Melanoma Skin Cancer:

Melanoma, also called malignant melanoma, is a cancer that usually starts in the skin. It can start in a mole or in normal-looking skin.

The first symptom of melanoma skin cancer is usually a change in the shape, colour or size of a mole. 

A superficial spreading melanoma is the most common type of melanoma. It is most often found on the arms, legs, chest and back. The melanoma cells usually grow slowly at first and spread out across the surface of the skin.

A nodular melanoma is the second most common type of melanoma. It can grow more quickly than other melanomas. It is also more likely to lose its colour when growing – becoming red rather than black. It is more commonly found on the chest, back, head or neck.

A Lentigo maligna melanoma is less common. It is usually found in older people, in areas of skin that have had a lot of sun exposure, such as the face and neck. It develops from a slow-growing, pre-cancerous condition called a lentigo maligna. Lentigo maligna is only in the upper layer of skin called the epidermis. It is sometimes called an insitu melanoma.

A acral lentinginous melanoma is rare. It is usually found on the palms of the hands, soles of the feet, or under fingernails or toenails. It is more common in people with black or brown skin. It is not thought to be caused by sun exposure.

Other rare types of melanoma include:
Malignant blue naevus
Desmoplastic melanoma
Amelanotic melanoma
Spitzoid melanoma

Treatment for Melanoma Skin Cancer:

Biopsy: Your doctor might remove the abnormal area to find out if it’s a melanoma skin cancer.

Common Biopsy Types
Shave/Saucerization Biopsy: A razor-type tool is used to remove a superficial area or “scoop” out the lesion, though it must be deep enough to avoid cutting through the tumour. 

Excisional Biopsy (Preferred): The entire suspicious mole is removed with a scalpel, allowing the pathologist to examine the whole sample and determine the tumour’s depth (Breslow thickness).

Incisional Biopsy: Only a part of the lesion is removed. This is generally reserved for large, irregular lesions where removing the whole area immediately is not feasible.

Punch Biopsy: A circular tool removes a core sample of skin. Usually used if the lesion is small (3-5 mm) or for deeper, smaller samples.

Wide local excision: After the biopsy, you normally have a second operation to remove more tissue if you’re diagnosed with melanoma. Your doctor removes a larger area of healthy skin and tissue around where the melanoma was. This helps to reduce the risk of the melanoma coming back.

Sentinel lymph node biopsy (SLNB): Performed during the Wide local excision, as a way of checking the lymph nodes closest to the melanoma. You may have this test even if your lymph nodes do not look or feel swollen. It can help to find very small amounts of melanoma that have spread to the lymph nodes.

Adjuvant therapy: An additional treatment given after the primary treatment (usually surgery) to lower the risk of the cancer returning. Adjuvant therapy is offered either via targeted therapy or immunotherapy.

Targeted therapy: Is offered if the melanoma contains a BRAF mutation. It targets the abnormal or faulty BRAF protein. It is taken as capsules and tablets daily for a year

Immunotherapy: The immune system protects the body against illness and infection. Immunotherapies are treatments that use the immune system to recognise and kill cancer cells. It is administered via drip every 3, 4 or 6 weeks for a year.

Scans – Pre/Post surgery:

Sentinel lymph node scan: A harmless amount of radioactive liquid is injected into the area where the melanoma started. The radioactive liquid travels through the skin’s lymphatic vessels. It drains into the lymph nodes closest to the melanoma. These are the sentinel lymph nodes.

You usually then have a scan using a special camera. It finds the nodes that picked up the radioactivity and shows them on a screen. The skin is marked over the sentinel node or nodes to help the surgeon find them easily and remove them. The scan finds the sentinel nodes but cannot show whether melanoma cells are in the lymph nodes.

CT scan: Should any cancer cells be found, you may be asked to attend a CT scan. A CT scan uses x-rays to build a detailed picture of the inside of the body.

MRI scan: Should any cancer cells be found, you may be asked to attend an MRI scan. A MRI scan uses magnetism to build up a detailed picture of areas of the body.

Doctors may use an MRI scan to find out:
-The size of a cancer and whether it has spread.
-Whether a lump or abnormal area is cancer