Melanoma ... every body jumps up and down about melanoma. The word 'melanoma' generates fear in doctors and patients. But, really it is that common ? The regular physician would see one every few years! and skin cancer practitioners/dermatologists would see one every few months and, most of these are early melanomas.
Out of 100 cancers we see ~70 will be BCCs, 23-30% SCCs and the rest ~< 5% Melanomas.
SCCs Kill more people than melanomas ! But, melanomas kill quicker and in younger population and this is why people panic.
The majority of melanomas arise out of the blue and only about ~20% arise in an already existing mole. There is no point in excising funny looking moles for preventative care. Pathology owners would love doctor to biopsy every funny looking moles but for the patient and the healthcare system it's simply a big rort.
Prophylactic excision of all atypical moles in a patients with multiple moles is totally wrong. This simply encourage a false sense of security. This does not remove the back ground increased risk of melanomas.
You would need to remove ~14,000 funny looking moles to pick up just 10 thin melanomas and 5 of these will be very very thin melanomas ( melanoma insitu). And, at our clinic the majority of melanomas we see are very thin i.e.. "melanoma insitu". The cost to the health system at bulking billing rate would be $714,000 per NON-insitu-thin-melanomas!!!!!
How do we diagnose melanoma:
1: Inspect for ugly duckling
2. Dermatocopic examination of lesion in question
3. Biopsy the lesion concerned.
A, Incisional if lesion is very big
B. Excisional if lesion is small
C. Shave or saucerise if lesion is superficial & in thick skinned area
How we manage melanoma:
One last note:
The majority of thin melanomas are easily treated by family doctors/dermatologist. Thick melanomas belong to the surgeons. Don't waste your time and money seeing non hospital surgeons for melanomas > 0.75mm-1mm thick. You will just be referred again, robbing you of time and bacons.