About the Condition
Melanoma is a relatively rare form of skin cancer, but is becoming more common. There are currently around 13,000 new cases diagnosed each year in the UK*. Melanoma is one of the most common cancers in people aged 15-34 and more than a third of cases occur in people under 55*. Melanoma occurs when the genetic material of cells in the skin become damaged or changed, producing mutations that affect normal cell growth and division. The abnormal cells then replicate, causing cancer. If undetected, the cancer can spread beyond the skin and move to other parts of the body.
Most skin cancer is caused by ultraviolet (UV) light damaging the DNA in skin cells. The main source of UV light is sunlight, which can be broken down into 3 different types – UVA, B and C. UVC is filtered out by the Earth’s atmosphere, but UVA and UVB damage skin over time, making it more likely for skin cancers to develop. UVB is thought to be the main cause of skin cancer.
Certain things are believed to increase your chances of developing all types of skin cancer, including:
- Having pale skin that does not tan easily
- Having red or blonde hair
- Having blue eyes
- Entering old age
- Having a large number of freckles
- Having an area of skin previously damaged by burning or radiotherapy treatment
- Having a condition that suppresses your immune system – such as HIV
- Taking medicines that suppress your immune system (immunosuppressants) – commonly used after organ transplants
- exposure to certain chemicals – such as creosote and arsenic
- Previous diagnosis of skin cancer having a lot of moles on your body, especially if they are large (over 5mm) or unusually shaped
- Using artificial sources of light, such as sunlamps and tanning beds
- Experiencing repeated sunburn, either by the sun or artificial sources of light
The first sign of a melanoma is often a new mole or a change in the appearance of an existing mole. Normal moles are usually round or oval, with a smooth edge, and no bigger than 6mm (1/4 inch) in diameter*. See your GP as soon as possible if you notice changes in a mole, freckle or patch of skin, especially if the changes happen over a few weeks or months.
Signs to look out for include a mole that is:
- getting bigger
- changing shape
- changing colour
- bleeding or becoming crusty
- itchy or painful
A helpful way to tell the difference between a normal mole and a melanoma is the ABCDE checklist:
- Asymmetrical – melanomas have two very different halves and are an irregular shape.
- Border – melanomas have a notched or ragged border.
- Colours – melanomas will be a mix of two or more colours.
- Diameter – melanomas are larger than 6mm (1/4 inch) in diameter.
- Enlargement or elevation – a mole that changes size over time is more likely to be a melanoma.
Melanomas can appear anywhere on your body, but they most commonly appear on the back, legs, arms and face. They may sometimes develop underneath a nail.
In rare cases, melanoma can develop in the eye. Noticing a dark spot or changes in vision can be signs, although it is more likely to be diagnosed during a routine eye examination.
If any of these symptoms apply to you, or if you have any concerns about similar symptoms, it is essential that you see your doctor at once, as your chances of recovery are much higher if your cancer is diagnosed early.
If you’re referred to CCL for diagnosis, your consultant or oncologist will advise you on which tests are relevant to your individual symptoms. Because melanoma is a relatively rare cancer, there are a number of different tests needed to confirm a diagnosis. These include:
- A physical examination of the affected area and surrounding area
- A biopsy, where cell samples are taken for examination for signs of cancer
- A Sentinel Lymph Node biopsy, which is a test to determine whether microscopic amounts of melanoma (less than would show up on any X-ray or scan) might have spread to the lymph nodes
- A Computerised Tomography (CT) scan, which shows a 3D image of the area being looked at
- A Magnetic Resonance Imaging (MRI) scan, which is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body
Health professionals use a staging system to describe how far melanoma has grown into the skin (the thickness) and whether it has spread. The type of treatment you receive will depend on what stage the melanoma has reached.
The stages of melanoma can be described as:
- Stage 0 – the melanoma is on the surface of the skin.
- Stage 1 – the melanoma is less than 2mm thick.
- Stage 2 – the melanoma is between 2 and 4mm thick, or thicker
- Stage 3A – the melanoma has spread into nearby lymph nodes or lymphatic channels
- Stage 4 – the melanoma cells have spread to other areas of the body, such as the lungs, brain or other parts of the skin
Each stage consists of several subtle, technical stages, which can best be described to you by your doctor.
At CCL, patients with malignant melanoma are treated by a team of different specialists, called a Multi-Disciplinary Team (MDT). This team works together to create a treatment plan to suit the individual needs of the patient. Treatment options include:
- Surgery, to remove the affected area, and potentially nearby lymph nodes depending on the stage of the cancer
- Radiotherapy, which is where high-energy rays are used to destroy the cancer cells
- Chemotherapy, which involves the use of chemical agents which are toxic to cancer cells, destroying them and preventing them from spreading to different areas. This can be given by injection or in tablet form
Cancer doesn’t just leave a physical impact on an individual, it can have a huge emotional effect as well. Cancer and its treatment can be overwhelming, causing a wide variety of emotions, and it is important to remember that there is no right or wrong response. Reactions vary hugely from person to person, and most people find that it becomes easier to cope when they’re given additional support, so that’s what we do.
At CCL we provide support that caters to both the physical and emotional needs of the patient, before, during and after treatment. We offer a wide range of services for patients, as well as their loved ones, designed to make a very difficult time as easy as possible, and to give our patients the best treatment and support possible.
Because any scarring you may get after treatment is external and visible, you may develop concerns about self-esteem, body image and recurrence. We are here to offer you all the support you need.