Melanoma
What It Is and How To Reduce Your Risk
What is melanoma?
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It is a potentially serious form of cancer, usually starting in the skin, arising
from pigment-producing cells called melanocytes
Most likely to affect those with large numbers of moles, a family history of
melanoma and those whose skin is sun-sensitive – which means it burns
readily and doesn’t tan easily or at all
The UK’s fifth most common and most rapidly-increasing cancer, with more
than 12,000 new cases every year – a fourfold increase since the 1970s
The second most common cancer in the 15-34 age group
A disease for which the number of cases is expected to rise more than any
other cancer by 2030
Why is melanoma on the increase?
The rapid rate of increase is thought to be linked to the increasing exposure of
people to ultraviolet (UV) radiation. Melanoma has become so much more
common as a result of damage (sunburn) during holidays in the sun, which
many people now experience from early on in their lives. Sunbeds, which are still
popular in the UK despite their danger, may also play a role.
People who have had excessive exposure to UV rays before the age of 20
have a greater chance of developing melanoma later in life.
Is there a difference between ‘melanoma’ and ‘malignant melanoma’?
The two are one and the same. There is no such thing as a ‘non-malignant
melanoma’ so the disease is increasingly known by the single word ‘melanoma’.
How does melanoma start?
Many melanomas develop on normal skin; this simple fact is not as well-known
as it should be. Others develop in an existing mole. Melanoma may occur
anywhere on the skin including the palms and soles, the scalp or under and
around the nails. In females it is most common on the lower limbs.
‘Skin lesion’ is a medical term for a patch, spot, lump or any other
abnormality on otherwise normal skin.
How do I know if a lesion on my skin could be suspicious?
The ‘ABCDE Checklist’ can help you identify some of the signs that may point
towards there being a problem:
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Asymmetry – the lesion may not be symmetrical, with the two halves
differing in shape
Border – the edges may be irregular or jagged
Colour – uneven and patchy, with different shades of black, white, grey,
brown or pink; any lesion with two or more colours may be suspicious
Diameter – most (but not all) melanomas are at least 6mm across, or about
the width of the rubber on the end of a pencil
Evolving – the lesion is changing in size, shape or colour, regardless of
whether it remains flat or becomes elevated
How reliable is this checklist?
While it is relevant for the most common type of melanoma, the checklist is not
completely reliable since a significant number of melanomas don’t show these
features. To make sure, you should also use the ‘skin safety first’ guidelines
below.
The ‘skin safety first’ guidelines
If there is an abnormality on your skin that is
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Changed – it is new or seems to have changed since you last saw it (don’t
look for detail; if you can see it has changed just by glancing at the lesion,
that’s enough)
Not going away – once a new lesion has appeared, it remains on the skin for
longer than 6-8 weeks
Odd (the most crucial test) – it simply looks strange, worries you or seems to
be different from other lesions on your skin
then you should get it looked at by a doctor, who may refer you to specialist
(generally a dermatologist). It is very important that the result is a confident
diagnosis of the lesion. The phrase ‘looks OK’ is not a diagnosis.
Remember: if in doubt, get it checked!
What happens if a skin lesion is diagnosed as a melanoma?
If found early, most cases of melanoma can be cured by surgical removal. The
earlier this is done, the better the long-term outlook is likely to be. However, in
some patients the melanoma can spread from the skin to the lymph nodes or
bloodstream. This is a more serious situation.
What are the implications of melanoma spreading?
In its advanced stages, melanoma may spread (or ‘metastasise’) to organs such as
the liver, brain and lungs. Advanced melanoma is often incurable. Each year
more than 2,000 people in the UK die from the disease.
When melanoma spreads, it remains a form of the same disease
regardless of the organ in which it appears; for example, if it spreads to
the liver it is still melanoma rather than liver cancer.
What are the treatment options if melanoma spreads?
Depending on the nature and ‘stage’ of the disease (see below), possible
treatment options may include surgery, radiotherapy, chemotherapy
(administering drugs) or immunotherapy (encouraging the body’s immune
system to identify and get rid of cancerous cells).
‘Staging’ is a system of identifying how far melanoma has spread.
Stages 1 and 2 mean that cancerous cells have been found but at present
there is no evidence that they have spread beyond the original location
in the skin. At the other end of the scale, stage 4 means the melanoma
has spread to distant organs or other parts of the body and the disease
has become much more serious.
How do doctors decide which treatment to use?
It is becoming clear that there are several – perhaps numerous – types of
melanoma. These differ in their behaviour and in their response to the various
forms of therapy, as well as to individual drugs. This means that every
melanoma must be fully assessed, categorised and ‘staged’ in order to decide
which treatment is likely to be most effective.
