Melanoma is a rare and deadly cancer. However, in 2023, more than 18,000 people were diagnosed with melanoma (Ministered Department of Health & Aged Care [MDHA], 2024). It can spread rapidly through lymphatic vessels to distant organs and parts of the body (Saenz, 2022). Thus, early detection is essential to ensure successful treatment (MDHA, 2024; Sherrell, 2024). Researchers claim they may have developed a blood test, which can detect melanoma before it is discovered by the naked eye (Glover, 2024, para. 1). With regard to such claims, due diligence is required, and certain considerations must be made. The conventional diagnostic pathway begins with a person presenting to a dermatologist with an unusual skin lesion, which is examined using a dermatoscope (Melanoma Institute Australia [MIA], 2024). If there are suspicious lesions, an excision, punch, shave or fine needle skin biopsy may be taken and sent to the pathologist for examination and diagnosis (Ibid). This tissue biopsy can yield genetic and epigenetic information useful for early detection and prognosis (Kim & Kim, 2024). The melanoma is then classified into levels known as the Clark level, which ranges from level 1 to level V, and then into stages of 0 to IV through microstaging of tissue, clinical staging examining lymph nodes and post staging investigation using CT, MRI and PET scans (MIA, 2024). Thus, as can be seen melanoma diagnosis follows a diagnostic pathway, of which each point is important for diagnosis and prognosis and subsequently drives treatment decisions.
The first step in preventing advanced melanoma diagnosis is to do regular skin examinations. Melanoma is not a uniform cancer and may have different presentations. There are five different types of melanoma, which include: superficial spreading melanoma, the most common, and presents with dark spots with irregular boarders; nodular melanoma with the most rapid growth rate, and appears as a raise lump with a brown, black, pink or red colour; acral lentiginous melanoma, which occurs on the hand palms and feet soles or under the nails; desmoplastic melanoma, which is the rarer type of melanoma and may appears as a spot that may resemble a scar; naevoid melanoma, another rare melanoma that is hard to diagnose because it resembles a benign mole with a brown, black, blue or red dome shaped appearance; lentigo maligna melanoma, which begins as a large freckle on the sun-exposes areas of the body such as the face, head, neck or upper torso; mucosal melanoma, which is found in the lining of the respiratory, digestive and reproductive tracts; and uveal (ocular) melanoma, which may be found in the eye (MIA, 2024). Thus, it can be seen that melanoma is a diverse cancer, and as such requires diverse methods of diagnosis that can differentiate the different types and genetic subtypes.
However, new techniques such as the Melaseq melanoma genetic panel are emerging that can differentiate melanomas. These technologies are not to replace professional medical diagnoses but to assist with precise and objective management of genetically susceptible individuals (Geneseq Biosciences [GB], 2024; Van Laar, 2024). The test panel has the ability to measure and analyse melanoma-related micro-RNAs changes, which are cellular non-coding genes that regulate genetic expression that control melanoma growth and spread (GB, 2024; O’Brien et al., 2018). The Melaseq test can distinguish between disease states such as angiogenesis (blood vessel growth) and inflammation, drug resistance, tumour growth and metastasis (GB, 2024). It must be noted though that this new technique is not yet approved for clinical use and is likely to be expensive (Ibid). The test is currently priced at $1,200 to $1,500 AU (Glover, 2024). However, steps are currently being undertaken to introduce reimbursement options and increase accessibility (Ibid). Furthermore, this is not a wholly blood-based diagnostic method as was claimed in the recent article but requires both solid tissue and blood-based microRNA signatures (Van Laar, 2024). Thus, it is still expedient to do self-examinations, have regular skin checks and depend upon the professional advice of the dermatologist.
References
Geneseq biosciences. (2024). MelaseqTM melanoma genomic score. Accessed December 16, 2024, from https://www.geneseq.com.au/melaseq/
Glover, A. (Dec 1, 2024). Melanoma blood test which detects skin cancer before it’s visible to naked eye could be available within months. 9 News. Accessed December 12, 2024, from https://www.9news.com.au/national/melanoma-blood-test-breakthrough-cancer-research-test-could-detect-skin-cancer-before-symptoms/ce91f14b-5f1f-49ae-9abd-ab0eb4fa08e6
Kim, H. J., & Kim, H.K. (2024). Molecular frontiers in melanoma: pathogenesis, diagnosis, and therapeutic advances. International Journal of Molecular Sciences, 25, 1—22. https://pmc.ncbi.nlm.nih.gov/articles/PMC10931637/pdf/ijms-25-02984.pdf
Melanoma Institute Australia [MIA]. (2024). Melanoma diagnosis. Accessed December 04, 2024, from https://melanoma.org.au/for-patients/melanoma-diagnosis/
Ministers Department of Health and Aged Care. (2024). National targeted skin cancer screening to be accelerated with $10.3 million investment. Commonwealth of Australia. Accessed December 04, 2024, from https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/national-targeted-skin-cancer-screening-to-be-accelerated-with-103-million-investment
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All information provided by Bloomhill is mainly based on research from the Qld Cancer Council and best practice guidelines. Our model of care utilizes the Clinical Oncology Society of Australia (COSA) domains of wellness along with available clinical evidence. Always consult your care team regarding matters that affect your health. This is a guide intended for information only.
