Skin cancer (melanoma)

Melanoma is a type of skin cancer that can spread to other organs in the body. See your GP as soon as possible if you notice changes in a mole, freckle or patch of skin, particularly if the changes happen over a few weeks or months.

Signs and symptoms of melanoma

The most common sign of melanoma is the appearance of a new mole or a change in an existing mole.

This can occur anywhere on the body. But the most commonly affected areas are the back in men and the legs in women.

Melanomas are uncommon in areas which are protected from sun exposure, such as the buttocks and the scalp.

In most cases, melanomas have an irregular shape and are more than one colour.

The mole may also be larger than normal and can sometimes be itchy or bleed. Look out for a mole which changes progressively in shape, size and/or colour.

An ’ABCDE moles checklist’ has been developed to help you tell the difference between a normal mole and a melanoma.

When to see your GP

See your GP as soon as possible if you notice changes in a mole, freckle or patch of skin, particularly if the changes happen over a few weeks or months.

They'll refer you to a specialist clinic or hospital if they think you have melanoma.

In most cases, a suspicious mole will be surgically removed and closely examined to see whether it's cancerous. This is known as a biopsy.

A biopsy usually involves removing a small tissue sample.  In cases of melanoma, the whole thing is usually removed from the beginning.

You may also have a test to check if melanoma has spread to the lymph glands (nodes). This is known as a sentinel node biopsy.

Types of melanoma

The information on this page mainly covers superficial spreading melanoma, the most common type. For pictures of the various types of melanoma see the NHS website.

Causes of melanoma

Melanoma is caused by skin cells that begin to develop abnormally.

Exposure to ultraviolet (UV) light from the sun is thought to cause most melanomas, but there's evidence to suggest that some may result from sunbed exposure.

The type of sun exposure that causes melanoma is sudden intense exposure – for example, while on holiday, which leads to sunburn.

Certain things can increase your chances of developing melanoma, such as having:

  • lots of moles or freckles
  • pale skin that burns easily
  • red or blonde hair
  • a close family member who's had melanoma

Who's affected

Malignant melanoma incidence is associated with increasing age.

In Northern Ireland, almost 70 per cent of people diagnosed are over the age of 50. Incidence rates are highest among men and women aged 90 and over.

Over recent years, skin cancer has become much more common in Northern Ireland.

After accounting for the ageing population, there has been a 4.2 per cent increase in yearly incidence of malignant melanoma in men and a 2.4 per cent yearly increase in incidence of malignant melanoma in women.

This is thought to be the result of increased exposure to intense sunlight while on holiday abroad.

Treatment for melanoma

The main treatment for melanoma is surgery. Your treatment will depend on your circumstances.

The health professional looking after your care will discuss treatment options with you.

If melanoma is diagnosed and treated at an early stage, surgery is usually successful.

If melanoma isn't diagnosed until an advanced stage, treatment is mainly used to slow the spread of the cancer and reduce symptoms.

This usually involves medicines that target specific genetic changes in the melanoma, or medicines that boost the body's immune responses to the melanoma (so-called checkpoint therapies).

Once you've had melanoma, there's a chance it may return. This risk is increased if your cancer was more advanced or widespread.

If your health professional feels there's a significant risk of your melanoma returning, you'll need regular check-ups to monitor your health.

You'll also be taught how to examine your skin and lymph nodes to help detect melanoma if it returns.

Outlook for melanoma

The age-standardised survival for men in Northern Ireland diagnosed with malignant melanoma between 2005-2009 was 88.4 per cent at five years.

 The age-standardised survival for women during the same time period was 92.0 per cent. Survival is consistently higher in women compared to men. Survival rates in Northern Ireland have improved over the last decade.

Stage at diagnosis (how advanced the cancer is) is one of the most important factors in malignant melanoma survival.

Five-year survival decreases as the time taken to diagnose and treat the cancer increases. It is important to check your skin regularly and seek medical advice early if you have any concerns.

Preventing melanoma

Melanoma isn't always preventable. But you can reduce your chances of developing it by avoiding getting sunburned (even going pink in the sun).

Most people get burnt while abroad on holiday or in Northern Ireland in the summer while doing outdoor activities, such as playing sports, walking or gardening.

On these occasions you need to be really careful, particularly if you have pale skin and many moles. You can help protect yourself from sun damage by using sunscreen and dressing sensibly in the sun. Sunbeds and sunlamps should be avoided.

Regularly checking your skin can help lead to an early diagnosis and increase your chances of successful treatment.

The information on this page has been adapted from original content from the NHS website.

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