Dr Ian Webster
Dr Ian Webster

Malignant Melanoma

As a Dermatology registrar at Groote Schuur Hospital for 4 years and in private practice for the past 23 years, I see people who are still under the impression that skin cancer is not a dangerous cancer that can kill you.

Approximately one in every fifty white South Africans will develop a malignant melanoma in their lifetime. On average one American dies from a malignant melanoma every hour and it is the second most common form of cancer in females aged 15-29 years in the USA.

The problem is that in the early stages a malignant melanoma has very few signs or symptoms. There may be subtle changes in size and shape and often by the time the lesion bleeds or becomes ulcerated it is too late.

South Africa has one of the highest incidences of malignant melanoma in the world besides Australia. Research has shown that a malignant melanoma is caused by short intensive bursts of sun exposure. Experiencing five or more blistering sunburns between the ages of fifteen and twenty increases the melanoma risk by 80%. Patients at high risk of developing melanoma are those with a fair Celtic complexion, a family history of melanoma and who have multiple moles on their body.

“There may be subtle changes in size and shape and often by the time the lesion bleeds or becomes ulcerated it is too late”

Where there is a family history of melanoma, or a child or an adolescent with multiple moles, the risk increases greatly. Melanomas usually arise from moles which develop from an overproduction of melanocytes and this commonly occurs during childhood or adolescence. While most moles are safe as long as they stay the same, the melanocytes can sometimes grow and mutate in an uncontrolled way and change the character of a mole. This is time to consult your GP or Dermatologist for a skin assessment.

“Melanomas usually arise from moles which develop from an overproduction of melanocytes and this commonly occurs during childhood or adolescence”

If you fall into the high risk category of developing a malignant melanoma you should be meticulously careful about avoiding excessive sun exposure. When outdoors always wear the appropriate clothing and hat (not a peak cap) and use a high factor, broad-spectrum sunscreen which should be re-applied regularly. New research has found that the daily use of a good sunscreen can cut the incidence of malignant melanoma in half. You should also schedule regular full body skin examinations preferably with mole mapping if indicated – not all moles require mole-mapping.

It is important to get to know your own, your partner and your children’s moles. If you notice that a mole has changed in size, colour or it starts to itch and bleed it is very important not to delay seeing your doctor. A quick easy guide to help you with your monthly self-examinations:

  • A – Asymmetry – check if one half of the mole does not match the other half
  • B – Border –check if they are irregular, ragged, blurred or notched
  • C – Colour – check for differing shades of tan, brown, black, red, blue, white
  • D – Diameter – check the size of the mole & note any changes to size
  • E – Evolution – check if the mole has grown or changed

Early screening, diagnosis and treatment of a malignant melanoma could save your life.

Posted in LEARN / SKIN CONDITIONS on September 15th, 2016.

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