Melanoma Diagnosis and Treatment in Mount Gravatt, Brisbane

The short answer: melanoma is a cancer of melanocytes, the cells that make skin pigment. It's less common than BCC or SCC, but it's the skin cancer most likely to spread. Found early, it's usually cured with a simple operation.

Australia has one of the highest melanoma rates in the world. The Australian Institute of Health and Welfare (AIHW) estimates around 17,400 new melanoma cases in 2025. Queensland has historically had higher rates than the national average, with the highest state rate in 2021 at 79 cases per 100,000 people (AIHW).

It isn't only an older person's cancer. AIHW estimates melanoma is the second most common cancer in Australians under 40. Melanoma Institute Australia reports that about 95% of melanomas are caused by UV exposure, and that about a third grow from an existing mole, while the rest appear as new spots (Melanoma Institute Australia).

Melanoma can affect anyone. Fair skin, many moles, a history of sunburn, a past melanoma or a family history all raise the risk. Olive, Asian and darker skin has lower risk, but not zero.

Melanoma is grouped into types based on how it grows. The type changes what it looks like, where it turns up, and how fast it can thicken.

Superficial Spreading Melanoma

The most common type. It grows outwards along the skin before it grows down, often over months to years. It usually looks like a flat, irregular brown or black patch with uneven colour, often on the back in men and the legs in women.

Nodular Melanoma and the EFG Rule

Nodular melanoma grows downwards quickly and may skip the flat phase. It's often a firm, raised, dome-shaped lump that can be black, red, pink or skin-coloured.

Because nodular melanoma often fails the ABCDE checklist, Australian authors use EFG: Elevated, Firm and Growing. The melanoma guideline summary advises that any lump that is elevated, firm and growing for more than a month should be checked promptly and is usually excised rather than watched (Australian melanoma guidelines, MJA 2017).

Lentigo Maligna Melanoma

This grows on sun-damaged skin, usually the face, ears and scalp of older adults. It starts as lentigo maligna, a slowly enlarging flat brown patch that's easily mistaken for a sun spot. When it invades deeper, it's called lentigo maligna melanoma. Dr Mitch was first author of the Australian clinical practice guidelines for lentigo maligna. See our lentigo maligna page.

Acral Melanoma on Palms, Soles and Nails

Acral melanoma appears on the palms, soles or under a nail, often as a dark stripe along the nail or a brown patch on the foot. It isn't linked to sun exposure the way other types are, and it makes up a larger share of melanomas in people with darker and Asian skin. We always check hands, feet and nails.

Amelanotic Melanoma

Amelanotic melanoma has little or no pigment. It may be pink, red or skin-coloured, and can look like a harmless bump or a patch of dermatitis. It's one reason dermoscopy and a careful history matter.

Once a melanoma is removed, a pathologist measures how deep it goes. This is the Breslow thickness, in millimetres. Thinner is better.

The report also notes features such as ulceration (whether the skin surface over the melanoma has broken down) and how actively the cells are dividing. Together these set the stage.

In plain terms, from Melanoma Institute Australia's early melanoma guide (MIA):

• Stage 0 (in situ): confined to the top layer of skin
• Stage I: up to 2 mm thick without ulceration, or up to 1 mm with ulceration
• Stage II: thicker, or ulcerated, with no spread to lymph nodes
• Stage III: spread to nearby lymph nodes or skin close by
• Stage IV: spread to distant parts of the body

We'll go through your own pathology report with you, line by line.

We don't take a partial shave sample of a suspected melanoma. The whole spot comes off, so the pathologist can see all of it:

• Flat spots are removed whole with a shave excision.
• Raised spots are removed with an excision biopsy and a 2 mm margin of normal skin, closed with a few stitches.

Why the whole spot?

• The pathologist needs the full depth to measure Breslow thickness accurately
• A partial sample can miss the deepest or most abnormal part
• An accurate thickness means the right margin and the right next step first time

Both are done in our rooms under local anaesthetic. An excision biopsy usually takes 20 to 30 minutes.

The margin is measured from the edge of the melanoma or biopsy scar. The Australian guidelines set it by Breslow thickness (Australian melanoma guidelines, MJA 2018):

• Melanoma in situ: 5–10 mm
• Up to 1 mm thick: 1 cm
• 1.01–2 mm: 1–2 cm
• 2.01–4 mm: 1–2 cm (2 cm may be preferred depending on site and features)
• Over 4 mm: 2 cm

Lentigo maligna may need a wider margin, because it often spreads further under normal-looking skin than you can see.

Most wide local excisions for in situ and thin melanomas are done in our rooms under local anaesthetic. The wound is closed in a line, or with a flap or graft where the skin is tight, such as the face, shins or scalp. Some sites, or excisions done with a sentinel node biopsy, are done in hospital by a surgical oncologist.

Yes, in most cases. Melanoma Institute Australia reports that around 90% of melanomas are cured by surgery when found early (MIA melanoma facts).

Across all stages, AIHW reports five-year relative survival for melanoma in Australia of 94% for people diagnosed in 2017–2021 (AIHW). The outlook is most favourable for in situ and thin melanomas, and falls as thickness increases.

Treatment for advanced melanoma has also changed a great deal. Melanoma Institute Australia reports five-year survival for advanced melanoma has risen from under 10% to over 55% (MIA).

Your own outlook depends on your pathology, and we'll talk it through honestly.

You'll need regular full skin checks for life. A past melanoma is the strongest risk factor for another one.

How often we see you is tailored to you. It depends on your melanoma, your own skin history and your family history. After stage III or IV, follow-up is usually shared with a melanoma unit and may include scans.

Between visits, check your own skin every month or two, including your scalp, soles and between your toes. Photos on your phone make changes easier to spot. Feel the scar and the lymph node areas closest to it (neck, armpits or groin) for new lumps.

If you have many moles, we'll discuss whether a referral for mole mapping makes sense.

A typical early melanoma involves four steps: a consultation, removing the spot for the lab, a results visit and a wide local excision.

• Specialist consultation: $395. A Medicare rebate applies with a valid GP referral.
• Removing the spot and wide local excision: Medicare-listed skin cancer procedures attract a rebate. Your fee is quoted in writing before each procedure.
• Pathology: billed separately by the pathology lab.
• Sentinel lymph node biopsy: done in hospital, billed by the hospital and surgical team. Private health insurance may contribute.

See treatment fees and the Medicare section of our skin cancer surgery page.