Melanoma: A deadly hidden cancer

Being an orthopaedic surgeon and a member of the Chinese medical team, I was sent to Malawi by my mission on March 13 2009.


During my period at Mzuzu Central Hospital, I have come across two patients who had melanoma (a type of skin cancer) on their feet and their tumours had become malignant. Amputation was performed on both of them.

However, three months later, metastases (secondary cancers) have been discovered in one of the patients. Therefore, I am very concerned about the situation because the future of the two patients does not look bright.

I write this article with the aim of informing Malawians about melanoma—how they can detect the early signs and intervene before it is too late.

Melanoma is a skin cancer which affects the pigmented (coloured) cells in the surface of the skin. In the early stages, it is usually a small growth, around 1-2 cm in radius. It usually originates from a mole or a freckle and it is black, darker in colour than the usual mole. It may be raised, with uneven edges. Usually, it is not painful or swollen, so patients may not seek medical attention. It occurs equally in males and females, but it is more common in adults than in children.

One to three percent of cancers in adults are malignant melanomas. Not all melanomas will turn out to be malignant, but once a lesion has become malignant, it is very difficult to treat, so it is better to seek medical intervention as soon as you suspect the signs to be melanoma.

Therefore, I have come to think of melanoma as a lion, following my patients and from now on, I would like us all to be mindful that this animal is after us.

There are many risk factors for melanoma, which can be divided into three broad areas. Mechanical factors, such as rubbing or compression; physical factors, including sunshine and ultra-violet light that come with living in a hot climate; and chemical factors such as medications.

So how can you recognise a malignant melanoma? One, the mole or freckle will become bigger and be raised. Two, it will be darker in colour. Three, the surface will ulcerate and bleed easily.

Four, around the tumour, the skin may become blackened. And lastly, around the mole, there may be tiny black dots, called ‘satellite phenomena’.

I want to inform the public that like any cancer, melanoma can be treated if detected early. If you have knowledge on how to recognise the signs, you will be able to seek help early enough. It is easy to spot; just ask a member of your family to help inspect all areas of the skin, especially those that you don’t look at often such as the soles of your feet. If you find any raised patches, or lesions that are darker than the rest of the area, go to your nearest health centre or hospital for check-up.

Usually, if a melanoma is caught early, all that is required is a simple procedure to remove part of the affected area of the skin. No amputation will be required, and you won’t even need to be put to sleep.

The surgeon will simply numb the skin around the mole or lesion and remove a small area of skin with a scalpel.

In China, I have experienced cases where patients died because they were not aware of how to spot melanoma.

I am, therefore, writing this article to help teach people how to recognise it so that they can escape danger.

—The author is a member of the Chinese medical team at Mzuzu Central Hospital.

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