What is Melanoma? Why is Early Diagnosis Key?

Melanoma is one of the most common cancers diagnosed in people aged 15 - 34 and cases are on the rise, with just under 13,000 people in the UK being diagnosed per year.

Melanoma is a type of skin cancer. It is more aggressive than other forms of skin cancer and can spread to other areas of the body quickly, developing in existing moles on the skin or in otherwise normal looking skin.

The main cause of melanoma is ultraviolet light associated with exposure of skin to the sun and sunbed use.

The chances of getting melanoma are often higher if you have a large number of existing moles, pale skin and if you have your own previous or a family history of skin cancer. Melanoma is slightly more common in women than men, and is more common in older people. Women are most likely to develop melanoma on the legs, and in men on the chest area and back. Melanoma can, however, appear anywhere on the body, with some rarer types affecting the eyes, soles of the feet, palms of the hands and genitals.

A correct diagnosis of melanoma, with the instigation of timely and appropriate treatment, is key to ensure the best outcome for an individual. If left untreated, a late diagnosis can mean the difference between making a full recovery and suffering spread of the cancer and/or development of malignant melanoma of which the prognosis is much more severe and sadly even fatal.

Symptoms of Melanoma. How to check and what to do!

Check, check and check again! It can be difficult to assess changes in your skin, but if you think an existing mole, an existing freckle, or previously normal-looking skin has changed, the ABCDE checklist can help to explain what to be looking for.

A - Asymmetry
Melanomas are most likely to be an irregular shape or asymmetrical, whereas ordinary moles are usually symmetrical with both halves looking the same.
B - Border
Melanomas are more likely to be uneven and may have a blurred or irregular border with jagged edges. Ordinary moles are usually round with a well-defined, clear, smooth-edged border.
C - Colour
Melanomas tend to be more than one colour or a mix of different shades. For example brown mixed with a black, red, pink, white, blue or even grey tint. Normal moles tend to be one shade of brown or a single colour.
D - Diameter (width)
Melanomas are usually larger and more than 6mm wide, whereas normal moles are ordinarily usually smaller.
E - Evolving (changing)
Normal moles do not usually change over time. A mole which may be a melanoma may change over time and become larger and change in shape or colour. This can include a change in shape with the affected area becoming raised or dome-shaped.

Other signs to consider are if an existing mole becomes itchy, is bleeding, crusty, swollen or sore.

Should you think any of the ABCDE criteria apply or if you have any other concerns, you should contact your GP as soon as possible.

What treatment is available to me?

Your GP should physically examine you; take a history of your concerns, and consider whether a referral to a specialist dermatology unit at hospital is necessary.

This may, in the first instance, mean a photograph of the affected area is sent to a dermatologist to review and report back to your GP with next steps.

Alternatively, you may be referred to hospital for an appointment with a dermatologist face-to-face should the GP consider that your condition needs to be investigated straight away. You should be given an appointment with a two week time frame if this is the case.

If a specialist at hospital determines that the area is concerning they may surgically remove this in minor surgery, together with a small border of skin around this area. This would then be sent for testing to determine whether the area is a melanoma. If not, you likely shall require no further treatment. If testing is positive for melanoma, the specialist will advise accordingly but you would typically immediately require a further excision of skin and further testing to consider any spread of the disease.

What if I think a melanoma diagnosis has been missed or delayed? Can I make a claim?

Firstly, do not further delay in seeking any further medical assistance and treatment required to deal with your condition.

Should you consider that any element of your diagnosis and/or treatment has been missed or delayed then you may have a potential claim for clinical negligence and should consider seeking the appropriate legal advice. Specialist advice can include a close examination of your medical records and potentially the instruction of medical experts to consider the facts of your case. Specifically a medical expert, such as a GP and/or a specialist cancer oncologist, may be instructed to comment upon any potential breaches of duty and to further comment upon whether any delay or missed diagnosis has made a difference to your outcome i.e. the staging of cancer.

Lanyon Bowdler’s Clinical Negligence Team has a wealth of experience in dealing with cases concerning melanoma and other skin cancers and includes members of the Law Society’s Clinical Negligence Panel and AvMA panel. Please get in touch to discuss matters further with a member of our team who shall guide you through the process sensitively.

Credit to www.nhs.uk and The Christie NHS Foundation Trust website – 16 November 2023