Melanoma Patients Australia
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Overview
Melanoma is a type of skin cancer that can spread to other parts of the body if it’s not found early. Australia and New Zealand have the highest rates of melanoma in the world.
Melanoma of the skin is called cutaneous melanoma. Other, rarer types of melanoma start in other parts of the body.
Learn more about the main subtypes of melanoma, the layers of the skin and who treats melanoma below.
What's on this page
What is melanoma?
Melanoma is a type of skin cancer. It develops in the skin cells called melanocytes. Melanoma most often develops in areas that have been exposed to the sun. It can also start in areas that don’t receive much sun, such as the eye melanoma; nasal passages, mouth and genitals (mucosal melanoma); and the soles of the feet or palms of the hands, and under the nails (acral melanoma).
Other types of skin cancer, called non-melanoma skin cancers or keratinocyte cancers, are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These are far more common than melanoma. However, melanoma is considered more serious because it can spread to other parts of the body, especially if not found early.
How common is melanoma?
Australia and New Zealand have the highest rates of melanoma in the world. Each year in Australia, almost 19,000 people are diagnosed with invasive melanoma (it has spread into the dermis, the lower layer of the skin) and 28,000 people are diagnosed with melanoma in situ (it is only in the epidermis, the top layer). In Australia, melanoma is the second most common cancer in men and the third most common in women (excluding non-melanoma skin cancers).
What are the main types of melanoma?
Melanoma of the skin is known as cutaneous melanoma. The main subtypes of cutaneous melanoma are shown below. Some rarer types of melanoma start in other parts of the body. Mucosal melanoma can start in the tissues in the mouth, anus, urethra, vagina or nasal passages. Eye melanoma can start inside the eye. Melanoma can also start in the central nervous system. See Eye melanoma or call Cancer Connect on 13 11 20 for more information.
Superficial spreading melanoma
Superficial spreading melanoma
How common? – Makes up 55–60% of all melanomas.
Who gets it? – Most common type of melanoma in people under 40, but can occur at any age.
What does it look like? – Can start as a new brown or black spot that grows on the skin, or as an existing spot, freckle or mole that changes size, colour or shape.
Where is it found? – Can develop on any part of the body but especially the area between the shoulders and hip (trunk).
How does it grow? – Often grows slowly and becomes more dangerous when it invades the lower layer of the skin (dermis).
Nodular melanoma
Nodular melanoma
How common? – Makes up about 10–15% of melanomas.
Who gets it? – Most commonly found in people over 65.
What does it look like? – Usually appears as a round, raised lump (nodule) on the skin that is pink, red, brown or black and feels firm to touch; may develop a crusty surface that bleeds easily.
Where is it found? – Usually found on sun-damaged skin.
How does it grow? – Often a fast-growing form of melanoma, spreading quickly into the lower layer of the skin (dermis).
Lentigo maligna melanoma
Lentigo maligna melanoma
How common? – Makes up about 10–15% of melanomas.
Who gets it? – Most people with this subtype are over 40.
What does it look like? – Begins as a flat, irrregular patch of discoloured skin which can be brown, pink, red or white.
Where is it found? – Mostly found on sun-damaged skin on the face, ears, neck or head.
How does it grow? – May grow slowly and superficially over many years before it grows deeper into the skin.
Acral lentiginous melanoma
Acral lentiginous melanoma
How common? – Makes up about 1–2% of all cases.
Who gets it? – Mostly affects people over 40 with dark skin such as those of African, Asian and Hispanic backgrounds.
What does it look like? – Often appears as a colourless or lightly coloured area, may be mistaken for a stain, bruise or unusual wart; in the nails, can look like a long streak of pigment.
Where is it found? – Most commonly found on the palms of the hands, on the soles of the feet, or under the fingernails or toenails.
How does it grow? – Tends to grow slowly until it invades the lower layer of the skin (dermis).
Desmoplastic melanoma
Desmoplastic melanoma
How common? – Makes up about 1–2% of all cases.
Who gets it? – Mostly affects people over 60.
What does it look like? – Starts as a firm, growing lump, often the same colour as your skin; may be mistaken for a scar and can be difficult to diagnose
Where is it found? – Mostly found on sun-damaged skin on the head or neck, including the lips, nose and ears.
