Is it Melanoma or Skin Cancer? – Be Sunsafe

Is it a Melanoma? – How to spot dangerous skin cancer

Your skin may experience some changes due to old age, long-term exposure to the sun, or even exposure to some chemicals. Dr Michael Kernohan is a specialist plastic surgeon providing skin cancer removal treatments in Southwest Sydney and Southern Highlands NSW.

What is Melanoma or Skin Cancer?

Melanoma or skin cancer is a common type of cancer of the skin. It can appear anywhere on the body, although it most commonly appears on the face, the neck, and the back – the areas that are generally exposed to the sun the most. Like any other cancer, melanoma is an abnormal growth of cells that lack the mechanism for controlled growth. If detected early enough, the early-stage melanoma survival rate is around 99%.

Melanoma Risk Factors

There are several risk factors associated with melanoma:

  • lighter skin colour or fair complexion
  • previous sunburns (especially heavy sunburns)
  • moles
  • a history of skin cancer,
  • exposure to certain chemicals (arsenic)
  • radiation exposure
  • excessive exposure to the sun, such as is found in agricultural workers, lifesavers or people working outside, in direct sunlight

If you fall in any of the categories, you may want to check your skin every three months for any changes. Changes that you should look for include the appearance of new moles, development in old moles, any localised pigmentation or changes in the skin texture. Not every change is melanoma, especially not a malignant melanoma, but the nature of the changes can only properly be addressed by a specialised plastic surgeon.

How to Identify Melanoma or Skin Cancer

If you have noticed any changes in the colour, shape or pigmentation of your moles, you should consult a specialist to examine the changes. If you see any new localised pigmentation of the skin, unexplainable swelling or changes which ooze, are itchy, sore or reddish in appearance, you should also consult a specialist. Your specialised plastic surgeon will be able to assess these changes and suggest proper treatment if needed. Dr Michael Kernohan will also be able to carry out the procedure of removal of these changes and provide adequate aftercare advice for your highest comfort.

Types of Melanoma

There are several types of melanoma. You should understand that not every skin cancer is melanoma, as there are different types of cancers depending on the tissue they appear on. There are:

Melanoma can be life-threatening if not detected early enough and properly taken care of. They can be:

  • Superficial Spreading Melanoma – this is a melanoma that starts in the upper layers of the skin. It penetrates deeper only at later stages;
  • Nodular Melanoma – the first nodular melanoma symptom is a nodule under the skin that is hard to touch. It grows quickly (the aggressive skin cancer melanoma);
  • Lentigo Maligna Melanoma – common in the elderly with heavily sun-damaged skin;
  • Acral Lentiginous Melanoma – a rare form of melanoma that appears on the palm and the soles. It can also be found under fingernails and toenails;
  • Amelanotic Melanoma – a type of melanoma that is difficult to diagnose. This cancer cell do not have any pigment.

Dangers of Melanoma

Melanoma is the most dangerous form of skin cancer. If left untreated, it can spread to the surrounding tissues, which significantly complicates the procedure and reduces the chances of positive long-term outcomes. In some cases, once cancer has spread, it can be more difficult to treat. This is known as metastatic melanoma.

Skin cancers, melanoma included, are easily taken care of if they are detected early enough.  The early-stage melanoma survival rate is around 99%. Good skincare routine, continuous use of SPF with a sun protection factor of 30+ and above, and regular skin checks are the best measures that any adult should practice regularly.


Identifying Melanoma vs. Moles – How to tell the difference

To easily distinguish between a melanoma and a mole, you should follow the ABCDE rule:

  • A – Asymmetry. Most melanomas are asymmetrical. The two halves do not match, whichever way you may look;
  • B – Border. Borders of melanoma are not clear lines; they may look uneven, blurry or distorted;
  • C – Color. Moles are of one colour. Melanomas may display a colour variety across their surface, which can range anywhere between white, over red, to almost completely black;
  • D – Diameter/ Darkness. They grow, so if you notice a growing mole, you should head to your doctor. Any change more than 6mm in diameter has to be checked by the doctor. Melanomas are usually darker than the surrounding tissue.
  • E – Evolving. Any change in shape, size or perceived depth can be an indicator of melanoma.

Melanoma Treatment and Surgical Removal Options

There are several skin cancer or melanoma removal procedures. Your seasoned plastic surgeon, Dr Michael Kernohan, will be able to properly assess your case and give advice on which approach may be the best in your case. The surgical procedures and non-surgical procedures that may be used during melanoma removal are:

  • Surgical Excision – the specialised plastic surgeon will surgically remove the skin lesion. This is done under local anaesthesia or general anaesthesia if the lesion covers a large area of the skin;
  • Cryosurgery (freezing) – liquid nitrogen is applied to the lesion, killing the cancer cells;
  • Mohs Surgery – thin layers of tumour and surrounding skin are removed. The procedure is repeated until healthy tissue is reached. This surgical procedure is most commonly used on the face;
  • Radiation Therapy – usually accompanies another procedure and is used to kill any remaining cancer cells;
  • Chemotherapy – applied locally or generally, this therapy slows down the growth of skin cancer cells, giving your immune system more time to fight them off;
  • PTD (PhoToDynamic) Therapy – uses a combination of drugs and a laser to kill cancer cells;
  • Biological Therapy – drugs that stimulate your body’s immune system to attack cancer cells.

Melanoma FAQs – Questions & Answers about melanoma or Skin Cancer

What does a melanoma spot look like?

