Melanoma Skin Cancer

What is melanoma skin cancer?

Frequently asked questions

• How do I know if I have melanoma? Is it a mole or melanoma?

  ABCDE! The ABCDE acronym helps you describe if your mole has changed or not. It stands for asymmetry, border, colour, diameter, and evolving. If you notice any changes in the appearance of your mole in any of these ways, such as if it has increased in size or become darker or lighter in colour, it’s worth getting it checked out by a dermatologist. Equally, if you’re developing any symptoms such as pain or bleeding from what was previously a mole, I’d also recommend getting that lesion seen by an expert.

• My mole has become more pale, could it be melanoma?

  Any change in pigmentation of a mole, whether it be getting lighter or darker should be taken seriously. Therefore you should see your doctor if this happens. There is a subtype of melanoma called amelanocytic melanoma which doesn’t produce the skin pigment that can give melanoma it’s dark appearance. This type of melanoma can look paler or even more pink/reddish/grey than the surrounding skin.

• Who is most at risk of getting melanoma?

  While melanoma can occur in anybody, there are certain groups of people that are more likely to get melanoma than others. These are people who’ve spent most more time in sunlight or other UV light such as sunbeds. People with fair skin and light eyes and those with lots of moles are at higher risk. Also, those with a family history of melanoma should be more vigilant to any change in their skin.

• I’ve had my melanoma removed and now my dermatologist wants to do a second operation. Why is that?

  The best way of diagnosing melanoma is with an excision biopsy. Sometimes once you skin lesion has been confirmed to be melanoma, your dermatologist may want to remove more tissue from around the site of the melanoma. That’s because the risk of your cancer coming back is dependent upon the amount of normal tissue surrounding the melanoma (the margin) that was taken away. If the margin is very close to the melanoma, we may recommend removing more skin to ensure that the melanoma has been fully cleared. This reduces the risk of it coming back in the future. The amount of normal tissue that needs to be removed from around the melanoma depends upon how deeply your melanoma has invaded into the skin, and your dermatologist will talk to you about the size of the margin that’s required to give you the best results.

• Am I going to be left with a scar?

  To remove the melanoma, you are going to be left with a scar. I work with a network of highly-skilled dermatologists and plastic surgeons who will ensure you get the best cosmetic outcome possible.

• Can my melanoma kill me? Am I going to die?

  Melanoma is a serious condition. It depends on your cancer and I’ll do all that I can to give you treatment that offers cure. The vast majority of people diagnosed with melanoma in the UK are given curative treatment.

  The likelihood of a melanoma causing your death depends on the stage of the melanoma when it was diagnosed. If you have a stage 1 melanoma, your chances of never having a problem with melanoma again after it’s removed with a good quality operation are very high. Conversely, if your melanoma has spread throughout the body, treatments aim at shrinking, controlling, and containing the disease for as long as possible, but unfortunately are unlikely to offer cure. The patients who present with disease that falls between these two extremes, that means those with high-risk features in their melanoma or those who present with a melanoma that has spread to the lymph nodes, treatment will be offered to reduce the risk of melanoma returning after you’ve had a successful operation. In some people, I recommend giving immunotherapy before an operation to give you the best chance of a successful operation and being cured of melanoma.

• Can drugs be used to reduce the chance my melanoma coming back in the future? Do I need to have chemotherapy?

  Some patients will be benefit from additional drug treatment to reduce the risk of the melanoma coming back or spreading. The most commonly used drugs are immunotherapy (pembrolizumab or nivolumab) or targeted therapy (dabrafenib with trametinib). Treatment is usually for 1 year after your operation.

• Will I need to take time off work?

  You will need to take some time off work to have any biopsies or surgical removal of your tumour, but depending on the stage of your melanoma, this may be a short period of absence. If you are receiving drug treatment or radiotherapy for melanoma, I’ll discuss the treatment schedule with you and, where possible, we can fit it around your work commitments. If you experience side effects of treatment, you may need to stay off work, but I’ll talk to you about the risk of this happening before treatment starts.

• Is there a risk of the cancer coming back or of me getting another cancerous mole somewhere else?

  With any cancer, there is always a risk of it coming back – the risk varies depending upon the individual characteristics of your melanoma and the degree to which the melanoma has spread in your body. We’ll agree on a follow-up schedule – both in clinic and with scans if needed – that is personalised to your individual risk to ensure that any cancer recurrence is detected promptly so that we can offer treatment quickly to give you the best chance of eradicating your cancer

• Are there any serious side effects of immunotherapy for melanoma?

  Immunotherapy enhances the immune system’s ability to detect and attack cancer cells, but it can also cause immune-related side effects. These side effects are different from those of chemotherapy or radiotherapy, as they result from the immune system attacking normal cells in the body. They can range from mild to severe and may appear during treatment or even months after it has ended. It’s crucial to be aware of these potential side effects and get in touch with me if you experience any symptoms.

  Immunotherapy, can cause side effects affecting various parts of the body, including the skin, bowels, lungs, liver, kidneys, hormones, heart, muscles, and nerves. Symptoms to watch for include rashes, diarrhoea, breathlessness, yellow skin or eyes, blood in urine, increased tiredness, and chest pain. Always contact the me or the emergency number I give you immediately if you notice any of these symptoms. With the right management, the benefits of immunotherapy can be maximised while minimising its risks, helping you maintain your health and well-being.

• What can I do to reduce my risk of getting melanoma?

  Excessive sun exposure is a leading cause of melanoma, to reduce the risk of developing a melanoma, I therefore advise avoiding the sun during the hours of its peak intensity (10am to 3pm), always us an SPF of 30 or higher (even on days that aren’t particularly sunny), reapply the sun screen every couple of hours, cover yourself with clothing, wide-brimmed hats during any extended periods in the sun.