Early detection of skin cancer
- What should I do if I notice any skin changes?
You should see your doctor for a skin examination if you:
- notice any unusual skin changes
- see or feel a spot or mole that is different to others.
Unusual changes to look for in a spot include:
- a change in colour, size or shape
- it is itchy or bleeding
- something that looks different to other spots (an 'ugly duckling')
- it has become raised ('sticky out') and looks shiny in appearance
- appears quickly
- it is new.
A skin examination involves a careful whole-body skin check under good lighting.
Your doctor may use a dermatoscope (a skin surface microscope) to examine spots more closely. Photography, including total body photography, may be used to record the appearance of spots on your skin.
Your doctor may suggest reviewing some spots at a later date to see if they have changed.
- How is skin cancer, including melanoma, diagnosed?
If your doctor suspects that you have melanoma, they may remove the suspected melanoma and some surrounding tissue to be checked. This procedure is called a diagnostic excision biopsy. Your doctor may do the biopsy or you may be referred to another doctor trained in the diagnosis of melanoma.
- What is a diagnostic excision biopsy?
The doctor gives you a local anaesthetic (injection) to ‘numb’ your skin. They then use a scalpel to remove the suspected melanoma and some surrounding tissue. Your skin sample is sent to a laboratory for examination under a microscope.
It sometimes takes about a week to get the results from the laboratory. During this waiting time, it may be helpful to talk about your concerns with a family member or close friend.
If you have not heard about the results within two weeks after the excision biopsy please contact your doctor, nurse or the hospital department that provided the treatment.
- Are some people more at risk of developing skin cancer including melanoma?
The chance of developing melanoma increases with age. Most melanomas are found in people aged 50 years or older. Melanoma is uncommon in younger adults and adolescents and is rare in children.
Some groups of people are at increased risk of developing melanoma. Factors that are known to increase risk compared to other people include:
- skin colour (light versus medium or dark skin)
- hair colour (red or blond hair versus black hair)
- skin type (burns easily/never tans versus easily tanning skin)
- skin damage due to sunburn versus never getting sunburnt
- family history.
- What if I am at high risk for melanoma?
If you are at high risk for melanoma you need specific advice from a doctor trained in the early detection and diagnosis of melanoma. Your doctor will be able to advise you about what methods of protection and checking of your skin is best for you. They can help you recognise and record suspicious skin changes. Your partner or carer should also receive this information.
You may be encouraged to have regular skin checks by your doctor, with six to 12-monthly whole-body skin examinations. Your doctor should use a dermatoscope and may arrange total body photography to monitor your skin over time.
At any time, if you are confused or unsure about what is happening – ask your doctor or nurse to help you understand. Also make sure you know if there is anything you should be doing, including self-checking your skin.
Other common questions about melanoma
- How is melanoma treated?
Most people will only need surgical removal of the melanoma. The melanoma is cut out, as well as a small area of normal-looking skin around the melanoma.
If the melanoma is found at an early stage, the whole melanoma is removed during the excisional biopsy.
If melanoma is confirmed, a second procedure called wide local excision is often undertaken to remove a wider area of surrounding skin. This is done to make sure all the melanoma cells have been removed.
Further investigations and treatment depend on the type of melanoma, how far it has spread, and the person’s general health and age. Treatment plans are made for each individual after discussion with their doctor and/or a melanoma specialist.
A few people with advanced melanoma may be offered further surgery, radiotherapy, chemotherapy or immunotherapy.
- What support is available for people diagnosed with melanoma?
There are also melanoma Clinical Nurse Specialists and Cancer Nurse Coordinators working within the district health boards that support patients who have melanoma.
DermNet New Zealand, in conjunction with the Waikato District Health Board, has made a number of short videos relating to melanoma and how it is treated in New Zealand.
The information on these pages is drawn from:
- New Zealand Guidelines Group. 2008. Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand
- Melanoma, Information for you, your family, whanau and friends.
- Standards of Service Provision for Melanoma Patients in New Zealand – Provisional - National Melanoma Tumour Standards Working Group (2013). You can access the document by clicking on the link in the 'Downloads' column of the right hand side of this web page.