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Broadly speaking skin cancers are classified into two groups: melanoma and non-melanoma skin cancer (NMSC).
Patients are often surprised to learn that melanoma has 4 recognized varieties: superficial spreading (the most commonly encountered in Australia), nodular (amelanotic ('red') a very dangerous form); and acral (prone to growing on the heel or bottom of the foot – the most common form in African and Asian decent peoples). The fourth variety is called Lentigo maligna and often arises from "liver/age spots", generally in the older age group, however not always.
In Australia, the rate of melanoma is growing; and worryingly increasing the in 16-26 age group. Melanoma grows from skin cells called melanocytes, which are responsible for pigment in your skin. However if these cells accumulate enough UV radiation they have the potential to become malignant. Some forms of inherited disorders such as dysplastic naevi syndrome, develop melanoma regularly via a genetic mechanism that is not well understood.
Doctors diagnose melanotic lesions with a special hand-help microscope call a dermatoscope, they look for 7 specific features. Change is color is sometimes noticeable to the naked eye, but doctors look for a increased in the different amounts of color, change is symmetry and shape, moth eaten edges, and ground glass appearance (which means the lesion has gone deeper into the skin). Science has further developed digital tools for melanoma detection, photographs can be digitally overlaid and changes can be tracked.
Melanoma is a surgical disease, if found early and small enough, the lesion is excised (excision biopsy) and sent to a specialist doctor called a pathologist, who stains the lesion with special dyes and looks for certain cell types and patterns. It the pathologist reports the lesion as positive, then the doctor is required to complete a clearance excise, which is guided to how deep the melanoma grows. Melanoma has proven to be quite resistant to chemotherapy treatment, and research is continuing on immuno-modulator treatments.
Risk factors
• Sun exposure, particularly during childhood
• Fair skin that burns easily
• Blistering sunburn, especially when young
• Previous melanoma
• Previous non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma)
• Family history of melanoma, especially if two or more members are affected
• Large numbers of moles (especially if there are more than 100)
• Abnormal moles (called atypical or dysplastic naevi)
Things you can do for you and your family:
• Sunscreen is secondary to shade! Use both to protect your skin;
• A single sunburn before the age of 6 remarkably increases your risk of melanoma;
• Over the age of 35, in rural communities, get your doctor to conduct a yearly skin check;
• Check your own skin regularly: a skin cancer will often itch or be irritated up to 18 months before it becomes dangerous;
• If you have a family history of skin cancer and melanoma ensure your doctor knows;
• Your chances of being diagnoses with melanoma increases with number of NMSC you have.
More information:
How to check you skin
http://www.nswcc.org.au/editorial.asp?pageid=1316
www.eyramedical.com.au/treatments/solarscan
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