As this is the most dangerous type of skin cancer – one should be very aware of the facts concerning melanoma. There are presently over 48 000 melanoma related deaths in the USA only. Don’t fool yourself in thinking it can’t target you or a loved-one. If you have more than 50 moles on your body and/or had at least one blistering sunburn as a child (18y or younger), have fair skin and light eyes - then read on.

Melanoma is a malignant tumour of melanocytes (the uncontrolled growth of pigment cells). UVA and UVB are the ultimate cause of melanoma. Genetics also plays a huge role. If a close relative had it, chances are another will get it. When you suspect a mole could be malignant, first thing you should do is to go to a dermatologist or surgeon. A biopsy will be done on the mole and one or two pathologists will then examine it. A mole should never be cauterized of shaved!! If your results come back ‘positive’ – surgery to remove the tumour will be performed within a week.

Melanoma gets graded in tumour thickness/depth. Any tumour 4mm or more will be treated with utmost seriousness. Even with melanomas under 4mm, regular 6month interval check-ups for 5 years (by your oncologist) will be required after surgery. These check-ups will mostly involve chest x-rays, liver scans and blood tests. Once you had a malignant mole, chances are you might get one again. Therefore one has to do self examination on a monthly basis, or visit a dermatologist 6 monthly, for at least 5 years. A good dermatologist should take photos of various moles to see if there are any changes in the months to come.

You should know that the removal of a malignant melanoma is a bigger operation than you might imagine. The surgeon will cut ¾ inches around the mole, in the shape of an eye – and also remove any invaded parts of skin beneath the mole. It is never a small cut, and often skin graphs are necessary after surgery. When removing such a tumour, the surgeon will also remove some lymph nodes closest to the infected area, and a pathologist will immediately test it for malignancy.

For tumours of 4mm or more, and/or the melanoma reached the lymph nodes closest to the malignancy, all those lymph nodes will be removed. You will receive chemotherapy, immunotherapy and/or radiotherapy soon after the surgery. Melanoma might metastasise to other organs like the lungs or liver, where it is extremely difficult to treat. This will be diagnosed as stage 4 cancer, and is very serious.

As our skin is our largest organ, one has to take very special care of it. Children under the age of 18 should NEVER sunburn. Most melanoma cases are related to childhood sunburns. Children should always wear a sun factor of 15 or higher and never be in the sun between 10am and 4pm. Apply lotion ½ hour before sun exposure, and re-apply at least 2hourly. Broad rimmed sunhats should always be worn. Even sunglasses that block UV rays are important, as melanoma can form in the eyes. There is a 78% risk reduction of melanoma if a person never experienced blistering sunburn as a child!!!

For adults, the same rules will apply. One should also think twice before using sun beds, as even moderate risks should be noted as dangerous – especially when there is a history of melanoma in the family. Always remember the ‘ABCD’ rule when inspecting a mole. A – for asymmetry (a bad sign), B – for borders (they shouldn’t be uneven), C – for colour (any change in colour should be noted), and D – for diameter (change in size, or moles larger than a pencil eraser is not good). If you have a mole removed and it was only a ‘dysplastic nevi’ – be aware that you still are at a high risk.

In males, melanoma usually forms in the upper body – especially the back, neck and head. In woman, the lower legs, soles of feet, palms of hands and nails are more at risk.

Please bare in mind that redheads are extremely susceptible to sunburn and melanoma.