Causes & Symptoms
Malignant melanoma is the least common but also the most dangerous type of skin cancer occurring on skin that has a high exposure to sunlight, however it can also occur in places that are covered.
Melanomas usually grow rapidly, from a lump, mole or mark on the skin. They enlarge horizontally as a flat stain, and within months spread, and grow upwards and form an easily-felt lump.
As the melanoma grows it usually becomes darker and sometimes almost black, however in rare conditions it becomes pale pink and grows. Melanomas tend to bleed often after minor injury such as rubbing with clothing or a towel. Itching is the final symptom of melanoma usually experienced around the exterior edge of the mole. In addition, this itchiness can be very frequent.
Large moles, often 6-10 mm or more in diameter, which have a mixture of colour, usually various shades of brown and irregular borders, are more likely to turn into melanoma. They are sometimes inherited and known as a dysplastic naevi, which means under the microscope there is evidence of abnormal cellular growth. Therefore, it is important to monitor these moles for any changes.
Treatment at The Skin Hospital
If melanomas are left untreated they can spread throughout the body and can cause death. Therefore, it is of high importance to keep checking your skin and if you do notice any changes, to book a consultation with one of our specialist doctors. It is important to get a specialist to conduct a skin check instead of trying to resolve the situation yourself by trying to freeze or burn the lump.
The type of treatment you receive will always depend on the type or stage of melanoma you have. Surgery is the most common treatment, however, there are other different treatment options also available. These are as follows:
- Wide Local Excision: This is usually recommended in order to reduce the risk of the melanoma recurring or spreading to other parts of the skin. This procedure removes added skin margins surrounding the melanoma. However, the amount of skin varies depending on the width and depth of the tumour. Most wide local excisions are closed with stitches, but in some cases a skin graft or skin flap will be used.
- Biopsy: This is a fairly simple procedure involving the removal of a suspected melanoma or mole. A local anaesthetic is usually administered and the wound can be closed with a few stitches. The skin that is removed is then sent for histopathological examination, that will assess the tumour progression, the depth and the chances of the cancer spreading.
- Sentinel Node Biopsy: This refers to a type of surgery for when a higher risk melanoma has been diagnosed after an initial biopsy. This determines whether the melanoma has spread. A sentinel node biopsy involves injecting dye into the skin around the melanoma to see if there are any malignant cells. This identifies the first “downstream” node known as the sentinel node. This area of the skin is then removed and sent for further testing to see if malignant cells are present.
- Lymph Node Dissection: this is where the melanoma has spread to the sentinel nodes in regional node groups such as the armpit, neck or groin. The melanoma can linger here before spreading to organs. This treatment usually involved removing all the nodes in the invaded area.
Furthermore, depending on the size of the treated melanoma, further reconstructive surgery may be needed, such as:
- Skin Graft: this is when a biopsy or wide local excision is too big for stitches. This results in removing skin from another part of the body in order to cover the wound.
- Flap repair: This involves lifting and moving skin over the wound without the skin being cut away.
The Skin Hospital runs a speciality clinic dedicated to the treatment of skin cancers at Darlinghurst and Westmead. If you would like to find out more about this speciality clinic please contact us. The following doctors specialise in the treatment of skin cancers:
|Dr Simon Lee|
Darlinghurst & Westmead
|Dr Tasman Lipscombe|
|Dr Nicholas Stewart|
Darlinghurst & Westmead
|Dr Gilberto Moreno-Bonilla|
If you would like any further information on melanoma, the sites below provide more in-deptj descriptions of melanoma: