Australia has one of the highest rates of skin cancer in the world. Two in 3 Australians will be diagnosed with skin cancer by the age of Excluding non-melanoma skin cancers, melanoma is the third most common cancer in Australia. It is most commonly 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 for their age group in the world.
Melanoma and other skin cancers generally develop from overexposure to UV radiation. Each time unprotected skin is exposed to UV radiation from the sun or artificial sources, changes take place in the structure of the cells. Too much UV radiation causes the skin to become permanently damaged, which will worsen with each exposure. Skin cancer can grow when the cells that make up your skin are damaged, causing them to grow abnormally. Every additional decade of overexposure to UV further increases your risk of skin cancer.
Increased use of sun protection will help prevent skin cancer and melanoma at any age. All skin types can be damaged by exposure to UV radiation. People with skin types that are less likely to burn are still at risk of developing skin cancer although this risk is lower than for people with skin types that are more likely to burn.
People with one or more risk factors are at increased risk of melanoma. Risk factors for melanoma are:. The melanin in naturally very dark skin offers some protection against the damaging effects of UV radiation and lowers the risk of skin cancer.
However, when skin cancer is detected in people with naturally very dark skin, it is often found at a later, more dangerous stage when the risk of death is much higher.
The first sign of flat melanoma is usually a new spot or an existing mole or freckle that changes in appearance. Some changes might include:. Melanoma can grow very quickly. It can become life-threatening in as little as 6 weeks and, if untreated, it can spread to other parts of the body. Melanoma can appear on skin not normally exposed to the sun. Nodular melanoma is a highly dangerous form of melanoma that looks different from common melanomas. Nodular melanomas are raised and are even in colour often red or pink and some are brown or black.
This type of melanoma grows quickly and can be life-threatening if not detected and removed quickly. See your doctor immediately if you notice any of these changes.
It's important to get to know your skin and what is normal for you, so you will notice any changes quickly. Check all of your skin, not just sun-exposed areas. If you notice anything unusual, including any change in shape, colour or size of a spot, or the development of a new spot, visit your doctor immediately. While melanomas usually occur on parts of the body that have been sunburned, they 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 successful treatment than melanomas on the body, neck or head which are usually detected at a later stage. Once a melanoma is diagnosed and treated, you are advised to have regular skin checks, as there is an increased risk of further melanomas developing.
Test results can take a few days to come back. It is very natural to feel anxious waiting to get your results. It can help to talk to a close friend or relative about how you are feeling. You can also contact the Cancer Council on Tel.
If a 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:. Most people with melanoma need to have surgery. In some cases, melanomas may be treated by immunotherapy and targeted therapy, chemotherapy , and less frequently radiotherapy.
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, how far it has spread, your general health and what you want. Melanomas are usually removed by surgery except when the melanoma is too advanced. Early diagnosis and treatment will give you the best chance of making a full recovery.
If you are diagnosed with nodular melanoma, remember that treatment options are available and many people live a long, healthy life after their diagnosis.
Treatment often includes surgery and, if the cancer has spread, may require further treatments like chemotherapy. Don't hesitate to find a support group or counseling, which may be beneficial in navigating the psychological toll of dealing with a cancer diagnosis and treatment.
Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Overview skin cancer melanoma. Updated February 7, Improving the early diagnosis of early nodular melanoma: can we do better?
Expert Rev Anticancer Ther. Memorial Sloan Kettering Cancer Center. Nodular melanoma. Patient-identified early clinical warning signs of nodular melanoma: a qualitative study.
BMC Cancer. DermNet NZ. Updated June Updated Melanoma risk factors, causes and prevention. Medline Plus. Updated January 21, American Cancer Society. Adjusting to life with cancer. Updated November 23, Psychosocial support options for people with cancer.
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Thanks for your feedback! It is measured vertically in millimetres from the top of the granular layer or base of superficial ulceration to the deepest point of tumour involvement. It is a strong predictor of outcome; the thicker the melanoma, the more likely it is to metastasise spread. The deeper the Clark level, the greater the risk of metastasis secondary spread.
It is useful in predicting outcome in thin tumours and less useful for thicker ones in comparison to the value of the Breslow thickness. The initial treatment of primary melanoma is to cut it out; the lesion should be completely excised with a cm margin of normal tissue.
Further treatment depends mainly on the Breslow thickness of the lesion. After initial excision biopsy; the radial excision margins, measured clinically from the edge of the melanoma, recommended in The Australian and New Zealand Guidelines for the Management of Melanoma are shown in the table below. This may necessitate a flap or graft to close the wound. Occasionally, the pathologist will report incomplete excision of the melanoma, despite wide margins. This means further surgery or radiotherapy will be recommended to ensure the tumour has been completely removed.
Melanoma staging means finding out if the melanoma has spread from its original site in the skin. In essence, the stages are:. If the local lymph nodes are enlarged due to metastatic melanoma , they should be removed entirely. This requires a surgical procedure, usually under general anaesthetic. If they are not enlarged, they may be tested to see if there is any microscopic spread of melanoma.
The test is known as a sentinel node biopsy. In New Zealand, many surgeons recommend sentinel node biopsy for melanomas thicker than 1 mm, especially in younger persons. However, although the biopsy may help in staging cancer, it does not offer any survival advantage.
The necessity for sentinel node biopsy is controversial at present. Lymph nodes containing metastatic melanoma often increase in size quickly. An involved node is usually non-tender and firm to hard in consistency. If this occurs between planned follow-up visits, let your doctor know promptly. If the melanoma is widespread , other forms of treatment may be necessary but are not always successful in eradicating cancer.
Immunotherapy , biologics such as ipilimumab , and the BRAF inhibitors dabrafenib and vemurafenib are showing promise. The primary purpose of follow-up is to detect recurrences early, but it also offers an opportunity to diagnose a new primary melanoma at the first possible opportunity. The Australian and New Zealand Guidelines for the Management of Melanoma make the following recommendations for follow-up for patients with invasive melanoma. The follow-up appointments may be undertaken by the patient's general practitioner or specialist, or they may be shared.
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