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Spotlight on Melanoma

What is Melanoma?
Melanoma is a malignant tumour of pigment producing cells called melanocytes. These cells are found in the skin, but also in the meninges which cover the brain and spinal cord, and in the eye. Melanoma most commonly occurs on the skin. Most melanomas are brown-black in colour, but some may be red or skin-coloured. We call these amelanotic melanomas and they are difficult to spot. The incidence of melanoma has risen in the past few decades, which is alarming as it is a tumour that leads to death in young adults. It occurs mainly in white populations , but can occur in other race groups. Melanoma is always malignant and a deadly cancer

What causes Melanoma?
Melanoma develops when melanocytes are damaged in some way and become cancerous. This can occur to melanocytes in a pre existing melanocytic naevus (‘mole’) or to a random melanocyte usually in the skin.

What makes these cells turn cancerous?
The most important contributing factors are sun exposure and sunburns, especially since these are the factors that can be controlled.
Genetic factors that contribute to melanoma risk include skin type, hair and eye colour, the presence of lots of moles and certain gene mutations. Researchers are discovering more and more gene mutations that contribute to causing melanoma. This helps with developing novel treatments for melanoma.

Is there a difference between Melanoma and Skin Cancer?
Melanoma is a one type of skin cancer. It makes up a small percentage of skin cancers but is the most deadly.

Can Melanoma spread?
Yes, melanoma is an aggressive skin cancer and can spread rapidly even though it remains a small spot or nodule in the skin.
In fact sometimes a melanoma can completely disappear on the skin without ever being noticed and first present with metastasis in the body.

Can Melanoma be life threatening?
Yes. Melanoma is one of the most dangerous cancers worldwide and causes death in young people.
But early detection can lead to successful treatment!

Is Melanoma hereditary?
Melanoma can be considered hereditary in some cases as certain gene mutations occur in families. The risk factors like skin colour, eye colour, hair colour and the presence of multiple moles also runs in families.
You have a greater risk of getting a melanoma if you’ve had a close family member who has had a melanoma.

When should I worry about a mole or skin spot?
You should worry about a new ‘spot’ on the skin or an existing melanocytic naevus (‘mole’) that is changing. Most melanomas occur as a new lesion. Only around one third of melanomas develop in pre-existing moles.

Can I reduce my risk of getting Melanoma?
Yes you can with safe sun practice. Do not allow your skin to burn. Do not allow your child’s skin to burn. Stay away from tanning booths.
If you have risk factors for melanoma as discussed above make sure you examine your skin and visit your dermatologist regularly.

How do I examine myself for skin Cancer?
Be aware of changes in your existing moles or new spots that appear on your skin. Sometimes these will be noticed by friends or family who draw your attention to it.
Take a look at your back and the backs of your arms and legs in the mirror, as most people do not look here.

What are my treatment options?
The treatment options for melanoma depends on the depth of the melanoma in the skin. We call this the Breslow depth and it is the most important prognostic indicator.

The best scenario is early detection of a melanoma. Melanomas that are early or ‘thin’ can be cut out completely giving you a normal life expectancy. Beyond a certain depth treatment options are limited with limited survival. These options include surgery, chemotherapy and newer classes of drugs called immunotherapy and targeted therapy. But even though there is lots of ongoing research we still do not have drugs to guarantee long term survival.

The bottom line is, be aware of your body, look after your body and if you have a mole that has changed, or a spot on your skin that is concerning you, contact your Dermatologist immediately.

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Sunspots- when to see a dermatologist?

“Sun spots” is a broad term which includes a range of cancerous and benign lesions. Common types of skin cancer include squamous cell carcinoma (SCC), basal cell carcinoma and melanoma.
Basal cell carcinoma presents as a pearly white, pink or pigmented nodule, a pink scaling patch, a non healing ulcer or an unexplained scar.

Squamous cell carcinoma commonly presents as a pink or brown scaling patch.

Melanoma is the most dangerous of all skin cancers and most often presents as a ‘new’ irregular pigmented spot. Early detection can save lives.

Solar keratoses (Actinic keratoses) are precancerous lesions and 10-25% of these may persist and progress to skin cancer.
It is important to regularly check your skin and be aware of new or changing lesions (spots).

Solar lentigenes are freckles which increase in number with age and cumulative sun exposure. These spots are benign, but should be checked so that a melanoma, which is a deadly skin cancer, is not missed.

Seborrhoeic keratoses (seborrhoeic warts) are warty, pigmented or skin coloured growths, which can occur because of a genetic predisposition and sun exposure.

Visit a dermatologist if you have:
1. Personal or family history of skin cancer
2. Frequent sun exposure with a history of sunburn
3. New or changing ‘spots’
4. Scaling / crusting lesions
5. New or rapidly growing nodules
6. Wound/ulcer that does not heal

While most sun induced spots are benign, it is important to make an early diagnosis of skin cancer
Your dermatologist will be able to make a clinical diagnosis, or perform a skin biopsy if necessary for a histological diagnosis.
It is possible to treat early or newly evolving lesions with non surgical treatment options like freezing with liquid nitrogen or topical creams.
If a skin cancer needs surgery, there is a greater chance of complete cure with an early lesion.
Checking your skin yourself and regular visits to a dermatologist will ensure that all sunspots are diagnosed early and dealt with effectively.