skin cancers
Melanoma
Melanoma is cancer of the skin's melanocytes (pigment cells) and the most dangerous form of skin cancer. If untreated, it can spread to other parts of the body.
A Melanoma may appear as a new spot on normal skin, or develop from an existing mole. If detected early, most melanomas are curable. Later, they become more serious. Melanomas usually begin as a flat spot that changes in size or shape or colour over months. While they are flat they are generally curable.
There are two main types of melanoma.
- Superficial spreading melanoma. It has an uneven, smudgy outline and is an irregular mix of colours.
- Nodular melanoma grows more quickly; it is raised from the start and even in colour. They may be red or pink; some are brown or black.
Melanomas can also arise in areas with minimal sunexposure such as the sole and palms (acral melanomas), under the finger nails (subungal melanomas) and on mucosal surfaces of the body.
Treatment of melanoma
Melanomas are always removed by surgery. The tumour is cut out, along with an area of normal-looking skin from around the melanoma. The amount of normal skin removed depends on the thickness of the melanoma, and may be from 5mm to 2cm.
In cases where there is limited ‘spare’ skin, skin grafts or skin flaps may be required.
For a graft, a layer of skin is taken from another part of your body and placed over the wound. New blood vessels then grow into the graft. A flap involves moving adjacent skin into the defect from an area of relative excess to close the wound.
Mr Bloom will decide which the most appropriate method of closure is in your particular case.
Regular follow-up, will be arranged following your surgery, as people who have had one melanoma are at increased risk of another melanoma in the future. An important part of your regular follow-up will be the examination of your lymph nodes.
Unfortunately compared with many other forms of cancer there is little in the way of radiotherapy or chemotherapy to additionally treat your melanoma.
Through his association with the Victorian Melanoma Service at the Alfred Hospital, Mr. Bloom is constantly updated on the latest treatment options, including potential trials using vaccines. At present none of these treatments are available outside of a trial setting and are generally reserved only for those with advanced disease.
One area showing some promise in the management of melanoma is sentinel node biopsy. This is a surgical procedure undertaken at the time of your excision, where the first (sentinel) draining lymph node is removed and sent for histological examination. At this time the procedure itself is not thought to be therapeutic but rather only provides additional prognostic information about your melanoma.
The decision whether to undergo such a procedure is a difficult one with many implications. Mr. Bloom will discuss all the pros and cons of having such a procedure.