Melanoma

What is Melanoma?

Melanoma is a type of skin cancer that begins in skin cells called melanocytes – the cells responsible for producing melanin, the pigment that gives skin its colour. These cells are located in the upper layer of the skin and can mutate into cancer cells when damaged by ultraviolet (UV) radiation. Damage tends to occur on body parts that are exposed to excessive sunlight, but melanoma can also develop in areas not regularly exposed. It’s commonly thought that melanoma only affects moles on the skin. However, melanoma can develop anywhere on the skin – even in areas not easily visible.

At Montserrat Medical Services, we deliver advanced, patient-focused care for early melanoma diagnosis and surgical treatments. Our expert team of surgeons and state-of-the-art facilities mean you will always get a safe and comfortable experience, so you can expect peace of mind throughout – from diagnosis through to recovery.

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Melanoma Symptoms

Identifying a melanoma in time can be difficult, as it can change the appearance of an existing mole or appear as a new spot on the skin, even in places on the body that can’t be comfortably reached. Early detection is therefore critical because melanoma can evolve very quickly. Melanomas come in many different forms, with some of the most common signs of their presence including:

Colour

A mole might change in colour, have uneven shades or appear blotchy.

Size

Moles that grow larger than 6mm are cause for concern.

Shape

Irregular shapes or asymmetrical moles are red flags.

Elevation

A mole may become raised or have an uneven surface.

If you notice any of these changes or are unsure about a suspicious spot, speak to your doctor or contact Montserrat Medical Services for a consultation. Early intervention can make all the difference.

Melanoma Risk Factors

Skin cancer, like melanoma, results from DNA damage in skin cells. While our immune systems can work to repair some of the damage, it can lead to these mutations that cause melanoma to grow. However, many factors increase the risk of melanoma and developing skin cancer, including:

  • Unprotected or excessive UV radiation exposure from the sun or tanning beds.
  • Having more than 50 moles and more than 10 above the elbows on the arms.
  • A high number of unusual moles.
  • Compromised immune system.
  • Family history of melanoma in a first-degree relative (parent, sibling or child).
  • Fair skin, which tends to burn and cause skin damage, light eye colour (blue or green), and light or red hair colour.
  • Having a previous melanoma or non-melanoma skin cancer.

Protecting your skin from UV damage and conducting skin checks regularly are the best ways to reduce your risk. If you’re concerned, our team at Montserrat Medical Services can give you expert care and advice about skin cancer prevention.

Melanoma Diagnosis

Discovering melanoma at an early stage is crucial. However, it can be difficult to recognise the warning signs and understand how to detect them. Below are the most common tests used to identify melanoma:

ABCDE

A doctor can use a handheld magnifying instrument called a dermascope to closely examine and assess suspicious skin spots for signs of melanoma. To help doctors correctly identify potential skin cancers, the ABCDE criteria are widely used and trusted for diagnosis:

  • A for Asymmetry: Most melanomas are asymmetrical, meaning they are uneven on both sides if you draw a line down the middle of the spot, unlike benign moles, which are typically symmetrical.
  • B for Border: Normal moles have smooth, even borders, while melanoma borders are often irregular, uneven or grooved, making them stand out during a close examination.
  • C for Colour: A melanoma usually has multiple shades of brown or black, and as it grows, additional shades like red, blue and even white can appear, which makes it more visually distinct.
  • D for Diameter: If a spot is 6mm in diameter or larger, it should be evaluated, as most benign moles are smaller and less likely to grow in size over time.
  • E for Evolving: This letter encompasses all the above factors and focuses on any changes in size, shape, colour or elevation, as well as the development of new symptoms like bleeding or itching.
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The Five Main Types of Melanomas

Superficial Spreading Melanoma
Lentigo Maligna
Acral Lentiginous Melanoma
Nodular Melanoma
Amelanotic Melanoma

Superficial Spreading Melanoma is the most common type of melanoma, which can grow in an existing mole or appear as a new lesion. In the early stages, it appears on the top layer of the skin before penetrating deeper into the body. It can look like a flat or slightly raised patch, and the colouration can include shades of tan, brown, black, red/pink, blue or white. This type of melanoma tends to develop on areas that are frequently exposed to the sun and grows at a relatively slow pace initially.

Lentigo Maligna is most common in older people and can spread to other body parts, making it a metastatic melanoma. It generally looks like a flat or slightly raised, blotchy patch with uneven borders and is usually blue-black, tan to brown or dark brown. This type of melanoma can appear on sun-damaged skin on the face, ears, arms or upper torso. Lentigo Maligna tends to develop over years and is more common in people who have had significant sun exposure throughout their lives.

Acral Lentiginous Melanoma is most common in people of colour and can appear under the nails and on the soles of the feet or palms of the hands. It can look like a black or brown area on the skin’s surface. This form of melanoma is generally diagnosed in later stages compared to other skin cancers, mainly due to its location in areas that are less frequently examined. Early detection can be challenging, which is why regular skin checks are vital for high-risk groups.

