Melanoma

What is Melanoma?

Melanoma is a serious type of skin cancer that develops in the cells that produce melanin, the pigment that gives skin its colour. While it can occur anywhere on the body, it most often develops on areas exposed to the sun. At Hills Surgical Oncology, Dr Muzib Abdul-Razak, a leading Head and Neck Surgeon and Surgical Oncologist in Sydney, specialises in treating melanomas that develop in the head and neck region. Melanoma is considered the most dangerous form of skin cancer because it can spread quickly to other parts of the body if not caught early. However, when detected and treated early, the outlook is generally very good.

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What are the different types of Melanoma?

There are several types of melanoma, each with their own unique characteristics. These include:

• Superficial Spreading Melanoma: This is the most common type, usually appearing as a flat or slightly raised discoloured patch with irregular borders.
• Nodular Melanoma: This type grows more quickly in thickness (downwards) than in diameter. It usually appears as a changing lump on the skin that can be black, blue, red, or skin-coloured.
• Lentigo Maligna Melanoma: This type typically occurs in older people and is usually found on chronically sun-damaged skin, especially on the face.
• Acral Lentiginous Melanoma: This is the most common form of melanoma in people with darker skin. It usually occurs on the palms, soles of the feet, or under the nails.
• Desmoplastic Melanoma: This is a rare form that usually appears on sun-damaged skin on the head, neck, and upper back.

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What causes Melanoma?

Melanoma occurs when something goes wrong in the melanin-producing cells (melanocytes) in the skin. Normally, skin cells develop in a controlled and orderly way, but sometimes healthy cells develop DNA damage, leading to uncontrolled growth and forming a mass of cancerous cells.While the exact cause of melanoma isn't clear, several factors may increase your risk:

• Ultraviolet (UV) light exposure: This is the most significant risk factor. UV light from the sun or tanning beds can damage the DNA in your skin cells.
• Fair skin: People with less melanin in their skin have less protection from UV radiation.
• History of sunburn: Having had one or more severe, blistering sunburns increases your risk.
• Moles: Having many moles or unusual moles increases your risk.
• Family history: If a close relative has had melanoma, you have an increased risk.
• Weakened immune system: People with weakened immune systems have an increased risk of melanoma.

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What are the symptoms of Melanoma?

The first signs of melanoma are often a change in an existing mole or the development of a new, unusual-looking growth on your skin. To help you identify potential melanomas, remember the ABCDE rule:

• A is for Asymmetry: One half of the mole doesn't match the other half.
• B is for Border: The edges are irregular, ragged, notched, or blurred.
• C is for Colour: The colour is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.
• D is for Diameter: The spot is larger than 6 millimetres across (about the size of a pencil eraser), although melanomas can sometimes be smaller than this.
• E is for Evolving: The mole is changing in size, shape, or colour.

In the head and neck area, melanomas can also cause:

• A sore that doesn't heal
• Spread of pigment from the border of a spot into surrounding skin
• Redness or a new swelling beyond the border of the mole
• Change in sensation, such as itchiness, tenderness, or pain
• Change in the surface of a mole – scaliness, oozing, bleeding, or the appearance of a lump or bump

If you notice any of these signs, it's important to consult a specialist like Dr Muzib Abdul-Razak at Hills Surgical Oncology promptly. Early detection and treatment can significantly improve outcomes for melanoma patients.

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How is Melanoma diagnosed?

Diagnosing melanoma involves several steps. At Hills Surgical Oncology, Dr Muzib Abdul-Razak uses a comprehensive approach to ensure accurate diagnosis:

• Skin Examination: The doctor will carefully examine your skin, looking for any suspicious moles or growths.
• Dermoscopy: This involves using a special magnifying lens to examine the suspicious area more closely.
• Biopsy: If a mole or growth looks suspicious, a biopsy will be performed. This involves removing all or part of the suspicious area and examining it under a microscope. There are several types of skin biopsies:
• Shave biopsy: The surface of the skin is shaved off.
• Punch biopsy: A small, round piece of skin is removed.
• Incisional biopsy: Part of the growth is removed.
• Excisional biopsy: The entire growth and some surrounding skin is removed.
• Imaging Tests: If there's concern that the melanoma may have spread, imaging tests such as CT scans, PET scans, or MRI scans may be ordered.
• Sentinel Lymph Node Biopsy: This procedure can help determine if the melanoma has spread to nearby lymph nodes.

As a skilled head and neck surgeon in Sydney, Dr Muzib Abdul-Razak has extensive experience in performing and interpreting these diagnostic tests. His expertise ensures that patients at Hills Surgical Oncology receive accurate diagnoses, which is crucial for developing effective treatment plans.

