Medicines for Melanoma

What it is

Melanoma is a serious type of skin cancer that develops from the pigment-producing cells of the skin (melanocytes). Although less common than non-melanoma skin cancers, it is more dangerous because it is more likely to spread to other parts of the body if it is not found and treated early. The main cause is exposure to ultraviolet (UV) light, from the sun or sunbeds, and the risk is higher in people with fair skin, lots of moles or freckles, a history of sunburn (especially in childhood) or heavy UV exposure, a family history of melanoma, or a weakened immune system — though it can affect anyone. Melanoma most often appears as a new mole, or as a change in an existing mole, so being aware of the warning signs is important. A helpful guide is the "ABCDE" of melanoma: Asymmetry (the two halves of the mole differ), Border (irregular, ragged, or blurred edges), Colour (uneven, with more than one shade), Diameter (larger than about 6mm, or growing), and Evolving (changing in size, shape, colour, or becoming itchy, crusty, or bleeding). Any new mole, or a mole or patch of skin that is changing, unusual, or has these features, should be checked promptly. Melanoma can also occur in less obvious places, including areas not exposed to the sun, under nails, or on the soles of the feet. Caught early, melanoma is usually treatable, often with surgery alone; if it is found later and has spread, treatment is more complex, though newer treatments have improved outcomes for advanced melanoma. Protecting the skin from UV and getting changes checked early are the key messages.

How it is treated

Melanoma is diagnosed and treated by specialists, and the outlook depends greatly on how early it is found, so prompt assessment of a suspicious mole or skin change is important. A suspicious lesion is examined (often with a dermatoscope, a special magnifier) and, if melanoma is suspected, removed and examined under a microscope (biopsy/excision) to confirm the diagnosis and assess how deep it is, which guides further treatment. Treatment options include: surgery — the main treatment, removing the melanoma with a margin of surrounding skin, which often cures early melanoma; and, where the melanoma is thicker, has spread to lymph nodes, or has spread further, additional treatments such as further surgery, and — for advanced melanoma — newer targeted therapies and immunotherapy, which have significantly improved outcomes, along with radiotherapy in certain situations. Assessment of the lymph nodes may be carried out in some cases. Follow-up is arranged to monitor for recurrence or new melanomas. Prevention and early detection are strongly emphasised: protecting the skin from UV — by seeking shade (especially in the middle of the day), covering up with clothing and a hat, using a high-factor broad-spectrum sunscreen, and avoiding sunbeds — reduces the risk; and being aware of your skin, checking moles and skin regularly, and knowing the ABCDE warning signs help detect melanoma early. Any new or changing mole, or a mole that is asymmetrical, has an irregular border or uneven colour, is larger than about 6mm or growing, or is itching, crusting or bleeding, should be checked promptly by a GP, who can refer urgently if needed. The reassuring message is that melanoma caught early is usually treatable, often with surgery alone, and that sun protection and prompt checking of skin changes are the most important things people can do.