What Is Melanoma?

Melanoma is a form of skin cancer that begins in the cells that produce melanin, the pigment that gives skin and hair their color. While defined as the most serious type of skin cancer, melanoma is easily curable when detected early, having a 5-year survival rate of up to 99%. Left untreated, the cancer can spread to the lymph nodes and nearby organs.

Who’s At Risk of Melanoma?

Certain factors contribute to a heightened risk of developing the condition:

• Repeated and prolonged UV exposure and sunburn from natural sunlight or artificial sources such as tanning beds
• High number of moles or unusual moles
• Fair skin that indicates less melanin, which protects the skin from damaging UV rays

Additionally, older age and a family history of melanoma also increase one’s risk of skin cancer.

What Are the Symptoms of Melanoma?

Melanoma is mainly characterized by the appearance of unusual growths and pigmentations, and significant changes in existing moles.

The ABCDE examination is used to assess a mole’s risk of becoming cancerous:

• Asymmetry - Irregular shape, with one half of the mole not matching the other half
• Border - Uneven, rough or blurred edges
• Colors - Multicolor or with uneven shades
• Diameter - Larger than 6mm (1/4in)
• Evolution - Continuous change in appearance with time

Melanomas may also be accompanied by itchiness, swelling, oozing or bleeding, and sores that don’t heal. A visit to a melanoma doctor in Singapore can help confirm the presence of cancerous moles and pigmentations.

How to Reduce the Risk of Melanoma

Steps one can take to reduce his or her risk of skin cancer include:

• Avoiding sun exposure as much as possible
• Applying sunscreen or wear sunglasses before going outside
• Avoiding tanning beds and sun lamps
• Conducting regular skin and mole assessments for signs of changes

Melanoma Surgery

The diagnosis of Melanoma can be worrying due to it’s association with poor outcome in the past. Most melanoma are diagnosed by a melanoma doctor in the early stages and is associated with good long term outcome.

Recent advances in imaging with PET/CT and SPECT scan have greatly increased the accuracy of staging and hence more focussed treatment.

Sentinel lymph node mapping and biopsy have provided useful information in evaluating the extent of spread in melanoma.

We provide full evaluation of advanced stage Malignant Melanoma, with radio-colloid directed sentinel lymph node biopsy, and subsequent full nodal dissection of all major nodal basin available. Our expertise include superficial and deep ilio-inguinal dissection, three level axillary dissection and retro-peritoneal dissection.

FAQs - Malignant Melanoma

• Is the diagnosis of Malignant Melanoma a “death sentence”?
  No, large majority of malignant melanoma is early stage and easily curable with surgery.
• What about late stage Malignant Melanoma?
  The treatment of advanced malignant melanoma is complex; surgery is the mainstay but detail staging with PET scan, CT-scan and biopsies are required prior to treatment.
• What is sentinel lymph node biopsy?
  The spread of malignant melanoma is sequential and fairly predictable in most cases. For higher stage tumor, identifying and exercising the sentinel lymph node for analysis is vital to further treatment: this is done with a radiopharmaceutical agent that is injected near the melanoma to track it’s lymphatic flow, hence identifying the initial lymph node involved; the sentinel lymph node.
• What if the sentinel lymph node is positive for Malignant Melanoma?
  Then a larger operation known as nodal basin dissection is required to provide a chance for cure.
  
  This procedure entails removing all the lymph nodes draining the primary melanoma location and is therapeutic and provide information on the need for adjunct treatment.
• What is SPECT scan?
  SPECT stands for Single Photon Emission Computed Tomography, it is a combination of conventional gamma camera with CT images giving 3 dimensional information for accurate localization of sentinel lymph nodes.
• Should I then have all pigmented Lesion excised?
  Not necessary, a dermatologist will be able to advise on which lesion needed to be excised and which to observe and follow up.

Dr Dennis Lim offers a personalized approach to thyroid surgery, parotid surgery, head and neck cancer management, and melanoma surgery in Singapore. His clinic, Dennis Lim Surgery, is recognized for its use of modern surgical techniques and evidence-based medicine to deliver optimal treatment based on the patient’s needs. For inquiries, call 6836-5167.