New Zealand has the world’s worst rates of new melanoma diagnoses and deaths. Because of our population growth and ageing population, the number of New Zealanders diagnosed with melanoma is expected to increase over the next two decades.
Melanoma is a serious type of skin cancer, because cancer cells spread from the skin to important organs such as the brain, liver and lung. It is caused by UV exposure in fair-skinned people. Older men in New Zealand are at particularly high risk due to occupational and lifestyle exposure in the past, but rates of melanoma among young people are starting to decline. This is almost certainly due to changing public behaviour, such as avoidance of sunburn through shade, protective clothing including hats and sunglasses, and regular application of broad spectrum sunscreen.
Advanced melanoma is now treated in New Zealand with immunotherapy agents called PD-1 inhibitors, funded since 2016. ‘Richard’, 73, is a typical New Zealand patient who has had successful treatment with one of these drugs, pembrolizumab. After having a melanoma removed from his back in 2016, he quickly developed tumours in the brain, lung and liver. Two years later, his scans are clear and he is living a normal life.
Many others have not been as fortunate and furthermore, treatment of metastatic (secondary) melanoma is hugely costly; the drugs and associated hospital care are very expensive, and patients carry the physical and psychosocial burdens of treatment
Prevention and early detection crucial
At the recent Melanoma Summit, experts from New Zealand Australia agreed that prevention and early detection of melanoma are much more effective strategies than treatment of advanced cancer.
“The general feeling was that we are complacent about the huge melanoma problem that we have in New Zealand,” says Dr Rosalie Stephens, oncologist and Melanoma New Zealand spokesperson.
“We concluded the meeting with a plan to refocus efforts on government policy relating to and public awareness of sun safety including the dangers of tanning beds, and the dramatic consequences of melanoma.”
Early detection plays a key role in reducing deaths from melanoma. Melanoma that is detected when it is less invasive can be treated effectively by simple surgery. Regular skin checks for those considered at high risk – fair skin and/or blonde/red hair, large numbers of moles, a family history of melanoma – are essential.
New Zealanders should consider using the free sun protection alert on their phones or company websites, and sharing this information with family, staff and customers (www.sunsmart.org.nz/sun-protection-alert), or downloading the uv2Day free smartphone app, which indicates UV status for the area (www.niwa.co.nz/node/111461).
As well as being vigilant about the sun, we need to be aware of our skin, checking it regularly and visiting a GP or skin specialist if a mole is new or changing, such as bleeding, crusting or becoming raised. It is recommended that those New Zealanders considered to be high risk for melanoma have whole-body skin checks every six to 12 months.