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The Good, the Bad & the Ugly - a close look at Melanoma

Writer: Shelley SilverwoodShelley Silverwood

Since it is Melanoma New Zealand’s annual melanoma awareness campaign called “Get Spotted” I wanted to delve into some information and statistics around melanoma in New Zealand and why it is the dreaded skin cancer of all skin cancers.



So what is melanoma?

Melanoma is the most serious type of skin cancer. It can spread rapidly and can be life-threatening if left untreated (Ministry of Health, 2023). In a melanoma there is an uncontrolled growth of melanocytes, the cells that produce melanin (Dermnet, 2022). Melanocytes are what give us moles (naevi) and freckles (solar lentigines), however, these are normal entities. When that growth becomes abnormal or cancerous, this gives rise to melanomas.


What are New Zealand's current statistics?

New research from JAMA Dermatology shows New Zealand has the world's highest death rate from melanoma with 350 New Zealanders losing their lives to melanoma each year (Cancer Society, 2022). In 2021, there were 2859 melanoma registrations (EHINZ, 2021); these statistics were worse for males. The mean age for melanoma diagnosis is 65.7 years among men and 62.4 years among women (Dermnet, 2022).


What causes Melanoma?

The most common cause of melanoma is overexposure to UV radiation causing cell mutation leading to uncontrolled growth of melanin-producing cells (Dermnet, 2022).

The other cause is a genetic predisposition and family history of melanoma.

You are most at risk of developing melanoma if:

  • you’ve had a skin cancer before

  • family/whānau members have had skin cancer

  • you’re a skin type that sunburns easily

  • you have red, blonde or light-coloured hair

  • you have many moles or larger moles

  • you used sunbeds/tanning beds (solariums)

  • you spent a lot of time in the sun unprotected


What does a melanoma look like?

Melanomas are mostly* pigmented lesions and can be new lesions or can arise within an existing lesion. The ABCDE rule was developed for people to easily remember the various characteristics of melanoma. If you notice a NEW lesion or a change in an EXISTING lesion, you should get it checked.


*(Please note that there are also melanomas that are lacking any pigment – amelanotic melanoma – however for simplicity, these won’t be discussed here due to their rare nature.)


How do I prevent getting a melanoma?

First and foremost, sun protection, sun protection, sun protection! As UV radiation is the biggest cause of melanoma, the best prevention method is:

  • sunscreen

  • UV protective clothing

  • wear hats

  • wear sunglasses

  • seek shade where possible

  • avoid sunbeds

Another great habit to get into is to see a health professional trained in dermsocopy to give you a skin check. They can map any of the more atypical moles and monitor lesions for change. This is particularly useful as some areas are tricky to self-monitor (such as the back and the back of the legs, etc.)


The outlook for melanoma

The good news is that if you catch a melanoma in its early stages, it can be easily treated with surgical removal. If by chance, a melanoma spreads, we now have some options for immunotherapy drugs, though these are limited in NZ.


The take home message

  • Be sun aware

  • Self-monitor your own skin

  • Remember the ABCDE rule

  • Get annual skin checks

  • If in doubt, check it out!

Check out the ABCDE rule here



Examples of Melanoma

Photos courtesy of Dermnet NZ



If you have a spot that is NEW, changing or you're not sure - get it checked. SKiNTUITION offers 'spot checks' using dermoscopy to analyse the lesion for you.


IF IN DOUBT, CHECK IT OUT!



 
 
 

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