Melanoma
Melanoma is the 3rd most common skin cancer in Australia. Around 9000 Australian are diagnosed with melanoma each year and about 1000 die from this disease each year. However, early diagnosis and treatment can greatly improve survival.
Melanoma in situ, or Level 1 melanoma, is confined to the top layer of the skin and is not as yet “invasive”. It is totally curable if completely excised. As melanoma grows in thickness the cure rate becomes greatly reduced. So it is most important that melanoma is detected as early as possible. A patient with a melanoma of less than 0.75 mm thick can expect to have 95% cure rate however, if the melanoma is 4mm thick the patient’s life expectancy on average is less than 50% at 5 years.
Risk factors for development of melanoma
The most important risk factor in Australia is excessive exposure to natural sun light in fair skinned individuals.
Sunscreen does not protect susceptible individuals but wearing protective clothing does.
Other common risk factors are: large number of moles, especially irregular shaped moles, large birth marks and family history of melanoma
Types of melanoma
- Superficial spreading melanoma is most common type and most amendable to simple excision.
- Nodular melanoma is the most dangerous melanoma as they are often very thick when diagnosed
- Lentigo maligna melanoma this type is most commonly found in elderly patients usually on the face or neck
- Melanoma in situ is the earliest form of melanoma and is totally curable with complete excision.
- Acral melanoma is on the sole of the foot or on the palm of the hand – it is uncommon and often goes unnoticed
Treatment options:
It is very important to avoid excessive sun-exposure in early life and, remember sun-screen may not prevent development of melanoma so wearing protective clothing is your most important insurance against this disease.
Melanomas are curable in the majority if diagnosed and treated early. excision. The gold standard of treatment for melanoma is complete excision, with a border of normal skin included in the excision: 0.5mm margin for in situ melanoma and 1.00 – 2.00 cm for more advanced melanoma.
Pictures of melanoma (Click to enlarge)
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Benign lesions which are commonly seen and may look like melanoma
- Seborrheic keratosis - very common and often called an aged-wart, senile wart or greasy wart
- Solar lentigo - flat brown lesion and known as liver spot or age spots – these are related to the seborrheic keratosis
- Haemangioma - a small blood blister-like lesion which is reddish or purple; there are usually quite a few present and can be a nuisance when nicked by the razor during shaving – they bleeds profusely!