Information and symptoms of melanoma

Melanoma is a type of skin cancer. There are three main types of skin cancer that are named after the cells that are affected: squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and melanoma. Melanoma develops from the melanocytes (pigment cells).

Melanoma is one of the least common skin cancers. However, it is one of the most serious types because it is more likely to spread to other parts of the body, especially if not detected early. If melanoma is found early, treatment is often successful.

On this page you will find information on:

Types of melanoma

Skin melanomas (cutaneous melanomas) are categorised by their appearance, thickness and how far they have spread.

Superficial spreading melanoma – This is the most common type of melanoma, making up almost 50% of all cases. It starts as a brown or black spot that spreads across the outer layer of the skin (epidermis). This type of melanoma becomes dangerous when it invades the lower layer of the skin (dermis).

Nodular melanoma – This type makes up about 10% of melanomas. It is usually a raised lump on the surface of the skin that is often red, pink, brown or black and feels firm to touch. 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% of melanomas and begins as a large freckle (lentigo maligna) in an area of skin that has had a lot of sun exposure, 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. These commonly present as a lightly pigmented, sometimes warty area and do not respond to treatments for warts or tinea. In the nails, they most often present as a long streak of pigment in the nail or discolouration in the skin around the nail.

Desmoplastic melanoma – 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 eyes, nervous system, anus, genital tract (urethra and vagina) and tissues that line the inside of the nose.

Melanoma in-situ – This is when the abnormal cancer cells are only contained in the area where the cancer cells have started to develop. This is the earliest stage of Melanoma, and it has not yet become invasive.

How common is melanoma?

Australia and New Zealand have the highest rates of melanoma in the world. Over 3100 people are estimated to be diagnosed with melanoma in Queensland every year. Melanoma is the third most common cancer in women and the second most common for men. It accounts for 13% of all cancer diagnoses. One in 13 Queenslanders will be diagnosed with melanoma before age 85.

What are the risk factors?

The main cause of all types of skin cancers is exposure to ultraviolet (UV) radiation from the sun or another source, such as a solarium tanning machine. Each time your unprotected skin is exposed to UV radiation, it changes the structure of cells and affects how they behave. Overexposure to UV radiation permanently damages the skin. This damage adds up over time. The most important years for sun protection are during childhood. However, increased protection against sun exposure is important and will help prevent skin cancer at any age. Sometimes melanoma runs in families. For most people this is due to factors such as similar skin type or too much sun exposure in childhood. However, approximately 7% of melanomas may be caused by an inherited faulty gene.

What are the symptoms of melanoma?

Melanoma can vary greatly in the way it looks. The first sign is usually a new spot or a change in an existing mole.

  • Size – The spot may begin to get, or keep getting, larger.
  • Colour – The mole may become increasingly blotchy with varying depth and shades of colour.
  • Shape or border – The spot may have an irregular edge (scalloped or notched) or lack of symmetry. That is, if a line was drawn through the middle of the mole, both halves would not match up. The spot may increase in height or become scaly.
  • Itching or bleeding – The mole may itch or bleed at times.
  • Elevation – Melanomas may develop a raised area or may develop from the start as a raised nodule. Such raised areas are often reddish or reddish brown.

It is normal for new moles to appear and change during childhood and teenage years. However, all adults who develop a new mole should see their doctor to get it examined. Even if you have had a mole checked before and it was benign, keep an eye on it because it could change in the future. Talk to your doctor immediately about any changes.

How is melanoma diagnosed?

Initial diagnosis of a melanoma begins by physical examination Usually you begin by seeing a doctor to have the suspicious spot or mole, and any other moles on your body examined. The doctor may use a magnifying instrument, called a dermascope, to see the spot clearly and will ask if you or your family have a history of melanoma.

If the doctor suspects that a spot on your skin may be melanoma, the usual procedure is to have a biopsy. This is generally a quick and simple procedure. Your GP may do it, or you may be referred to a dermatologist or plastic surgeon.

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. Your medical team will discuss the best treatment for you based on how far the melanoma has spread.

Advanced melanoma (also called metastatic melanoma) means the cancer has spread to distant skin sites, lymph nodes or internal organs. Treatment may include surgery, radiotherapy, immunotherapy, targeted therapies and chemotherapy.

For more information on the treatment of melanoma please refer to the Understanding Melanoma booklet.

What is the prognosis for melanoma?

Prognosis means the expected 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. The type of melanoma you have, how well you respond to treatment, and other factors such as age and medical history are all important in assessing your prognosis.

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 skin, the greater the risk that it may spread to draining lymph nodes or other organs.
In Australia, more than 90% of people with melanoma are treated successfully with surgery. With early detection and treatment, the outlook has steadily improved over the past 50 years.

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.

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You don’t have to face cancer alone – we’re here to help.

For more information on melanoma please refer to the Understanding Melanoma booklet. You can download the PDF or order a hard copy.