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What are the treatment options for Melanoma?

Treatment for melanoma depends on several factors, including the stage of the cancer, its location, and the patient's overall health. At Hills Surgical Oncology, Dr Muzib Abdul-Razak works closely with a team of specialists to provide comprehensive care. The main treatment options include:

Surgery

Surgery is the primary treatment for most melanomas. The type of surgery depends on the stage of the melanoma:

• Wide Local Excision: This involves removing the melanoma along with a margin of normal skin around it. The size of the margin depends on the thickness of the melanoma.
• Sentinel Lymph Node Biopsy: This may be done at the same time as the wide excision to check if the melanoma has spread to nearby lymph nodes.
• Lymph Node Dissection: If melanoma is found in the sentinel lymph nodes, more lymph nodes in the area may need to be removed.
• Reconstructive Surgery: For larger or complex excisions, especially in the head and neck area, reconstructive surgery may be needed to restore appearance and function.

As a highly skilled Surgical Oncologist in Sydney, Dr Muzib Abdul-Razak specialises in complex head and neck surgeries. He uses advanced techniques to remove melanomas while preserving as much normal function and appearance as possible.

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Immunotherapy

Immunotherapy helps your immune system fight cancer. It's often used for advanced melanomas or to help prevent recurrence after surgery. Types of immunotherapy include:

• Checkpoint inhibitors
• Cytokines
• Oncolytic virus therapy

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Targeted Therapy

These drugs target specific gene changes in melanoma cells. They're often used for advanced melanomas with specific mutations.

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Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It may be used:

• After surgery to kill any remaining cancer cells
• To treat melanomas that can't be removed surgically
• To relieve symptoms of advanced melanoma

Chemotherapy

While less commonly used now due to the effectiveness of newer treatments, chemotherapy may still be an option for some advanced melanomas. Dr Muzib Abdul-Razak at Hills Surgical Oncology stays up-to-date with the latest advancements in melanoma treatment. He works closely with each patient to develop a personalised treatment plan that offers the best chance of success while considering the patient's overall health and preferences.

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What is the recovery like after Melanoma surgery?

Recovery from melanoma treatment can vary depending on the extent of the treatment. After surgery, the initial recovery period typically lasts a few weeks. During this time, patients may need to:

• Care for the surgical site as instructed
• Manage pain with prescribed medications
• Attend follow-up appointments to monitor healing and check for any signs of recurrence

For patients who've had extensive surgery in the head and neck area, rehabilitation may be necessary. This could include:

• Physical therapy to regain strength and mobility
• Occupational therapy to help with daily activities
• Speech therapy if speech or swallowing has been affected

Patients who've had immunotherapy, targeted therapy, or chemotherapy may experience side effects that can last for several weeks or months after treatment ends. These may include fatigue, skin changes, and immune-related side effects. Long-term follow-up care is crucial for melanoma survivors. Dr Muzib Abdul-Razak and the team at Hills Surgical Oncology provide ongoing monitoring to check for any signs of cancer recurrence and manage any lasting effects of treatment.

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Why choose Hills Surgical Oncology for Melanoma treatment?

When facing a melanoma diagnosis, choosing the right care team is crucial. Here's why patients in the Hills area, Wahroonga, Norwest, and throughout Sydney choose Hills Surgical Oncology:

• Expertise: Dr Muzib Abdul-Razak is a highly skilled head and neck surgeon and surgical oncologist with extensive experience in treating complex melanomas.
• Comprehensive care: We offer a multidisciplinary approach, coordinating with other specialists to provide complete care from diagnosis through treatment and recovery.
• Advanced techniques: We use the latest surgical techniques and technologies to achieve the best possible outcomes while minimising side effects.
• Personalised treatment: We understand that every patient is unique. Dr Muzib Abdul-Razak takes the time to develop individualised treatment plans that consider each patient's specific needs and preferences.
• Supportive environment: Our team is committed to providing compassionate care in a supportive, patient-centred environment.
• Convenient locations: With clinics in Wahroonga and the Hills area, we make it easy for patients to access high-quality care close to home.

If you're concerned about melanoma or have been diagnosed with this condition, don't hesitate to reach out to Hills Surgical Oncology. Dr Muzib Abdul-Razak and our team are here to provide the expert care and support you need throughout your treatment journey. Remember, early detection and treatment are key to successful outcomes with melanoma. Regular skin checks and prompt attention to any suspicious changes can make a significant difference. At Hills Surgical Oncology, we're dedicated to providing the highest quality care to help our patients overcome melanoma and return to their normal lives.

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Useful Links

1. The Melanoma Institute of Australia