In bustling Terrigal, 38-year-old Adam was living life to the fullest. A lover of outdoor adventures, his weekends were spent surfing along the golden shores or hiking.

One sunny afternoon, while applying sunscreen onto his skin before hitting the waves, Adam noticed an irregular mole on his shoulder. He attributed it to a harmless blemish from trying to get a darker tan. He decided to ignore it for the time being.

Weeks passed, and the mole began to evolve. Its borders were jagged, its hues ominous. Concern gnawed at Adam’s mind, so he finally sought medical advice. The diagnosis was chilling. Melanoma.

What is melanoma?

Melanoma is a type of skin cancer that develops from melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color. It can occur anywhere on the skin, including areas not exposed to the sun, and sometimes even in the eyes or mucous membranes.

According to the Cancer Council, over 18,200 new cases of melanoma were diagnosed in 2023 in Australia. Australia and New Zealand have the highest rates of melanoma in the world.

How is melanoma caused?

Melanoma is caused by exposure to ultraviolet radiation. This changes the structure and behaviour of the skin cells. The damage is permanent and builds up each time the person has unprotected exposure to the sun.

When you’re exposed to ultraviolet radiation, your skin increases the production of melanin in an attempt to protect the skin from further damage. Melanin is the same pigment that colours your hair and eyes.

Getting a tan will not protect your skin from sunburn or other skin damage. Tanning also causes premature aging of the skin, making it appear wrinkly and leathery over time.

What are the types of melanoma?

There are five main types of melanoma:

Superficial spreading melanoma

The most common is the superficial spreading melanoma. These are the most common type for people aged under 40 but can occur at any age.

Modular Melanoma 

These account for about 10 to 15% of cases and are usually found in people over 65.

Lentigo maligna

These are found in about 10 to 15% of cases and are the most common subtype for people over 40.

Acral lentiginous

These mostly affect people over 40 with dark skin such as African, Asian, Hispanic backgrounds

Desmoplastic

These affect about 1 to 2% of people and usually affect people over 60.

How do I spot melanoma?

Get to know your skin and look for any changes. Narara Valley Medical has some clinical expertise in skin cancer and can give you a skin cancer check by appointment. If a mole looks suspicious, they may take a sample and order a biopsy.

How dangerous is it?

Melanoma is considered highly dangerous because it has the potential to metastasize (spread) to other parts of the body, making treatment more challenging. If not detected and treated early, melanoma can be life-threatening.

How is melanoma diagnosed and detected?

Detection typically involves regular self-examination of the skin to identify any changes in moles, spots, or lesions. Suspicious changes include asymmetry, irregular borders, variations in color, diameter larger than a pencil eraser, or evolving size, shape, or color.

Diagnosis usually requires a biopsy, where a sample of the suspicious area is removed and examined under a microscope by a pathologist. Read about how melanoma is diagnosed on the Cancer Council website.

What are the treatment options?

Treatment options for melanoma depend on the stage of the cancer but may include surgery, chemotherapy, immunotherapy, targeted therapy, radiation therapy, or a combination of these approaches.

How do I prevent melanoma?

All of us can follow some simple prevention strategies:

  • SLIP, SLOP, SLAP, SLIDE: Slip on a shirt, slop on some sunscreen, slap on a hat, slide on some sunglasses.
  • Use sunscreen with a high Sun Protection Factor (SPF), even if it’s overcast.
  • Wear protective clothing, such as hats and long-sleeved shirts when outdoors.
  • Seek shade during peak sun hours. Walk on the shady sides of streets, or beneath awnings.
  • Avoid tanning beds and excessive sun exposure.
  • Perform regular skin self-exams and promptly report any changes to your doctor.

By adopting these preventive measures and remaining vigilant about changes in the skin, we can reduce their risk of developing melanoma and improve their chances of early detection and successful treatment.

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Adam was diagnosed with topical melanoma. He was lucky that it had not spread to his lymph nodes or other areas. With a mole scan and clinical advice, he was able to recover quickly.

However, the experience convinced him that perfect skin did not mean brown skin. He determined to slip, slop and slap and be happy with a creamier, more luxurious look. And when that would make him a very youthful 70-year-old one day.

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March is Melanoma Awareness Month.

‘There is nothing healthy about a tan. Nothing. Our bronzed Aussie culture is actually killing us,’ Professor Georgina Long, co-president of Melanoma Institute Australia says.

‘So we call on advertisers, and social media influencers – stop glamourising tanning, or using it to sell or entertain. And our fellow Australians – when you see it, call it out, and demand change,’ she said.

The aim of Melanoma March is to stop the glamourisation of tanning.

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If you’re unsure how to check your skin, Know your skin is a free resource that can help check for signs of skin cancer.

As always, this is general advice only and doesn’t represent personal medical advice. For your own health, nothing beats a consultation with a good doctor.