Articles on Melanoma and Skin Cancer

InTech Management of head and neck melanoma

Article in “Beautiful You” Magazine Volume 2, Autumn/Winter 2006


30 May 2005 News release


Hundreds of New Zealanders are dying because too many are still ignoring the melanoma message and are too slow in seeking specialist treatment, says world expert in the disease, Professor Jim Shaw of Auckland.

Prof Shaw has been invited to present his latest research on the deadly disease at the Quincentenary (500th anniversary) of the Royal College of Surgeons of Edinburgh in July.

Ten years ago Prof Shaw and his team discovered that New Zealand had the highest incidence of melanoma in the world, ahead of Australia, which was previously recognised as having the highest rate.

Today, we still have the highest rate of melanoma worldwide and this will remain so unless New Zealanders get the message of ‘slip, slop, slap’,” he says.

“So many New Zealanders are of Celtic origin with fair skin yet they still go out in the strong ozone depleted South Pacific sun with little or no protection. The only solution is education and protecting your largest organ, namely your skin.”

Prof Shaw is acknowledged as a world expert in the surgical management of melanoma, in particular when it occurs in the head and neck. He is one of only three New Zealanders to be appointed a member of the most prestigious surgical society in the world, the James IV Association of Surgeons and is currently the only active New Zealand member.

In Edinburgh he will release new findings from his work, which will effectively establish the blueprint for how melanoma behaves in the head and neck area and how it should be treated.


“It is a great honour to be invited to participate in one of the master classes at the 500th anniversary of the Royal College of Surgeons of Edinburgh. The clinical research I will be presenting will help surgeons around the world treat this deadly and unpredictable disease,” he said.

“There are three key reasons why head and neck melanoma is of interest to surgeons around the world. Firstly, the head and neck is a preferred site for melanoma (18% of all melanoma occurs in this area which only accounts for 9% of the skin’s surface area). Secondly, there are cosmetic issues that are important in this part of the body, and thirdly because the behaviour and therefore the management of melanoma in the head and neck area is more complex than in other parts of the body due to the intricate lymph gland anatomy.”

Prof Shaw (55) has operated on several thousand New Zealanders with melanoma, several hundred of whom had the disease in the head and neck area or region.

He has analysed how melanoma behaves in the head and neck area and this study of 508 patients is probably one of the largest of its kind from one centre anywhere in the world.

His findings include:

  • Melanoma is more difficult to manage in the head and neck than in the rest of the body and particularly if it occurs on the scalp or lower neck.
  • The margin of clearance of healthy tissue required around the primary melanoma is critical to minimise recurrence of the melanoma and increase chances of survival. Despite this, current recommendations for margins are much more conservative than 30 years ago meaning less disfigurement for patients, fewer skin grafts and a better quality of life.
  • Establishing optimum guidelines for managing lymph gland involvement for patients with head and neck melanoma is one of the most critical findings of this research.
  • Patients with lymph gland involvement from head and neck melanoma had significantly better outcomes following resection of lymph glands plus radiotherapy when compared with patients who had surgery alone.


    “Melanoma is one of the most unpredictable cancers and can quickly spread to every other part of the body. If you have moles that are definitely changing, in particular getting darker, itchy, bleeding or growing, you need to get them removed within a matter of weeks – waiting several months or a year will make a world of difference,” Prof Shaw said.

    “To save lives, patients with changing skin lesions must see a melanoma specialist as soon as possible to diagnose if they are melanomas and adequately treat them. Melanoma is a surgical disease and virtually all patients need a surgical procedure to adequately remove the growth.”

    Skin cancer is by far the most common cancer in New Zealand. Melanoma is the least common skin cancer (behind basal cell and squamous cell).

    Melanoma is by far its deadliest form and has a high incidence in New Zealanders aged 20 to 40. Figures from the Cancer Society show that about 200 people die from melanoma each year.

    The risk of developing melanoma as an adult is heavily weighted if you had sunburn as a child. Most at risk are fair skinned people with green eyes and red hair and a family history of melanoma means your chances of getting it are doubled.

    Note to Editors:

    Only 100 surgeons worldwide belong to the James IV Association of Surgeons at any one time. Professor Jim Shaw was awarded membership in 2001. He is only the third New Zealander to belong to the society. The others were pioneering heart surgeon Sir Brian Barratt-Boyes and WWII reconstructive plastic surgeon Sir Archibald McIndoe.

    Other highlights of Prof Shaw’s career include being the top clinical student in Otago Medical School’s Graduate Class of 1974 graduating with distinction in medicine, surgery, paediatrics and psychiatry. Being a Research Fellow jointly at Harvard Medical School, Massachusetts Institute of Technology and Massachusetts General Hospital from 1981 to 1984 and being the first New Zealander to be a Clinical Cancer Surgery Fellow at the famous Memorial Sloan-Kettering Cancer Centre in New York (1983/84).

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