Melanoma

Australian’s suffer the highest rates of skin cancer in the world and each year around 1600 Australian’s die from what is mostly a preventable disease.

There are three major types of skin cancer, squamous cell carcinoma, basal cell carcinoma and Melanoma. Melanoma is the most dangerous and if left untreated can spread to other parts of the body and may not be curable.

Symptoms
The first sign of melanoma is usually a new spot or an existing mole or freckle that changes in appearance. Some changes might be;

• The spot may grow larger
• The edges may look irregular rather than smooth.
• The spot may be mottled with a range of colours, black, brown, blue, red, white or grey.
• The spot may be itchy or may bleed.
• The change usually happens over weeks or months, not days.

Risk Factors
Overexposure to UV radiation from the sun and other sources is the major cause of melanoma. Repeated bouts of sunburn, particularly during childhood greatly increases the chance of melanoma.

People with fair skin are at a higher risk. The melanin in darker skin offers some protection against UV radiation but is no substitute for sunscreen or protective clothing.

Hereditary factors play an important part in your chances of skin cancer. Skin type is genetic so if one or both of your parents have had a skin cancer you could be at risk.

Solariums tan the skin by radiating it with UVA and UVB radiation. Both these types of radiation are dangerous to the skin. UV radiation from a solarium is also more intense than natural sunlight, emitting up to 5 times as strong as the midday summer sun.

Diagnosis
Physical examination, including medical history.
Biopsy where part of the suspected melanoma is removed and tested.

If melanoma is diagnoses then further tests will be needed to see if the cancer has spread and will include x-rays and blood tests, ultra sound, MRI, CAT and bone scans and Lymph node biopsy.

Treatment
Treatment depends on how advanced the melanoma is and there are 3 main stages, Early (stage 1) High risk (stages 2 and 3) and Advanced.

Treatment for early stage when there is no spread involves having the mole removed with surgery. This is usually done in your Doctor’s surgery under local anaesthetic and he will take the mole plus a margin of surrounding skin and is usually the only treatment required.

Treatment for high-risk melanoma, or stages 2 and 3 is due to the melanoma having spread to deeper skin layers and the affected tissue will have to be removed under general anaesthetic. The wound may be stitched or require a skin graft. You will be tested to see if the cancer has spread to lymph nodes in your groin, armpits and neck and if so these may also need removal. This can be a big operation and may be followed by radiotherapy, which involves precise targeted x-rays to kill any remaining cells.

Treatment for advanced melanoma may include chemotherapy, radiotherapy or immunotherapy or a combination of the three. This treatment will not cure the cancer but will help control it.

Summary
Melanoma is the most dangerous type of skin cancer and can appear as a new spot or as a change in the appearance of an existing mole or freckle. Obviously the earlier the detection the less the chance of the cancer spreading and the greater the chance of a successful treatment. Those of us that are a wee bit older and cover up well now are not suddenly immune as we all spent too much time in the sun as kids and we should be even more vigilant with any changes to our skin as the damage was done years ago.

Sources of information include www.medicalonline.com.au  and www.betterhealth.vic.gov.au