Australia has amongst the highest rates of melanoma in the world and therefore, melanoma has long been described as Australia’s cancer.
During the last year, with less patients attending their GPs and skin cancer clinics due to COVID-19, there has been a significant reduction in new melanoma diagnoses.
As we start 2021, it is important that patients with a new pigmented skin lesion, a changing lesion or a past history of melanoma attend their local doctor to have these lesions assessed and if suspicious excised in order to ensure that they do not represent a new diagnosis of melanoma.
The last decade has seen a dramatic improvement in outcomes for patients with a new diagnosis of melanoma and the vast majority of patients diagnosed with melanoma will be cured of their disease.
It is for this reason that risk stratification is required to identify those patients at the highest risk of recurrence so that they can be treated appropriately. The standard of care for risk stratification is the use of sentinel lymph node biopsy, where patients with a risk of lymph node spread from their melanoma have surgery to remove the lymph node at highest risk of containing a deposit of cancer spread. This procedure is done at the same time as the surgery to achieve a safety margin (wide excision) at the site of the melanoma.
Patients with melanoma identified in the sentinel node are at much higher risk of recurrence than those who do not have sentinel node involvement and therefore will be considered for 12 months of drug treatment to reduce this risk.
There are a number of tools available to identify which patients have most to gain from sentinel node biopsy including the use of a risk nomogram developed by the Melanoma Institute of Australia in Sydney. This is the best tool currently available to guide patient selection for sentinel node biopsy, which is a point that Associate Professor David Gyorki made during a recent debate that he was invited to participate in for the Society of Surgical Oncology.
For more information regarding melanoma and sentinel node biopsy: