Dr Maritha Van Der Walt, Chief Medical Officer at Discovery Life

Melanoma is the deadliest form of skin cancer. According to the World Health Organization (WHO), 330,000 new cases were diagnosed globally in 2022, claiming nearly 60,000 lives. In the past, this type of skin cancer was relatively rare. But it is on the rise globally due to multiple factors, including UV exposure and increased awareness and detection. Due to population growth and ageing alone, the WHO’s International Agency for Research on Cancer projects that by 2040, there will be 510,00 more new melanoma cases and almost 100,000 more deaths each year.

Reflecting its severity, Discovery Life’s 2024 claims data shows that melanoma accounted for the third-largest cancer by payout from its Severe Illness Benefit.

What is melanoma and why it is important to be addressed?

Melanoma starts in pigment-producing cells called melanocytes and can appear anywhere. It can even appear on areas not exposed to the sun, such as the soles of the feet or inside the mouth. However, the most common type usually begins on sun-exposed skin (cutaneous melanoma).

“Melanoma is an aggressive form of skin cancer that can spread to distant parts of the body, like the brain and liver,” says Dr Maritha Van Der Walt, Chief Medical Officer at Discovery Life. “Once advanced, it is difficult to treat and sadly often fatal.”

Countries with high UV exposure and outdoor lifestyles face the greatest risk. A recent study in the International Journal of Cancer shows that more than 80% of melanoma cases worldwide are due to exposure to the sun’s UV radiation. Australia and New Zealand are at the top of this list. In South Africa – which has a high UV index most of the year – melanoma is one of the top 10 invasive cancers affecting men and women.

Why early detection matters

Caught early, melanoma is highly treatable. Stage 0 (in situ) or stage 1 melanomas can often be removed with minor surgery.

Discovery Life has seen a 64% increase in severe illness claims for melanoma over the five-year period from 2020 to 2024. Encouragingly, 78% of claims in 2024 were for early-stage melanoma, indicating that more people are being diagnosed before the disease spreads. In fact, the number of in situ (very early) melanoma claims have almost doubled since 2020.

According to the US-based Surveillance, Epidemiology, and End Results (SEER) database, the five-year survival rate for localised melanoma (where it hasn’t spread beyond where it started) is almost 100%.

What happens if melanoma comes back

Even after successful treatment and remission, melanoma has a reputation for returning – sometimes years later. Advances in medical treatment mean more people are reaching remission, but that doesn’t eliminate the risk of recurrence or even developing a completely new, unrelated cancer.

“Unfortunately, melanoma is notorious for reappearing – or relapsing – in the same area or in distant organs,” explains Dr Van Der Walt. “However, due to increased surveillance after an early cancer diagnosis, if there’s a relapse, it’s usually detected at an early stage, but this means it needs treatment again. There’s also a chance you get a second primary cancer – another cancer unrelated to the melanoma.”

Melanoma warning signs – the ABCDE

Often the first sign of melanoma is a change in the shape, colour, size, or feel of an existing mole. However, melanoma doesn’t always look the same, and any skin changes should be flagged. Watch for the ABCDE warning signs:

• A – Asymmetry: one half looks different from the other.
• B – Border: edges are uneven or poorly defined.
• C – Colour: multiple shades (brown, black, red, white, or blue) instead of a uniform black or brown.
• D – Diameter: larger than 6 mm.
• E – Evolving: any change in size, shape, colour, or texture.

Other warning signs include new moles, rapidly growing bumps, itchiness, bleeding, or tenderness. If you notice anything unusual, don’t wait – see a doctor immediately.

Know your melanoma risk factors

Melanoma can occur in any skin type. However, some people are more vulnerable to melanoma and should take extra care, especially if they have fair skin, light or red hair, freckles, and blue or green eyes. Other risk factors include:

• A family or personal history of skin cancer.
• Frequent sun exposure through work or outdoor activities.
• Childhood sunburns (these significantly increase lifetime risk).
• Weakened immunity or being immunosuppressed.
• Use of tanning beds or intentional tanning.

The importance of prevention and protection

“Avoid UV damage,” urges Dr Van Der Walt. “There’s no such thing as a safe tan, because UV exposure damages skin cells and increases cancer risk. Stay out of the sun between 10:00 and 16:00, when UV rays are strongest. Many weather apps have UV Index indicators (measuring 1 to 11+). And if you have very fair skin and plan on being in the sun for more than an hour, you may even need to be cautious if the UV Index is only 3.”

Other sun-safe pointers include:

• Wear wide-brimmed hats, UV-protective sunglasses, and long-sleeved clothing. Rash vests are great for beach days.
• Apply sunscreen correctly. Use a broad-spectrum SPF 50+ sunscreen with UVA and UVB protection. Apply 20 minutes before going outside and reapply every two hours, or after swimming or sweating. Follow the seven-teaspoon rule – one teaspoon for each limb, one for your front, one for your back, and half a teaspoon each for your face and neck.

“Once‑a‑month self-checks are essential. Ask a family member or friend to examine your back and the top of your head, and look out for the ABCDE warning signs. If something doesn’t look right, seek medical advice – it could save your life,” adds Dr Van Der Walt.

ENDS