Melanoma

Melanoma is the most serious form of skin cancer. It arises from the pigment forming cells of the skin called melanocytes. There are about 4000 cases of melanoma diagnosed every year in New Zealand. That is 13 per day.

It may develop from a preexisting mole, but the majority will arise from where there was no preexisting mole.

If diagnosed early the cure rate is 100%.

Melanoma Stages

Melanoma Consultation

I don’t need a referral from your GP but can send them a note if you wish to. For most patients I first check the moles that they are concerned about, either be it a new mole or a changing mole. This is followed by a full head to toe consultation of all the moles with the dermoscope.

Only the moles of concern can be checked if you wish, but the cost remain the same. If you are insured with southern cross, I can claim for you. I am an affiliated provider for southern cross.

You can request a chaperone or bring in a support person. Your modesty is maintained all the time with appropriate covering. Skin of the breast, genitals or buttock areas are not routinely checked. You should alert me if there are any moles under these areas to be checked.

It would help me if you do not wear facial make up. Nail polishes needs to be removed before the check.

Treatment in the form of cryotherapy or liquid Ice is usually performed at the time of the consultation. If you require a biopsy or surgical excision, it will be scheduled for a different day.

Consultation Fee – $140.00

Melanoma Types

There are many types of Melanoma.

Superficial Spreading Melanoma

The most common and easily diagnosed melanoma is the superificial spreading melanoma. This is the melanoma where you the ABCDE criteria can be used to diagnose. Asymmetry, Border irregularity, Colours, Diameter and Evolution.

What does melanoma mole look like?

Nodular Melanoma

These melanoma do not have the typical melanoma features. The can be coloured or plain. They may start as a bump which can bleed. ABCD criteria is of no use but E ( evolution, change) is very important to pick these up. IF YOU NOTICE A RAPIDLY CHANGING BUMP YOU NEED TO GET THIS CHECKED OUT ASAP.

It is very important to pick these up very early. It has a very aggressive growth phase and grows about 0.49 mm depth per month (compared to superficial spreading melanomas which grow at a rate of 0.12 mm depth per month).

Self Skin Examination – Why it is so critical?

Amelanotic Melanoma

These melanoma do not have pigment. THEY LACK THE ABCD (A for symmetry, B for border irregularity, C for colours and D for dimension.) This could be a red bump or flat.

Why is survival after diagnosis of amelanotic melanoma is poorer than after pigmented melanoma?

Melanoma FAQ

What is melanoma?

Melanoma is the most serious of skin cancers. It can occur from a previous mole, but most time occurs when there is no preexisting mole. There are several types of melanoma both coloured and non coloured. (pigmented and non pigmented) If picked up early the cure rate is 100%.

What causes melanomas?

The most important cause is exposure to excessive sunlight (UV radiation) which damages the skin (sun burn). If this happens it causes changes to the structure of the pigment producing cells of the skin. If you have had significant sun burns in the past this increases your risk of a melanoma.

How do I know if my mole or freckle is a melanoma?

Most moles are normal. If you have a mole that is new or changing in any form or colour or shape, gets crusty or bleeds or itches it needs checked.

What does melanoma look like?

If your mole is new and changes it needs checked. Melanomas can occur in a preexisting mole. It may stand out, become darker, itches, or gets crusty, or grows . Please click here to see a melanoma image.

Am I at risk of developing a melanoma?

Intense, intermittent sun exposure is the most high risk factor for melanoma.

If you have

fair skin that burns
have many moles
have had sun burns in the past

you should have a regular skin check with a doctor trained in early skin cancer diagnosis. Are you at risk?

How do I diagnose melanoma early?

I use a skin surface microscope called Dermoscope to diagnose early melanomas. I have used this for over 13 years now. Light, magnification and cross polarisation increases penetration of light. This make it easier to read a mole. Read more…

How is your Melanoma mole check different to the one done at molemap or molecheck or with my GP or the dermatologist?

Molemap and Molecheck companies use a dermoscope. A dermatologist reads at a later time the pictures taken by a nurse in molemap. You dont see the dermatologist or a skin cancer doctor at molemap. Molecheck are GPs trained like me. Your GP may or may not have had training to use a dermoscope. A dermatologist uses a dermoscope as well to diagnose early melanomas.

What qualifications or further education do you have to do a mole check?

Advanced Certificate in Dermoscopy and Dermal Imaging, University of Queensland, 2007.
Certificate in Dermoscopy, Skin Cancer College of Australia, 2017.
Auckland Hospital GP with special interest in skin cancer work – 2012 to 2017. Skin cancer meetings headed by melanoma specialists every month during that period.
Rotorua GP conference every year attend sessions with particular focus in skin cancer.
Diploma in Dermoscopy, completed 2019 (University of Queensland, Australia)
Southern Cross Affiliated Provider for Skin Cancer Work 2012 – current.ed

What happens when I book in for a full body mole check with you?

Avoid face make up. Wear clothes that are easy to remove. Moles of concern to you checked first. Then a thorough dermoscopic check from head to toe is undertaken. I check your palms and soles as well. Pictures taken of the moles that need re-looking in three to six months. Options of treatment for moles that needs treatment now discussed.

Do you do a full mole map or picture all my moles?

Molemap or Mole Map is a term used by the company who popularised it. It means taking pictures of your moles for follow up. For a vast majority of patients, this approach is not necessary. If you have a very high risk of melanoma and have more than 100 moles, it may be a good idea. I take pictures of the moles which needs follow up ( same as mole map). If I am not sure about a mole you will know about it straight up and options of treatment as well.

What happens if you think I have a melanoma?

If suspected of a melanoma, the only option is to remove it for the pathologist examination.

If I have to have surgery can I have it done it with you or someone else?

The bottom line is it is your choice. I have been a surgeon since 2003. My results are good. If you wish me to do the mole removal, the procedure discussed in detail. If referral is what you wish, I can recommend or will go with your choice.

When will the biopsy report be ready?

The biopsy is send to lab test. It takes 2 weeks for the report to be back. As soon as I know the report I will contact you and discuss options if further treatment is necessary.

If the biopsy report says I have a melanoma what does that mean in term of my survival?

It depends on the type of melanoma. If this is less than 1mm thick, it is highly likely it is fully curable. With the modern diagnostic methods, we pick these up early with resulting 100% cure. Melanoma Stages.

Do I need to have further surgery if the biopsy report is a melanoma?

Yes you almost always need further surgery. If the melanoma is less than 1mm thick you need a wider excision of the scar. If this is more than 1mm thick you needs a wider excision of scar and a sentinel node biopsy. This means removing the lymph nodes in the region of the melanoma.

Once the melanoma is cleared what follow up do I need to have?

For the first year I need to see you 3 monthly. After that a 6 monthly review for the rest of your life.

Can you pick up other forms of skin cancer early?

Yes we can pick up other forms of skin cancer early with the dermoscope. The main non melanoma cancers are Basal Cell Cancers and Squamous Cell Cancers which can be picked up very early by the Dermoscope. This offers complete cure.

What advice would you give to protect from further sun damage?

Slip on a shirt, Slop on the 50+ sunscreen, Slap on a hat, Seek shade or shelter, Slide on some glasses used to block out sun.

Is surgery always necessary if you think it is a melanoma, can I use creams like Efudix or Aldara?

Yes surgery is always needed if a melanoma is suspected.