Nodular Melanoma is the most aggressive type and grows more profoundly into the skin faster. The tumour is commonly found on the torso, legs and arms but can also be found on the scalp in older men. It’s often recognised as a bump on the skin and usually a blue-black colour, but it can also appear as red and pinky. Unlike other types, nodular melanoma grows vertically rather than spreading along the skin’s surface, which increases its potential to invade deeper tissues and spread to other parts of the body.

Amelanotic Melanoma is a less common but still potentially dangerous type of melanoma that lacks the typical pigmentation seen in other forms. This makes it much harder to identify. The melanoma occurs as a pale, pink, red, or skin-coloured patch, which can resemble benign conditions like rashes or scars. It’s also a melanoma that can appear anywhere on the body, including areas not exposed to the sun. As such, it’s more likely to be detected in advanced stages.

Melanoma Treatment Options

At Montserrat Medical Services, we specialise in diagnosing and treating melanoma skin cancers. The surgical method we use to remove cancerous tumours depends on several critical factors, including the biopsy report results, the location and type of melanoma, and the risk of the cancer spreading.

Staging

During the diagnosis phase, test results will determine whether melanoma is present and if it has spread to other parts of the body. The next step is staging, which helps predict the course of treatment by measuring the thickness of the skin cancer. Staging is categorised from 0 to 4, usually written as Roman numerals:

  • Stage 0: less than 0.1mm
  • Stage I: less than 2mm
  • Stage II: greater than 2mm
  • Stage III: spread to lymph nodes and 
  • Stage IV: spread to other parts of the body.

Options for Early Melanoma

Early-stage melanomas are typically removed through surgical excision, which is generally effective in eliminating the cancerous tissue entirely and preventing further spread. It’s a relatively straightforward procedure, so there’s minimal disruption to the patient’s daily life.

To reduce the risk of biopsy-confirmed melanomas recurring at the original tumour site, we can perform a procedure called a wide local excision – this involves removing the cancerous tissue along with a surrounding margin of healthy skin cells to make sure all abnormal melanoma cells are eliminated. The width of the margin depends on the size, thickness and location of the melanoma.

Patients undergoing this procedure can expect a specialised treatment plan, with post-surgical care for wound healing and monitoring for any signs of recurrence.

Surgical Melanoma Treatments

All surgical treatments are performed under local anaesthetic and typically take about 30 minutes for smaller melanomas. Most wounds heal within a few weeks. If suturing isn’t possible, a skin flap or graft may be needed. Scarring varies based on the melanoma’s size and location, as well as post-operative wound care. At Montserrat Medical Services we provide a range of effective melanoma treatments including:

Surgical Removal/Excision
A local anaesthetic is carefully applied to numb the affected area to support minimal discomfort during the procedure. The cancerous tissue is then removed using a scalpel, along with a surrounding margin of healthy tissue to ensure all abnormal cells are eliminated. It’s a highly effective method of treatment for early-stage melanomas and should prevent the cancer from recurring or spreading to other parts of the body.
Flap Surgery
For larger or more complex wounds that cannot be closed with simple sutures, healthy skin and underlying subcutaneous tissue are carefully transferred from a nearby area of the body. This technique covers and repairs the wound while maintaining blood supply to promote faster and better healing. Flap surgery is used in areas where keeping the natural contour and function of the skin is important.
Graft Surgery
Similar to flap surgery, this technique involves transplanting healthy skin from another part of the body to cover the affected area. However, in this method, the grafted skin relies on the blood supply from the wound site itself to heal and integrate successfully. This approach is used for larger wounds or areas where the skin can’t be stretched to cover the defect.

If you have any questions concerning melanoma or suspect you are at risk of developing skin cancer, get in touch with one of our Montserrat Medical Services clinics and we can organise a consultation.

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Our Doctors Who Perform Melanoma Excisions

At Montserrat Medical Services, we understand a melanoma diagnosis can be overwhelming. Our team is committed to providing clear, accessible information and comprehensive care to guide you through every stage of your treatment. With state-of-the-art facilities and a patient-centred approach, we strive to make your experience as reassuring as possible. Schedule a consultation with our expert specialists today and take the first step towards peace of mind.

Dr Kevin Hung

General Surgeon | FRACS MBBS

No Gap Doctor
Languages: Mandarin (Chinese), Hokkien & English
Dr Hung qualified as a General Surgeon is 2014, and has since spent the majority of his career providing care in regional settings. He appreciates
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Dr Rasika Kotakadeniya

General Surgeon | MBBS MS FRACS

No Gap Doctor
Languages: Sinhalese & English
Rasika has over 20 years of experience in general surgery. With extensive training both internationally and locally, he credits his surgical experience in Sri Lanka
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Dr Grace Lim

General Surgeon | MBBS, MS, FRACS

No Gap Doctor
Telehealth Available
Languages: Malay, Mandarin & English
Dr Lim has been a General Surgeon for over two decades and is renowned for her holistic approach to patient care. Dr Lim has excellent
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Contact our experienced team for personalised care and support today.