Melanoma

Melanoma is the least common, but most dangerous, form of skin cancer. This is because it can spread (metastasize) to other organs and can be life-threatening. Melanoma is a cancerous (malignant) tumor that begins in a certain type of cells, called melanocytes. Melanocytes are the cells that produce the color (pigment) called melanin. Melanin colors our skin, hair, eyes, and moles.

CAUSES

The exact cause of melanoma is unknown. You may have a higher risk if you:

  • Spend or have spent a lot of time in the sun. This includes sunlamp and tanning booth exposure.

  • Have had sunburns. This put you at a particularly increased risk for melanoma. The more blistering sunburns a person has, the higher the risk.

  • Spend time in parts of the world with more intense sunlight.

  • Have fair skin that does not tan easily. You may have a lower risk if you have a darker skin color. However, people with darker skin can get melanoma, especially on the hands and feet (acral areas).

  • Have a close relative (parent, sibling) who has melanoma.

  • Have a large number of skin moles (more than 100).

SYMPTOMS

A skin mole is suspicious if it has any of these 5 traits. This is called the ABCDE's of melanoma:

  • Asymmetry: Irregular shape, not simply round or oval.

  • Border: Edge of the mole is irregular, not smooth.

  • Color: Mole may have multiple colors in it, including brown, black, blue, red, or tan.

  • Diameter: More than 0.2 inches (6 mm) across.

  • Evolving: Any unusual change or symptoms in the mole, such as pain, itching, stinging, sensitivity, or bleeding.

A mole that is noticeably changing in appearance, or any new mole, should be checked for melanoma. In general, people develop new moles until age 30. New moles after this age should be brought to the attention of your caregiver.

DIAGNOSIS

Your caregiver can look at your skin and find lesions or moles that may be suspicious. A patient may also notice a mole with symptoms or a mole that does not look like most of the other moles on his or her body. This is called the "ugly duckling" sign. A tissue sample (biopsy) examined under a microscope is needed to determine if it is melanoma. The size and extent of the biopsy will depend on the location, size, and appearance of the skin lesion or mole. The biopsy can also reveal whether melanoma has spread to deeper layers of the skin.

TREATMENT

Surgery to completely remove the melanoma is required. Lymph nodes may also be removed. If the melanoma has spread to other organs, such as the liver, lungs, bone, or brain, cancer-fighting drugs (chemotherapy) must be used. Your caregiver will discuss your treatment options with you. You can ask about being included in a clinical trial to evaluate new forms of treatment. Melanoma can occasionally recur years after the initial diagnosis. If you have melanoma, you will need follow-up visits with your caregiver for many years.

PREVENTION

Risk for melanoma can be reduced by minimizing sun exposure. Practice the 3 S's:

  • Slip on a shirt.

  • Slop on sunscreen.

  • Slap on a hat.

Do not spend time in the sun during peak midafternoon hours. Sunscreen/sunblock with SPF 30 or higher and UVA/UVB block should be applied regularly. You should do this even during brief exposure to sunlight. You should also do this on cloudy days and in winter, even though the perceived sunlight is less. Always avoid sunburn! Wear sunglasses that block UV light. Be sure to see your caregiver if you have any new or changing moles.

HOME CARE INSTRUCTIONS

  • Follow wound care instructions after surgical removal of your melanoma.

  • Practice good sun avoidance and protective measures as described above.

  • Let your close family members (parents, children, siblings) know about your diagnosis. This puts them at a higher risk of getting melanoma than the general population.

SEEK MEDICAL CARE IF:

  • You notice any new moles, or you have any moles that are changing.

  • You have had a melanoma removed and you notice a new growth near the same location.

  • You have had a melanoma removed and you experience any new or unexplained health problems.