Melanoma is a type of skin cancer. It develops from the melanocytes (pigment cells) and usually occurs on parts of the body that have been overexposed to the sun. Rare melanomas can also start in a part of the skin or body that has never been exposed to the sun.
Although one of the less common types of skin cancer, melanoma is considered the most serious types of skin cancer because it is more likely to spread to other parts of the body, especially if not detected early. The earlier melanoma is found, the more successful treatment is likely to be.
On this page you will find information on:
- Types of melanoma
- How common is melanoma?
- What are the risk factors?
- What are the symptoms of melanoma?
- How is melanoma diagnosed?
- What is the treatment for melanoma?
- What is the prognosis for melanoma?
- What support is available?
Types of melanoma
The major subtypes of skin (cutaneous) melanoma are:
Superficial spreading melanoma
This is the most common type of melanoma, making up almost 55-60% of all cases. It is more common in younger people and is often related to a pattern of irregular high sun exposure, including episodes of sunburn. It can start as a brown or black spot that spreads within the outer layer of the skin (epidermis), or an existing spot, freckle or mole that changes size, colour or shape. This type of melanoma becomes dangerous when it invades the lower layer of the skin (dermis).
This type makes up about 10-15% of melanomas. It usually appears as a round, raised lump on the surface of the skin that is often red, pink, brown or black and feels firm to touch. It is most commonly found in older people on severely sun-damaged skin on the head and neck. It is a fast growing and aggressive form of melanoma, so if suspected it is important to see your GP (general practitioner) without delay.
Lentigo maligna melanoma (LMM)
This type of melanoma is most common in older people. It makes up about 10-15% of melanomas and begins as a large freckle (lentigo maligna) in an area of sun-damaged skin, such as the face, ears, neck and head. It may grow slowly and superficially over many years until it penetrates more deeply into the skin.
Acral lentiginous melanoma
This is an uncommon type of melanoma that is most commonly found on the palms of the hands, soles of the feet or under the fingernails or toenails. It commonly appears as a colourless or lightly pigmented area, which may be mistaken for a stain or bruise. In the nails it most often presents as a long streak of pigment in the nail or discolouration in the skin around the nail.
This is another uncommon type of melanoma that presents as a firm, progressively growing lump, often on the head or neck. Many are skin-coloured and not pigmented.
Other types of melanoma
There are some other rarer types of melanoma, which start in the tissues in the mouth, nervous system, anus and nasal passages. Ocular melanomas start in the eye.
How common is melanoma?
Australia and New Zealand have the highest rates of melanoma in the world. More than 3600 people are estimated to be diagnosed with melanoma in Queensland every year. Melanoma is the third most common cancer in both men and women. One in 14 men and one in 24 women will be diagnosed with melanoma before age 85. Although melanoma is more common in people aged over 60, it is among the most commonly diagnosed cancers in all age groups.
What are the risk factors?
The main risk factor associated with all types of skin cancers is overexposure to UV radiation from the sun or another source, such as solariums (tanning beds). When your unprotected skin is exposed to UV radiation, the structure and behaviour of the cells can change.
Overexposure to UV radiation can permanently damage the skin. This damage adds up over time. Even though sun protection during childhood is very important, increased protection against sun exposure will prevent melanoma at any age. Anyone can develop melanoma, however the risk is higher in people who have:
- Unprotected exposure to the sun
- A history of childhood tanning and sunburn
- Lots of moles
- Moles with irregular shape and uneven colour
- A previous melanoma or other type of skin cancer
- A strong family history of melanoma
- Pale, fair or freckled skin, especially if it burns easily and doesn’t tan
- Experienced short, intense periods of exposure to UV radiation, especially if it caused sunburn
- Light coloured eyes, and fair or red hair
- A weakened immune system
What are the symptoms of melanoma?
Melanoma can vary greatly in the way it looks. In people who have lots of moles, melanomas stand out and look different from the other moles. The first sign is usually a new spot or a change in an existing mole.
- Size – The spot may appear or grow larger.
- Colour – The mole may become increasingly blotchy with different depth and shades of colour (brown, black, blue, red, white, light grey, pink or skin-coloured).
- Shape or border – The spot may increase in height, become scaly, have an irregular edge (scalloped or notched) or lack symmetry (the halves look different).
- Itching or bleeding – The mole may itch or bleed at times.
- Elevation – the spot may start as a raised nodule or develop a raised area, which are often reddish or reddish brown.
It is normal for new moles to appear and change during childhood and teenage years, and during pregnancy. However, all adults who develop a new mole should see their doctor to get it examined, particularly if it is noticeably different from your other moles, or is raised, firm and growing. Even if you have had a mole checked before and it was benign, it is important to monitor your skin as the mole could change in the future. Talk to your doctor immediately about any changes.
How is melanoma diagnosed?
Physical examination – if you notice any changes to your skin, your doctor will examine you, paying particular attention to any spots you have identified as changed or suspicious. The doctor will ask if you or your family have a history of melanoma.
Removing the mole (excision biopsy) – If the doctor suspects that a spot on your skin may be melanoma, the usual procedure is to remove the whole spot for examination by a pathologist. This is generally a quick and simple procedure in your doctors office. Your GP may do it, or you may be referred to a dermatologist or plastic surgeon.
Checking the lymph nodes – If the melanoma has been diagnosed, the doctor will check the nearby lymph nodes to see if the cancer has spread. This provides more accurate information about the stage of the melanoma.
What is the treatment for melanoma?
Melanoma that is found early can generally be treated successfully with surgery. If the melanoma has spread to nearby lymph nodes or tissues, treatment may also include removal of the lymph nodes and adjuvant treatments.
- Surgery – is the main treatment for early stage melanoma. Most of the time it is the only treatment needed.
- Removing the lymph nodes – if the sentinel lymph node biopsy showed that the melanoma has spread to your lymph nodes, they will be removed in an operation.
- Adjuvant therapies – if there is a risk that the melanoma could come back, other treatments are sometimes used after surgery such as radiation therapy, targeted therapy, immunotherapy.
For more information on the treatment of melanoma please refer to the Understanding Melanoma booklet.
What is the prognosis for melanoma?
Prognosis means the predicted outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of the disease.
Melanoma can be treated most effectively in its early stages when it is still confined to the top layer of the skin (epidermis). The deeper a melanoma penetrates into the lower layers of the skin, the greater the risk that it could spread to the nearby lymph nodes or other organs.
In recent years, clinical breakthroughs have led to new treatments that continue to improve the prognosis for people with advanced melanoma.
Discussing your prognosis and thinking about the future can be challenging and stressful. It may help to talk with family and friends. You can also call Cancer Council 13 11 20 if you need more information or emotional support.
What support is available?
Whether you have been diagnosed with a melanoma, or have a family member or friend who is affected by cancer, there are times when you may need support. Our professional services and support programs are here to help you.
Find out more about:
- Phone support
- Email support
- Cancer counselling
- Practical and financial support
- Support groups
- Information sessions
You don’t have to face cancer alone – we’re here to help.
You can also refer to the Melanoma What to Expect guide to help you make sense of what should happen, and to help you with what questions to ask your health professionals to make sure you receive the best care at every step.