The Little Surgery

What is a malignant melanoma?

Melanocytes are a type of skin cell and are responsible for producing brown pigment when exposed to the sun. It is this brown pigment which gives us a 'sun tan'. Groups of melanocytes often form coloured lumps, called moles , in the skin. Ordinary moles are quite harmless. However, occasionally, the cells in a mole can become cancerous and start to grow and spread. This cancer is called a malignant melanoma.

As the cancer grows, some of the cancer cells can spread to other areas of the body. If not treated early, the liver, lungs, brain, abdomen, and other parts of the body, can become invaded by cancer cells.

What causes a malignant melanoma?

How common is it?

Who gets it?

Risk factors include -

• being a woman (twice as likely to develop malignant melanoma, compared to men)
• having fair skin with lots of freckles
• spending time sunbathing, especially in the tropics
• indoor workers with pale skin, who sit out in strong sunlight during the summer
• episodes of severe sunburn in the past
• having lots of moles on your skin
• other members of your family with skin cancer

Malignant melanomas are very rare before puberty, so children are very unlikely to develop them.

They are rare in people with dark skin. However, people with black or brown skin can develop malignant melanomas, sometimes on the soles of your feet.

What are the symptoms?

Because malignant melanomas are usually due to too much sun exposure, the commonest site for a malignant melanoma to develop is on the legs, if you are a woman. Men are more likely to have a melanoma on their backs. But, melanomas can develop anywhere on the body, even on the soles of the feet, and under finger and toe nails.

Very occasionally, a type of malignant melanoma can develop which contains no coloured pigment, and is not dark brown or black.

When should I see my doctor?

If in doubt - get it checked.

When does a mole need checking?

Here are some useful guidelines, to help you decide when a mole may need checking with your doctor.

You should see your doctor if you answer 'YES' to any of these questions. Has your mole increased in size recently? Has your mole got an irregular edge? Is the colour of your mole uneven or irregular?

You should see your doctor if you answer 'YES' to two or more of these questions Is your mole more than 7mm in diameter? (larger than the end of a pencil?) Is your mole looking red and inflamed? Is your mole itching, or does it feel odd in some way? Is your mole bleeding or oozing fluid?

Photos of malignant melanoma

There is some variation of colour, but there is a regular pattern to the colour and texture of the mole. The edge of the mole is sharp and clear.
Here is a photo of a malignant melanoma.

You can see this mole looks odd. It has an irregular edge and appears to be spreading into the surrounding skin. The colour is uneven, with one area much darker than the rest.
You can see more photographs on this page

What tests will my doctor want to do?

Once the mole has been removed, it will be examined under the microscope by a pathologist. The pathologist will be able to tell you and your doctor whether or not your mole is a malignant melanoma.

Most funny looking moles turn out to be perfectly normal. However, a malignant melanoma needs to be removed as early as possible, before it has a chance to spread. It is important to get any suspiscious looking moles checked as soon as you can.

What is the treatment?

If your mole is found to be a malignant melanoma, any further treatment you receive will depend on how deep the melanoma has invaded your skin, and whether it has spread to other areas of your body. If you have a funny looking mole removed, and it is found to be an early malignant melanoma, then you may not need any further treatment. However, you may need to return to surgery for removal of the surrounding skin or lymph nodes.

If the cancer appears to be spreading, you may need radiotherapy or chemotherapy. You will be referred to a cancer specialist, who will advise you on the best treatment in your case.

How can I prevent a malignant melanoma?

To reduce your risk, you should take the following precautions

• Avoid strong sun, especially between the hours of 11am and 3pm.
• Do not get sunburnt
  1. Slip on a shirt
  2. Slap on a hat
  3. Slop on the suntan cream (factor 15 or above)
• Build up your tan gradually
• Get any funny looking moles checked by your doctor