodes may also be removed if there is a risk that the cancer has spread to them.

In addition to surgery, there are other treatment options for advanced melanoma that has spread to other parts of the body. These include:

• Immunotherapy: This is a type of treatment that helps the immune system to attack the cancer cells. There are several different types of immunotherapy drugs that may be used to treat melanoma, including checkpoint inhibitors and targeted therapies.

• Radiation therapy: This involves using high-energy radiation to kill cancer cells. It may be used in combination with surgery or as a standalone treatment for advanced melanoma.

It's important to note that the specific treatment plan will vary depending on each individual's circumstances. 

What should you do if you have been diagnosed with a melanoma?

If you have been diagnosed with a melanoma-in-situ, lentigo maligna or invasive melanoma, make an appointment with a dermatologist as soon as possible. They will confirm the diagnosis and work with you to develop a treatment plan that is tailored to your specific circumstance. They will also advise on future monitoring and prevention.