Early Detection Saves Lives

Australia has one of the highest rates of skin cancer in the world. Fortunately, most skin cancers can be detected early and treated successfully through regular skin examinations.

The three common types of skin cancers are:

• Squamous Cell Carcinoma or SCC
• Basal Cell Carcinoma or BCC
• Malignant Melanoma or MM

Melanoma is the most dangerous among the common types of skin cancers. It usually starts as a simple skin lesion. The cancer cells then get into the bloodstream and can spread to any other part of the body. It is the spread elsewhere that can result in death. Out of every ten people who die of skin cancer, eight die of melanoma.

Elixir @ Hunter is a skin cancer clinic in Maitland, offering quality skin cancer treatment. Book your consultation today!

Why Is Melanoma So Dangerous?

Melanoma develops from pigment-producing cells (melanocytes) in the skin.

Many melanomas initially grow across the surface of the skin (horizontal growth phase). During this stage, they are often highly curable if detected and removed.

The danger begins when melanoma starts growing deeper into the skin (vertical growth phase).

As melanoma penetrates deeper layers of the skin, cancer cells gain access to blood vessels and lymphatic channels, allowing them to spread to other parts of the body. Once melanoma has spread beyond the skin, treatment becomes more complex, and survival rates decrease.

Early diagnosis before the blood borne spread or lymphatic spread offers the best chance of cure.

Most Melanomas Are Asymptomatic

One of the biggest misconceptions about melanoma is that it should hurt.

In reality, most melanomas:

• do not itch
• do not bleed till they ulcerate
• do not hurt
• do not cause discomfort

This is why relying on symptoms alone is dangerous.

Many melanomas are found only because they are noticed during:

• professional skin cancer examinations
• routine self skin checks
• partner-assisted skin checks

What does it look like?

It is generally a dark coloured mole that may have an irregular shape. Most of these lesions are flat lesions within the skin rather than sticking out from the skin. Most of them will appear just like a common flat mole with asymmetrical distribution of pigmentation but they are usually asymptomatic.

Points at a glance:

• a new mole
• an existing mole that changes
• a flat dark patch
• a rapidly growing lump
• a pink or skin-coloured lesion
• A changing lesion without pigment (amelanotic melanoma)

Most of these lesions are neither painful nor itchy, and most can’t be felt. Some melanomas can appear as a bump in the skin. A melanoma that can be felt is more serious than one that can be seen but not felt.

Most of the melanoma grows horizontally on the skin surface before they start going deeper. The depth of the melanoma is the most important prognostic criteria. Melanoma over 0.75 mm Breslow thickness (measuring scale for melanoma) can have more potential to spread in the body as compared to thinner melanomas. The melanoma that appears as a bump in the skin has more potential to spread, as this type of melanoma starts to grow vertically almost from the onset, and these are the melanomas that can become life-threatening in as little as 6 weeks.

Risk Factors

The most common sites for melanoma are on the arms, legs or back, but they can grow on any area of the skin, including palms, soles and under the nails.

Around 90% of the melanomas are linked to damage from Ultraviolet or UV rays.

A genetic condition called “Dysplastic Naevus Syndrome” or “Atypical Naevus Syndrome” is a major risk factor for melanoma. Dysplastic naevus syndrome is a condition where a patient has 5 or more dysplastic melanocytic naevi. These people are at substantial risk of developing melanoma. The patients of Dysplastic naevus syndrome have a future melanoma risk much more as compared to the general population.

Dysplastic moles mostly look like very dark or black moles. They often have a strange, irregular distributed pigmentation, like the map of a country, but are otherwise smooth to touch.

Patients with Dysplastic naevus syndrome are at high risk of melanoma. It is therefore essential that extreme measures are taken to avoid sun damage.

Regular, careful skin checks are essential and are the key to Dysplastic Naevus Syndrome. In most of these people, melanoma mostly grows from normal looking skin rather than from existing dysplastic moles. As such, simply removing lots of dysplastic moles is not the answer.

These patients need a regular 6-monthly professional skin checkup and they also need to check their own skin every 2-3 months or even every month. There are parts of your skin you can’t see. Ask your partner or friend to check these areas for you. If any new or changing mole develops between the scheduled appointments, do not wait. Please make an appointment to see your doctor as soon as possible.

Risk of getting more melanomas after a diagnosis of melanoma

Any person who has developed a melanoma is susceptible to further skin cancers. This includes a further lifetime risk of getting melanoma and non-melanoma skin cancers.

It is recommended to have regular and ongoing skin checks for life.

FAQs

Is melanoma deadly?

Melanoma can be deadly, but outcomes depend heavily on how early it’s caught. When detected while still confined to the top layers of skin, melanoma has a very high cure rate with surgical excision alone.

Risk rises once the cancer penetrates deeper into the skin (measured by Breslow thickness) or spreads to lymph nodes or other organs. This is why regular skin checks and prompt review of any new or changing spots matter more than the diagnosis itself.

Can you die from melanoma skin cancer?

