Melanoma

Condition

• Melanoma

Definition

History

• Risk factors for melanoma
• Older age
• Men > Women
• History of sun burn (Melanoma is more associated with episodic intense sunburns than more continuous sun exposure).
• past history of melanoma increases risks by 10 fold
• non melanoma skin cancer may increase the risk fourfold 
• Family history: first-degree relative doubles the risk of a person developing melanoma

Examination

• examine the whole skin surface under good lighting 
• if melanoma is suspected, the patient should be examined for enlarged lymph nodes in the appropriate draining area (e.g. axial or groins)

Investigation 

• excisional biopsy if possible: 
• stage 0 < 0.1mm
• stage 1 < 2 mm without ulceration or up to 1mm with ulceration 
• stage 2 > 2mm 
• Stage 3: spread to lymph nodes
• stage 4: distant spread

Management

• excisional biopsy 
• often requires referral

Key points:

• In Australia, it has been shown that up to 75% of patients detect their own recurrences.
• No evidence that earlier detection by routine scans or examinations improves the outcome.
• Instruct patient to gain awareness of lesions on their skin and report any persisting symptoms promptly.
• Sun protection when the ultraviolet (UV) index is 3 or above to prevent further skin damage and subsequent skin cancers

References:

Check program 2015 September Cancer