Melanoma

Risk factors for melanoma include the following:

People who have had melanoma are at increased risk of developing a new melanoma.

Melanoma is less common among people who have darker skin. When melanoma does develop in darker-skinned people, it often develops in the nail beds and on the palms and soles.

Melanomas are very rare in childhood. However, congenital melanocytic nevus is a dark-colored patch of skin, like a mole or a birthmark, that is present at birth. When large in size, for example, more than about 8 inches (about 20 centimeters), congenital melanocytic nevus is a risk factor for malignant melanoma.

Although melanomas occur during pregnancy, pregnancy does not increase the likelihood that a mole will become a melanoma. Moles frequently change in size and darken during pregnancy.

All people should know the ABCDEs of melanoma The ABCDEs of Melanoma so they can check their moles for any malignant (cancerous) changes.

Melanomas can vary in appearance. Some are flat, irregular brown patches containing small black spots. Others are raised brown patches with red, white, black, or blue spots. Sometimes melanoma appears as a firm red, black, or gray lump.

Less than 10% of melanomas produce no pigment. These so-called amelanotic melanomas may be pink, red, or slightly light-brown and may look like noncancerous growths or a form of nonmelanoma skin cancer.

A new mole or changes in a mole—such as enlargement (especially with an irregular border), darkening, inflammation, spotty color changes, bleeding, itching, tenderness, and pain—are warning signs of possible melanoma and so are the ABCDEs of melanoma The ABCDEs of Melanoma . If these or other findings lead doctors to suspect melanoma, they do a biopsy.

For the biopsy Biopsy Doctors can identify many skin disorders simply by looking at the skin. A full skin examination includes examination of the scalp, nails, and mucous membranes. Sometimes the doctor uses a hand-held... read more , doctors remove the entire growth if it is small or only part of it if it is large. They then examine the sample under a microscope to determine whether the growth is a melanoma and, if so, whether all the cancer has been removed. If the biopsy shows that the growth is a melanoma and the growth has not been completely removed, it is then completely removed.

Most darkly pigmented growths that are removed for biopsy are not melanoma but, rather, simple moles Moles Moles are small, usually dark, skin growths that develop from pigment-producing cells in the skin (melanocytes). Most people have some moles, but the tendency to develop atypical moles is sometimes... read more . Nonetheless, removing even many harmless moles is preferable to allowing a single cancer to grow. Some growths are neither simple moles nor melanomas, but something in between. These growths, called atypical moles Atypical moles Moles are small, usually dark, skin growths that develop from pigment-producing cells in the skin (melanocytes). Most people have some moles, but the tendency to develop atypical moles is sometimes... read more (dysplastic nevi), sometimes turn into melanoma later.

There are additional tools that doctors may use to help distinguish an atypical mole from a melanoma. These tools include polarized light and dermoscopy, which help to better evaluate the growths.

Melanoma may spread rapidly and cause death within months of diagnosis. The less a melanoma has grown deeper into the skin, the greater the chance that surgery will cure it. Almost 100% of the earliest, most shallow melanomas are cured by surgery. However, melanomas that have grown deeper than about ¹/₃₂ inch (about 1 millimeter) into the skin have a higher risk of metastasizing to the lymph nodes and blood vessels.

Once melanoma has metastasized to the lymph nodes, the 5-year survival rate ranges from 31.9 to 70.6% depending on how much of the skin over the melanoma has broken down (ulcerated) and the number of affected nodes.

Once melanoma has metastasized to distant parts of the body, the 5-year survival rate is 31.9%. Some people live for less than 9 months. However, the course of the disease varies greatly and depends in part on the strength of the body’s immune defenses. Some people survive in apparent good health for several years despite the spread of the melanoma.

Because melanoma may be caused by long-term sun exposure Overview of Sunlight and Skin Damage Sunlight stimulates vitamin D production, helps control some chronic skin diseases (such as psoriasis), and causes a sense of well-being. However, sunlight can cause skin damage. Damage includes... read more , people can help prevent this cancer by doing the following, starting in early childhood:

Doctors do not know with certainty whether these measures decrease the chances of people developing or dying of melanoma. However, using tanning beds, particularly by young people, does seem to increase the risk of melanoma.

Anyone who has had a melanoma is at risk of developing other melanomas. Therefore, such people need regular skin examinations. People who have many moles should have total body skin examinations at least once a year. People can be taught to examine themselves to detect changes in existing moles and to recognize features suggesting melanoma The ABCDEs of Melanoma . In people without risk factors, doctors do not know whether routine yearly skin examinations reduce the number of deaths from melanoma.

Doctors treat melanomas by cutting them out (sometimes using Mohs microscopically controlled surgery Mohs Microscopically Controlled Surgery ), taking a border of almost ½ inch (1 centimeter) or more of skin around the tumor.

For people who have the most shallow melanomas (that is, melanomas that have not invaded past the epidermis—called melanoma in situ) and who cannot have surgery (for example, because their health is too poor) or choose not to (for example, because their melanomas are in cosmetically important areas), doctors may treat with imiquimod cream or may use extreme cold (cryosurgery) to destroy the melanomas.

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.