The following information is based on patient info leaflets produced by the British Association of Dermatologists, and can be found at http://www.bad.org.uk

What is Melanoma?

Melanoma is a type of skin cancer, which arises from the pigment cells (melanocytes) in the skin. In a melanoma skin cancer, the melanocytes become malignant and multiply excessively. One of the most important causes of melanoma is exposure to too much ultraviolet light in sunlight. The use of artificial sources of ultraviolet light, such as sunbeds, also increases the risk of getting a melanoma. 

Melanocytes make a brown/black pigment (known as melanin), and often the first sign of a melanoma developing is a previous mole changing in colour or a new brown/black lesion developing. Most frequently there is darkening in colour but occasionally there is loss of pigmentation with pale areas or red areas developing. 

Melanoma is considered to be the most serious type of skin cancer because it is more likely to spread (metastasise) from the skin to other parts of the body than other types of skin cancer. If melanoma has spread to other parts of the body, those deposits are known as secondary melanoma (secondaries/metastases).

Diagnosis and initial treatment

 Although a diagnosis of melanoma can be serious, most melanomas are caught at an early stage and so do not cause any further problem. If lesions are not caught at the early stages, then there is a higher risk of the melanoma spreading, which can reduce life expectancy.

 The initial treatment for a suspected melanoma is to cut out (excise) all of the melanoma cells. When the lesion is first removed, we do not know for sure if it is a melanoma or not, and if it is a melanoma how thick it is, so the excision is usually done with narrow margins (the area of normal skin around the suspected melanoma). The specimen that is cut out from the skin is sent to a laboratory, so that a pathologist can examine it under the microscope. Pathologists look to see if what has been removed is a melanoma and how thick it is. This is the only way a diagnosis of melanoma can be confirmed. Once confirmed as a melanoma further surgery will be require. This involves a wider excision of the site where the melanoma was found and, if needed, a reconstruction. It may also involve a sentinel node biopsy, in which a number of lymph nodes near the melanoma are removed and examined to see if the melanoma has spread here. However, the decision regarding further procedures will be discussed with the patient once the initial histology results have returned.