Yes, melanoma is responsible for the majority of skin cancer deaths, even though it’s less common than non melanoma skin cancers.

Death from melanoma occurs when the cancer spreads beyond the original skin lesion into the bloodstream or lymphatic system and establishes itself in vital organs.

It is not the skin lesion itself that becomes fatal; it’s the spread. Melanoma caught before it spreads is highly treatable.

How quickly does melanoma kill you?

There’s no single timeframe, because it depends on the type of melanoma and how it’s growing. Superficial spreading melanoma, the most common type, tends to grow outward across the skin for some time before it grows deeper, giving a wider window for detection.

Nodular melanoma, however, grows vertically from the outset and can become life-threatening in as little as six weeks from when it first appears. This is why any new lump or rapidly growing mole needs urgent review rather than a “wait and see” approach.

How long before skin cancer becomes dangerous?

This varies by skin cancer type. Basal cell carcinomas typically grow slowly and rarely spread. Squamous cell carcinomas are mostly picked up on  time and treated in time as they are usually symptomatic and the patient usually seeks medical attention for them due to the symptoms of pain and discomfort. Squamous cell carcinomas have a potential to spread in the body (metastasize) if not treated in time, and can rarely become life threatening.

Melanoma is the exception; some forms can become dangerous within weeks rather than months. As a general principle, any new or changing skin lesion should be assessed by a doctor within days to a couple of weeks of being noticed, not left for a routine annual check.

How do you die from melanoma?

Melanoma becomes life-threatening once cancer cells travel via the bloodstream or lymphatic system to other parts of the body, commonly the lymph nodes first, then potentially the lungs, liver, or brain.

Death results from organ failure caused by this spread (metastasis), not from the original skin lesion. This is why the depth and spread of a melanoma at diagnosis are the key factors doctors use to judge prognosis.

Is melanoma painful when it spreads (is dying from melanoma painful)?

The original skin lesion itself is usually painless; melanoma is rarely itchy or sore, which is part of why it can go unnoticed. If melanoma spreads to other organs, symptoms and discomfort depend on where it spreads to; for example, spread to bone or nerve tissue can cause pain, while spread to organs like the liver may not cause pain until later stages.

Modern palliative and oncology care can manage pain and other symptoms effectively at any stage, and patients with advanced melanoma are supported by a medical oncology team throughout treatment.

Is death from melanoma painful?

Pain associated with advanced melanoma is not inevitable and, where it does occur, is generally manageable with modern palliative care. Pain depends on which organs are affected rather than the cancer itself.

Anyone diagnosed with metastatic melanoma is typically referred to a medical oncologist or melanoma specialist centre who coordinates pain relief and symptom management as part of ongoing care.

Where can melanoma spread in the body?

Melanoma can spread anywhere. The commonest site is the lymph nodes. It can also spread to nearby skin sites. It is more serious when it spreads to places like the lungs, liver and brain. A spread to these distant sites has a concerning risk of death.

What is the usual treatment?

Skin melanoma lesions are invariably excised. Melanoma treatment is almost always in at least two stages.

The doctor will initially take out just the lesion with a narrow margin to confirm the diagnosis and to check the depth and other prognostic factors of the melanoma.

Once the diagnosis and other prognostic factors are confirmed, a wider excision is organised. This second excision requires a wide ring of non-involved skin to be removed from around the melanoma. The clearance is usually 1 or 2 cm of apparently normal skin on all sides depending on the pathology report of the initial excision.

Early diagnosis and treatment of a melanoma is the key to maximising survival. Try to catch the melanoma before it has spread.

Can the melanoma come back?

Wide excision with the recommended melanoma margin guidelines minimises the risk of recurrence of melanoma.

The chances of recurrence of melanoma depend on individual factors, including the thickness of the cancer that penetrates the skin, its body location, whether the cancer had an ulcer on its surface, whether there are lymph nodes involved and whether it has spread to other parts of the body.

What happens if a melanoma spreads in the body?

While usually fatal in the past, there are now new treatments available for metastatic melanoma. If you have a metastatic melanoma, you will be referred to a medical oncologist, a specialist in these cancer drug therapies.

If the melanoma has spread to a single site, surgery can be helpful.

Radiation is not commonly used for managing melanoma, but it can be useful when a site of spread produces marked local pain.

How to reduce the risk of getting a melanoma?

• Reducing sun exposure helps. Suntan or sunburn means future skin cancer risk. Avoid outdoors 11:30 AM to 3:00 PM.
• Apply and reapply sunscreen regularly.
• Shade over the pool & playgrounds protects our kids.
• Long-sleeved shirts.
• Hats with a brim.
• Drive with windows up.
• Sunglasses.
• Long pants or skirts.
• 50+ Sunscreen.
• Umbrellas and shelters.
• Enclosed tractors.
• Check your own skin each month.
• See your doctor if any new or changing skin lesions develop.
• Have a regular skin checkup with a professional every 1-2 years.
• Patients who have had a melanoma need 6-12 monthly skin checks by a doctor for life as advised by the treating doctor.