Shortcuts / 30 January 2024


Melanoma is a type of skin cancer – and it’s been in the news in a big way a couple of times over the last week. Sarah Ferguson, the Duchess of York, confirmed she has melanoma and will require treatment. And our 2024 Australians of the Year are Georgina Long and Richard Scolyer, who were awarded for their work pioneering treatments for the disease. So in this Squiz Shortcut we’ll get into the basics on ‘Australia’s national cancer’, the treatments that are helping more people survive it, and what you can do to get onto any problems early.

It’s weird how sometimes you won’t see something in the news at all, and then you see it a lot… 
And look, melanoma is not a rare disease – someone in Australia is diagnosed with melanoma every 30 minutes, which means that 16,800 Aussies are expected to be diagnosed with melanoma this year. It’s the third most common cancer in Australia after breast cancer and prostate cancer.

It also claims a lot of lives…
That’s right – about 1,300 Australians will die from melanoma this year. 

So melanoma is a skin cancer, right?
It is. There are 3 kinds of skin cancers that occur when skin cells are damaged, usually from UV radiation from the sun. There’s basal cell carcinoma and squamous cell carcinoma – they are what’s called keratinocyte cancers, and they are not as deadly as melanoma. 

Those less deadly types form in the keratinocyte cells in the epidermis, which is the outermost layer of the skin. 

And melanoma? 
It forms in the deeper melanocyte cells – what happens is abnormal melanocytes grow in an uncontrolled way, usually after being damaged by sun exposure. About a third of all melanomas develop from existing moles, and the rest develop anywhere on the skin – which is why you have to keep a good eye on your existing moles to see if they’ve changed AND keep an eye out for any new moles/skin abnormalities popping up. 

How do you spot a melanoma?
Melanoma won’t always be black or brown like a run-of-the-mill mole – they can be pink or even skin coloured… And they won’t always be on your skin – they can be in your eye or under the fingernails, or even in the gastrointestinal tract.

What happens after a melanoma forms?
In the worst case, melanoma can spread via the blood and lymphatic system to distant organs like the lungs, liver, and brain. That spread is called metastasis, and that makes melanoma particularly nasty. The trick is to pick it up before it gets to that point… 

Righto, but… how?
Getting checked by a doctor or skin specialist regularly is a good idea, and the experts say to look for changes in your moles’ colour, size, and shape, or if it starts to itch or bleed. And for any new skin growth, get it checked out. 

Who’s most at risk of melanoma?
Basically anyone, and particularly people with fair skin. That’s why it’s so important to slip, slop, and slap, especially when you’re young… 

What is it about being young? 
Exposure to the sun during these years greatly increases your chance of getting melanoma because the damaged cells have longer to grow and develop into cancer.

So how is melanoma treated?
If a melanoma hasn’t metastasised then surgery is the answer. The idea is that you remove the tumour, and a wide margin of healthy skin around the edge is also removed to ensure that no cancer cells are left behind. If things have developed a bit, treatment can also include chemo and radiation.

… and what if a melanoma has metastasised?
It’s less straightforward, but the good news is that some promising treatments have been made in the last decade, and the 5-year overall survival rate for advanced melanoma has increased from less than 10% to more than 50%. That’s been made possible by immunotherapy. 

This takes a little moment to explain. Cancer cells are mavericks, but they are your own cells, and your immune system is designed not to attack your own cells. But immunotherapy allows your immune system to attack its own cancer cells. 

Yes, and 2 of the clever people working on this problem are the medical directors of Australia’s Melanoma Institute. They are Professors Georgina Long and Richard Scolyer. They’re long-term research partners, and they were named Australians of the Year last week for their work on revolutionary treatments for melanoma patients using immunotherapy.

Tell me more about these champions…
Both are considered internationally to be leaders in their field, and they’ve won a ton of prizes and honours from their profession. They’re also both ardent campaigners for prevention. While accepting their Aussie of the Year award, they called for advertisers and social media influencers to stop glamorising tanning or using it to sell or advertise for entertainment.

What else did they say?
Long said our “bronze Aussie culture is actually killing us”, and Scolyer said we “must elevate sun safety to equal status with other life-saving safety measures like wearing a seatbelt or a helmet.” But their story has another twist to it… 

Which is…
Last year, Richard Scolyer was diagnosed with an incurable Stage 4 brain cancer – the worst of the worst. But he and Long are having none of that – what they’ve done is use the groundbreaking discoveries of their immunotherapy approach from their melanoma work to treat his brain cancer. 

Scolyer has called it a “world-first experimental treatment” – and that it’s “an opportunity for us to crack another incurable cancer and make a difference, if not for me, then for others.” 

That’s pretty inspiring…
It sure is. 

Squiz recommends

Watching – The ABC’s Australian Story episode on Professors Long and Scolyer – it’s very moving. 

Reading A factsheet from the Cancer Council about what to look for when you check your skin.

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