Melanoma is the most feared of the skin cancers occurring in eighteen people out of every 10000. The most common sites of melanoma are the back and legs although they can occur anywhere on the body. If detected early this type of skin cancer can be cured, while late detection will ultimately be fatal, regardless of the treatment.
An early melanoma is usually a painless, two-tone freckle which lies flat on the skin. It is only in the later stages that it becomes raised, itchy and bleeds. Once bleeding occurs, the prognosis is generally poor. Although people are aware of melanoma, they tend to look for the wrong lesion. Most people believe that melanomas are raised and itchy, whereas such lesions are more likely to be innocent moles. Meanwhile, the ‘silent’ melanoma goes undetected.
Any two-tone lesion, especially with an area of black spreading into a brown area, should be regarded with suspicion. The outline of a melanoma is irregular, like the map of Australia. They have also been described as looking like ‘a squashed fly’ or ‘chocolate smudged on the skin’. If you suspect a melanoma, you should see a doctor as soon as possible. He or she will confirm the diagnosis by removing the lesion and examining it under a microscope. If a melanoma is detected early, simple, conservative surgery will lead to a total cure. Radical surgery does not improve the prognosis except in more advanced cases, and is becoming increasingly obsolete.
People with very large, irregular moles, called dysplastic naevi, have a greater risk of developing melanoma. They should be checked every six months, using photographs to detect any changes in their moles or any new lesions.