  • A melanoma spot will characteristically be of irregular shape, darker in colour than the surrounding tissue and growing. Melanoma may appear in the place of a mole on your body, and in this case, it will usually look like a red ring around the mole in the initial stages of development.

How do you identify melanoma?

  • Sydney specialist plastic surgeon Dr Michael Kernohan will be able to assess your case and provide a professional diagnosis. Melanoma identification means counting in several factors, such as shape, size, colour, texture, skin complexity, lifestyle choices and habits, as well as your medical history and your family’s medical history.

How does Melanoma feel?

  • Melanoma may feel itchy and sore without any other symptoms in the early melanoma stage. In later stages, especially if you have a case of metastatic melanoma, the organs it has spread to may show signs of declining function, and you may feel tired.

Do you feel tired with melanoma?

  • In later stages of melanoma development, such as when metastasis is present, you may feel more tired than usual. This is especially noticeable if cancer spreads to the lungs, as their function might decline.

Does melanoma show up in blood work?

  • No. Melanoma does not usually show up in blood tests. Your melanoma expert or surgeon may order an LDH (lactate dehydrogenase) blood analysis if he suspects you may have a more advanced form of melanoma.

Are skin cancers itchy?

  • Yes, skin cancers can appear itchy. This is especially true for basal cell skin cancer, which may feel itchy and look similar to a healing wound. If you notice any such changes, consult Dr Kernohan, and schedule a check-up appointment.

Is melanoma flat or raised?

  • Some melanomas are flat, and some are raised. Lentigo Maligna Melanomas first appear in upper skin layers and may develop as a flat change on the skin for a while. Melanomas that occur as the growth of cancer or pre-cancer cells in moles will normally have a raised shape.

Is melanoma hard or soft?

  • Melanomas are mostly hard to touch. The Nodular Melanoma will be hard to the touch and in the shape of a nodule under the skin.

Can melanoma be white?

  • Yes, amelanotic melanomas are generally of lighter colour since they produce no melatonin.

Is melanoma always black?

  • No, melanomas are not always black. Melanomas may range in colour from white, over purple, red, and brown, to completely black. Some melanomas may even display a variety of colours.

Does melanoma weaken your immune system?

  • In general, melanoma does not weaken your immune system. In the case of late-stage melanoma, where metastasis is present, the overall deterioration of health may induce some changes to the way your immune system behaves.

Can melanoma go away on its own?

  • Yes, in some cases. Sometimes melanoma can spontaneously regress without any treatment. This does not mean that you should wait to notice any changes in your skin: most melanomas do not spontaneously disappear.

What do early signs of melanoma look like?

  • Early signs of melanoma include changes in the skin, which are different in shape, size and colour. Additional symptoms which may appear include changes in the texture, itchiness, oozing from the change or even bleeding.

What are the five warning signs of malignant melanoma?

  • Follow the ABCDE rule here: Asymmetry, Borders, Colour, Diameter, Evolving. – If any of these should be noticed, schedule an appointment with Dr Kernohan.

How quickly can melanoma appear?

  • Melanoma can appear and spread very quickly. Melanoma may become life-threatening in as little as six weeks as it spreads to the surrounding tissues.

What is early stage melanoma?

  • Based on how much cancer has spread, it is divided into five categories, ranging from 0 to 4. 0 is the initial stage, where melanoma is present only on a portion of the skin (usually a very small change). Stage 4 means that metastasis is present.

What is the most effective treatment for melanoma?

  • Wide excision is the most effective treatment for melanoma. The specialised plastic surgeon will surgically remove the melanoma and the surrounding skin during this procedure.

Does Stage 1 melanoma require chemo?

  • Most probably not. Stage 1 melanoma mostly does not require additional treatments.

What does Stage 2 melanoma look like?

  • Stage 2 melanoma is more than 1mm thick and may have spread to deeper skin layers. It has not spread to other parts of the body yet.

Can you have stage 4 melanoma and not know it?

  • Yes. In some cases, even stage 4 melanoma may not give any symptoms. The change is detected through a scan.

How do you know what stage melanoma you have?

  • After removal, your specialised plastic surgeon will examine the tissue removed. He may look at the thickness and other characteristics to determine the stage in the development of cancer. He may also order a full biopsy of the tissues.

Where does melanoma usually spread first?

  • Melanoma may release some of its cells into the intercellular space. These cells are then carried by lymph to the nearest lymph node.

Can you tell if melanoma has spread?

  • Yes and No. If melanoma has spread only in the skin area, you may feel small nodules that increase in size and number over time. In some cases, the cancer cells may spread to deeper tissues where it can be difficult to tell they are there.

Can melanoma be cured?

  • Yes, melanoma can be cured. The 5-year survival rate in patients with early detection of changes is around 99%.

What should I eat if I have melanoma?

  • In general, eating a healthy and well-balanced diet rich in fibres, antioxidants and zinc should be enough to keep your body healthy and happy. Your doctor may be able to give you some more advice on the exact peculiarities of your diet since some cases may require mild adjustments to suit better any medication you may be taking.

What can be mistaken for melanoma?

  • Pyrogenic Granuloma, Dermatofibroma and Seborrheic Keratosis may be mistaken for melanoma.

What is the treatment for early stage melanoma?

  • Surgical excision is the best treatment for early stage melanoma. Various other procedures, such as cryotherapy, PTD therapy, and laser therapy, may be used in early-stage melanoma treatment.

Does vitamin D prevent melanoma?

  • High vitamin D concentrations have been shown to slow down the progress of melanoma and improve melanoma patients’ survival rates.

Further Reading about Melanoma