Are any major advances in sight in the fight against melanoma?
There has been significant progress in the treatment of advanced melanoma in
recent years, with some of the latest drug therapies beginning to show
encouraging results. However these have all been in terms of prolonging, by a
modest amount, the lives of melanoma sufferers with disease that has spread,
rather than an outright ‘cure’. Nonetheless, there is a degree of guarded
optimism among clinicians.
Improvement may seem slow but behind the scenes enormous efforts,
backed by extensive clinical trials, are being made to reduce the lethal
effects of this disease. Melanoma Focus supports several research
initiatives – which is why we need to raise as much money as possible.
As with other serious diseases, the best option of all is prevention. The next
section deals with this aspect.
How can I reduce the risk of melanoma?
Put simply, the main task is to avoid an excessive amount of skin exposure to UV
radiation. A moderate quantity of sunshine is beneficial for most people. But
overdoing exposure to the sun to the extent of burning (which means causing
any degree of redness), especially when young, can have serious consequences
later on.
The key is to ‘know your own skin’: melanoma is mainly a cancer affecting pale
skin so the advice here is aimed at anyone who has ever burnt in the sun, has red
or auburn hair, any freckles, lots of moles or a family history of melanoma. If you
have dark skin which never burns and no other risk factor, then – so long as you
don't burn – the rigorous protective measures below are unnecessary except in
very sunny places. Indeed, sun exposure makes us feel good and allows the body
to manufacture sufficient vitamin D, which is likely to be important.
The methods of avoiding exposure to excessive amounts of UV are largely
common sense. Advice includes:
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In sunny weather use a UVA + UVB sunscreen, preferably with a sun
protection factor (SPF) of 30 or higher with 5 stars UVA protection and
follow the instructions about repeat applications
Cover exposed skin with clothing and a broad-brimmed hat, especially in the
heat of the day or when one particular area of the body is continuously
exposed (such as the shoulders, the ears or a bald head) when walking,
gardening or playing sport
Protect the eyes by wearing wrap-around sunglasses
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Avoid direct sunlight altogether by staying in the shade, especially between
about 11am and 3pm
NEVER use sunbeds
Sunscreen should be applied regularly and thickly during the day. You
can easily halve the sun protection factor by not using sufficient
amounts or not repeating applications. If redness of the skin occurs this
means that not enough sunscreen is being used, or it suggests that more
clothing is needed (or you should be moving inside) earlier in the day.
Is it certain that sunbeds are bad for you?
Yes – there is evidence that sunbeds increase the risk of melanoma. According to
Cancer Research UK, it has been found that using sunbeds for the first time
before the age of 35 increases the risk of melanoma by 59%. Here are some
further sunbed facts:
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Since 2011 it has been illegal in the UK for under-18s to use sunbeds in
premises such as beauty salons
Many sunbeds give out doses of UV that are higher than from the midday
Mediterranean sun; and researchers have assessed the cancer risk from
sunbeds as twice that of an equivalent period spent out in the sun in the Med
Many sunbeds are faulty: a check by Cancer Research UK found their UV
output was, on average, twice the recommended level, with 9 out of 10
sunbeds emitting UV at levels higher than British and EU standards
The background to Melanoma Focus
We were formed in 2012 as the result of a merger between two well-established
charities, the UK Melanoma Study Group and the former Melanoma Focus. This
initiative has allowed us to build our public, patient and carer services on the
foundations of research and professional education inherited from our
predecessors. Melanoma Focus is now the principal UK melanoma charity.
How are donations to Melanoma Focus used?
Melanoma Focus differs from other charities in maintaining a professional core,
consisting of melanoma scientists, clinicians and nurses, combined with its
public information services and activities. Our unique national educational
events assist the UK melanoma community to achieve a better understanding of
the disease.
The charity is involved in organising several research projects, which
are described in detail on our website (www.melanomafocus.com).
These are connected with supporting scientific investigation into
various aspects of melanoma.
Donating
We can arrange for a donation to be gift-aided if you let us know your details. To
donate please
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Click on the JustGiving button on our website (www.melanomafocus.com);
or
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Write a cheque to ‘Melanoma Focus’ and forward it to the address overleaf;
or
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Donate online using the BACS system. Bank details: account name:
Melanoma Focus; sort code: 40-16-08; account number: 52679418; reference:
surname and the word ‘donation’. Please let us know about the donation by
mail or email.
Please contact us if you have any questions about the content of this leaflet or the
charity itself.
Melanoma Focus
Registered Charity No. 1124716
Queen Anne House
Gonville Place
Cambridge CB1 1ND
Phone: 01223 324359
Email: info@melanomafocus.com
Website: www.melanomafocus.com