Melanoma (skin cancer)

Melanoma is a particular type of skin cancer. Melanoma occurs when cells in the skin grow in a way that’s not normal.

Your skin is made up of many types of cells. One of these cell types in our skin – called melanocytes – produces a brown pigment called melanin. Melanoma is cancer that occurs in melanocytes.

Melanoma is more likely to spread to other parts of the body than other skin cancers, which is why we should protect our skin and stay on the lookout for any changes.

Melanoma is one of the most preventable cancers. And while melanoma and other skin cancers are less common in our mob, we can still get melanoma and it still causes deaths in our community every year.

Melanoma can happen at any age, although it is more common in older people than in younger people.

There are a number of symptoms you should look out for, including:
- a new spot on your skin that doesn’t go away
- a spot or mole that is changing its size, or shape, or colour
- a spot that is uneven or is bigger than about 6mm wide, or the colour spreads into the skin around it
- a sore that doesn’t heal
- a mole that is itchy, scaly, sore or swollen or bleeding or oozing
- a painful mole.
Having these symptoms may not mean you have cancer, but it’s important to check.

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander Health Worker.
You won’t know if you have melanoma of the skin until your doctor has yarned with you, completed a physical examination and done some tests. The tests might include:
- a photo of your spot so they can check later to see if it changes
- a dermatoscopy, where the doctor looks over your skin and checks your spots with a strong light and a magnifying glass
- a biopsy, where they take a tiny bit of your skin and look at it with a microscope
- imaging tests like an ultrasound, a CT scan or MRI scan to see what your insides look like.
Most people who have these tests find out they don’t have cancer. But it’s important to check.

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.
If you have melanoma, you might be told it’s at a certain stage. This describes whether or not it has spread to other parts of the body, and how far.

Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.
- Stage 0: The cancer is still only in the outermost layer of the skin and hasn’t spread into the layer of the skin underneath.
- Stage 1: The cancer is only in the skin.
- Stage 2: The cancer is thicker than stage 1, but is still only in the skin.
- Stage 3: The cancer has spread to the lymph nodes and close organs but not further.
- Stage 4: The cancer has spread to other parts of the body such as the lungs, liver or brain – this is also known as metastatic cancer.
With all stages of melanoma of the skin,there is plenty of treatment and support that can help you, including traditional medicine and practices like ceremony and being on Country.
Most people with melanoma have surgery. Some also have radiotherapy or chemotherapy, or immunotherapy, or targeted therapy. If you have melanoma, you might need one of these, or a combination of them.

Your doctors will talk to you about what treatments they recommend and what options are best for you.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have. You can also yarn about including traditional healing, bush medicines and cultural practices into your treatment plan.

Surgery

Surgery is a procedure done to remove the cancer and help stop it from spreading to other parts of the body. Some people have minor surgery in a clinic or the doctor’s surgery. Others need to stay to hospital and have an anaesthetic and an operation. Sometimes just the melanoma and some skin around it is removed, and sometimes the lymph nodes near it are too.

Your doctor will yarn with you about what treatments they recommend, and which options are best for you. It is important to also talk to your doctor about what support you and your family need during this time and any traditional medicine or cultural practices you want to include.

Read more about surgery.

Radiotherapy

Radiotherapy, also called radiation therapy, uses X-rays to destroy cancer cells in one part of your body.

Most people who have radiotherapy have it every day (Monday to Friday) for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, assistance is available for travel and accommodation for you and your family.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about radiotherapy.

Chemotherapy

Chemotherapy, or ’chemo’, involves you taking strong drugs to kill or slow the growth of the cancer cells. Chemo may be less effective for melanoma than for some other types of cancer. Immunotherapy and targeted therapy may be better treatments for melanoma. Chemotherapy is sometimes used to prolong survival or relieve symptoms.

Many people have chemo in cycles – usually two days every three weeks, or one day every three weeks. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic. But you usually don’t need to stay in hospital for chemo.
Most chemo comes as injections into your arm or hand that drip in over a few hours. Some chemo or medications come as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can do to help.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. Mob who have had chemo before say that spending time on Country, traditional healing, bush medicines and engaging in cultural practices can help.

Read more about chemotherapy and side effects.

Immunotherapy

Immunotherapy is treatment with drugs that help your immune system attack the cancer cells. Immunotherapy is given in your arm through a vein. It is usually given in cycles of once every few weeks. You will need to go to a hospital or clinic to have this treatment.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker, and with other mob who have had the treatment.

Read more about immunotherapy.

Targeted therapy

Targeted therapies are newer drugs that try to stop the cancer growing. Targeted therapies attack cancer cells without harming healthy cells. If your doctor thinks they might help, here are some questions to ask.

Read more about targeted therapy.
It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, have someone else come to appointments to help remember information. Mob who have been diagnosed with cancer say that yarning with trusted family, friends and Elders helps with making decisions.

Yarn with your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about treatment.
Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Ask your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.
It all depends on the type of treatment you’re having. People will have treatment for different durations of time.

After treatment is finished, your doctors will keep in touch with you to so they can check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.
There are some features that are more common in people who develop melanoma. These features are called ”risk factors”.

Having one or more risk factors does not mean that you will develop cancer. It can also be unclear whether a risk factor contributed to the development of the cancer in a person. However, by modifying these risk factors we can reduce the risk of developing melanoma.

The greatest risk factor for melanoma is exposure to sunlight and other sources of ultraviolet (UV) energy.

Risk factors for melanoma you can change:
- be sun smart – avoid exposure to sunlight and other sources of ultraviolet (UV) energy, particularly tanning beds.
Risk factors for melanoma you can’t change:
- fair complexion – particularly skin that burns when exposed to the sun
- increasing age – around half the people who develop melanoma are older than 50 years
- having some large moles, many small moles, or moles that look different from normal moles
- a family history of unusual moles or melanoma
- history of sunburn that cause blistering, especially in childhood
- occupational exposures to radiation and some chemicals
- a personal history of skin cancer, including melanoma.
If you have any of these risk factors or you’re worried about your risk for melanoma, yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker

Read more about melanoma risk factors.
Clinical trials might be an option for you. Talk to your doctor to help you decide if taking part is a good option.

Read more about clinical trials.

Read more on melanoma.

Read more about healthy lifestyle and how to be sun smart.

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