Melanoma | North Bristol NHS Trust

What is melanoma?

Melanoma (also called malignant melanoma) is a type of skin cancer that may develop from a preexisting mole (one you already have) or in normal looking skin. Research shows UV rays from the sun or tanning beds can harm the skin.

Symptoms

The first symptoms of melanoma are a new or changing mole with an irregular outline, shape, or colour.

Diagnosis

Your moles will be examined at the clinic using a handheld instrument called a dermatoscope. You may be advised to have the mole removed if it is suspicious.

How is melanoma treated?

First treatment will be surgery to remove the mole. This is called an excision biopsy.

Excision biopsy: The first step is to numb the area around the mole. Then the mole is removed and sent for testing. It takes about 4-6 weeks to get the results. Specialists called histopathologists look at the sample closely to see how deep it goes. Thin melanomas are less likely to spread elsewhere in the body.

If melanoma is found, the doctor might recommend a second treatment. This is called wide local excision.

Wide local excision: This means cutting out more skin around where the melanoma was, to make sure no cancer cells are left and to help prevent it from coming back in the same area. They might stitch up the wound or do other treatments like a skin graft. How long it takes to recover depends on the surgery.

There is a small chance that your melanoma may spread or come back, and this may be removed by further surgery.

Follow-up

After your surgery you will have a hospital appointment to check the scar and surgical site, receive your results, and discuss a follow-up plan. If you have started treatment elsewhere, we will discuss referring you back to them.

Self-examination

We will show you how to examine yourself to detect any recurrence at the site of removal or in the surrounding skin. This is one of the most important things you can do to help yourself.

Check for any new or existing moles that change colour, bleed, or itch. Most changes are harmless, but they may indicate the start of a skin cancer.
Any dark spots that develop either at or near the site of the removal of the melanoma should be reported to your skin cancer clinical nurse specialist.

Melanoma cells can spread to lymph nodes, causing lumps in the neck, armpits, or groins.

Any unusual symptoms that persist (don’t go away) should be reported. If you would like more information on this, please discuss with your skin cancer nurse specialists. If discharged, please go directly to your GP.

How do I examine myself?

It is important that once a month you perform your own examination at home.

A simple method is to use the palm of your hand to feel the skin. Many people find this works best when having a bath or shower. Use this same method to check the skin, between the scar, around the lymph nodes and the nodes.

For melanomas in the head or neck area, check the nodes on the side of the neck, under the chin, above the collarbones, behind the ears, and the back of the neck.
For melanomas on the arm, check the armpit on the affected side, above the collarbones and in the lower neck.
For melanomas on the leg, examine the nodes behind the knees and in the groin. Compare one side of your body with the other.
For melanomas on the front or back of your body, check your groins and armpits.

If you have any concerns and have been discharged, please see your GP. If you are under regular follow-up, please feel free to phone your skin cancer nurse specialist. The phone numbers are on the back of this leaflet.

Future protection

Take care whilst in the sun.
Never allow your skin to burn.
Wear a hat with a large brim.
Avoid strong sunshine between 11am and 3pm if possible.
Do not use sun beds or sun lamps.
Use high factor sunscreens (SPF 30+).
Sit under a shade.

Insurance

Inform your life insurance company if you have been diagnosed with melanoma. If you have critical illness insurance, you may be able to make a claim.

If you have a cancer diagnosis, or have had cancer in the past, this can affect your travel insurance. The company may consider you as higher risk. Fortunately, many insurance companies now assess cases individually rather than refusing everyone with a history of cancer.

Vitamin D advice

Protecting yourself from the sun is important, but regular exposure to a small amount of sunshine helps our bodies make vitamin D. If you avoid sunlight due to sensitivity or skin cancer risk, you may want to consider getting your vitamin D levels checked at your GP. You can take supplements and eat foods rich in vitamin D such as oily fish, eggs, meat, fortified margarines and cereals to maintain adequate levels.