How does it grow? – Tends to be slower to spread than other subtypes, but often diagnosed later; sometimes can spread via nerves.
The skin
The skin is the largest organ of the body. It protects the body from injury, controls body temperature and prevents loss of body fluids. The 2 main layers of the skin are called the epidermis and the dermis. Below these is a layer of fatty tissue known as the hypodermis.
Epidermis
The epidermis is the top, outer layer of the skin. It is made up of several sublayers that work together to continually rebuild the surface of the skin. The main sublayers are the basal cell layer and the squamous cell layer.
Squamous cell layer
This sits above the basal cell layer. Basal cells that have matured move up into the squamous cell layer. Here they are known as squamous cells or keratinocyte cells. Squamous cells are the main type of cell found in the epidermis.
Basal cell layer
This is the lowest layer of the epidermis. It contains basal cells and cells called melanocytes. The melanocyte cells produce a dark pigment called melanin, which gives skin its colour. When skin is exposed to ultraviolet (UV) radiation, melanocytes make melanin to try to protect the skin from getting burnt. This is what causes skin to tan. When melanocytes cluster together, they form non-cancerous spots on the skin called moles or naevi.
Dermis
This layer of the skin sits below the epidermis. The dermis is made up of fibrous tissue and contains the roots of hairs (follicles), sweat glands, blood vessels, lymph vessels and nerves.
What causes melanoma?
Exposure to ultraviolet (UV) radiation is the cause of most types of skin cancer. If unprotected skin is exposed to the sun when the UV index is 3 or above or to other UV radiation, the structure and behaviour of the cells can change. This can permanently damage the skin, and the damage builds up every time a person spends time unprotected in the sun.
UV radiation most often comes from the sun, but it can also come from artificial sources such as solariums (also known as tanning beds or sun lamps). Solariums are now banned for commercial use in Australia because research shows that people who use solariums have a much greater risk of developing melanoma.
Which health professionals will I see?
You will probably start by seeing your general practitioner (GP). You may see a GP at a general practice, medical centre or skin cancer clinic. Skin cancer clinics are run by GPs with an interest in skin cancer.
If a GP diagnoses or suspects melanoma, they may remove the spot themselves or refer you to another doctor, such as a dermatologist or surgeon, for the biopsy. If there’s a waiting list, your GP can ask for an earlier appointment if necessary.
Your GP may arrange further tests. Depending on the nature of the melanoma and their expertise, the GP may recommend ways to treat it, or refer you to a dermatologist or surgeon who will manage your care. In more complex cases, treatment options may be discussed at a multidisciplinary team (MDT) meeting (see below).
Attending a melanoma unit
Management and treatment for advanced melanoma can be complex. People with advanced melanoma – as well as some diagnosed with earlier stage melanoma – can benefit from being treated in a cancer centre that has doctors who specialise in treating advanced melanoma.
Cancer centres are located at hospitals in major cities around Australia. You will be able to see a range of health professionals, called a multidisciplinary team, who specialise in different aspects of your care.
To find a multidisciplinary melanoma unit near you, check with your doctor or call Cancer Connect on 13 11 20.
Health professionals you may see
Health professionals you may see
- GP – checks skin for suspicious spots, may remove potential skin cancers and refer you to specialists
- dermatologist – diagnoses, treats and manages skin conditions, including skin cancer
- general surgeon – performs surgery to remove early melanoma and lymph nodes, and to reconstruct the skin
- reconstructive (plastic) surgeon – performs surgery that restores, repairs or reconstructs the body's appearance and function; may also remove lymph nodes
- surgical oncologist – performs surgery to remove melanoma and conducts more complex surgery on the lymph nodes and other organs; can be a general surgeon or a reconstructive surgeon
- medical oncologist – treats melanoma with drug therapies such as targeted therapy and immunotherapy
- radiation oncologist – treats cancer by prescribing and overseeing a course of radiation therapy
- cancer care coordinator – coordinates care, liaises with MDT and supports you and your family throughout treatment; care may also be coordinated by a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)
- counsellor, social worker, psychologist – help you manage your emotional response to diagnosis and treatment
- physiotherapist, occupational therapist – assist with physical and practical issues, including restoring movement and mobility after treatment and recommending aids and equipment
- palliative care specialist and nurse – work closely with the GP and cancer team to help control symptoms and maintain quality of life
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