What is melanoma?

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Melanoma is a type of skin cancer that affects the melanocytes. Melanocytes are skin cells that produce melanin, which is the substance that provides the skin with color.

Melanoma is a serious form of skin cancer. It is the least common type of skin cancer, but it is the most dangerous. Melanoma is more likely to metastasize, or spread to other organs, and comes with the highest risk of death.

When caught early, most patients respond well to melanoma treatment. However, this early diagnosis and treatment are crucial to a good prognosis. If you believe you may have melanoma, contact your doctor as soon as possible. Seeing a dermatologist is the only way to receive the treatment necessary to address melanoma.

If you are at an increased risk for developing melanoma or other skin cancers, consider establishing contact with a dermatologist before symptoms appear. Proactive skin management is the best way to prevent and treat skin cancer.

What are common melanoma causes?

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Like other forms of skin cancer, ultraviolet (UV) light exposure is the primary melanoma cause. This UV light can come from tanning beds and sunlight. Early and intense sun exposure, which includes getting frequent sunburns as a child, increases a person’s risk for developing melanoma.

However, other factors may contribute to melanoma. This includes:

  • Skin Tone: People with lighter skin tones, freckles, light eyes, and blonde hair are at a higher risk for developing all forms of skin cancer. This includes melanoma.
  • Age: Melanoma risk increases with age. Almost half of all new melanoma diagnoses occur in patients over 55 years old. However, it is important to remember that melanoma can affect people of all ages.
  • Immune System: People who take immunosuppressants, as well as those with conditions that weaken the immune system, are at a higher risk for developing skin cancers.
  • Family and Personal History: If a close family member has had melanoma, a patient is more likely to develop the condition. Additionally, people who have previously recovered from skin cancer are at an increased risk.
  • Genetic Conditions: Certain inherited conditions can affect the skin’s ability to repair itself after ultraviolet light damage. This can lead to an increased risk of developing skin cancers, like melanoma.

If you are at an increased risk for developing melanoma, it is important to schedule regular appointments with a dermatologist. Only a medical professional can identify, diagnose, and treat skin cancer.

What are the symptoms of melanoma?

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Melanoma symptoms can occur in two ways: the development of a new growth, or changes to an existing mole. However, not all growths, discolorations, and moles indicate melanoma. Your growth may be skin cancer if it has any of the following characteristics:

  • It has an irregular border
  • It has an irregular shape
  • It changes in size or color
  • It itches or bleeds
  • It is larger than ¼ of an inch

If you are unsure whether a mole is changing, see a doctor. In some cases, it can be helpful to track the growth with regular photos. Providing a dermatologist with photos of the mole over time can contribute to a diagnosis.

Melanoma lesions are likely to develop on more exposed parts of the skin, like the fact, shoulders, and neck. However, this type of skin cancer is known to form in other areas, like fingernail beds, the soles of the feet, and the palms of the hands. In some cases, a person may develop mucosal melanoma. This skin cancer occurs in the mucous membranes of the nose, urinary tract, digestive tract, and/or mouth. Eye melanoma, which occurs underneath the white of the eye, is also possible.

What are the types of melanoma?

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Like with other skin cancers, the melanoma’s appearance will depend on the type of melanoma a person has. There are four primary types of melanomas:

  • Superficial Spreading Melanoma: This is the most common type of melanoma. Superficial spreading melanoma has uneven borders and is red, black, or pink in color. It often spreads across the skin’s surface.
  • Nodular Melanoma: This type of melanoma appears in deeper layers of the skin. It often manifests as a raised bump.
  • Metastatic Melanoma: This form of the skin cancer occurs once the melanoma has spread. It can affect the person’s organs, bones, and/or lymph nodes. This is the most dangerous form of melanoma.
  • Lentigo Maligna Melanoma: This melanoma is more common in older patients. It appears as a dark, uneven patch on the skin’s surface. Lentigo maligna melanoma often occurs on the face.

How is melanoma diagnosed?

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A routine physical exam or skin check is the first step toward getting a melanoma diagnosis. If you notice any skin abnormalities, make an appointment with your doctor. The doctor will be able to assess whether any moles appear concerning.

If there are any dangerous-looking skin lesions, the doctor will conduct a skin biopsy. In this procedure, the physician will collect a sample of skin cells from the affected area. They will then observe these cells under a microscope to determine if any are cancerous. Some doctors may also test the blood for lactate dehydrogenase levels. Higher levels of this enzyme are associated with melanoma.

If the doctor suspects the melanoma has spread, they will biopsy a lymph node to check for metastasis. A physician might also use various imaging tests, like an MRI, PET scan, or CT scan, to assess where the cancer has spread.

What are the stages of melanoma?

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When melanoma is diagnosed, a doctor will describe the disease’s progression in terms of stages. These stages indicate whether the cancer has spread and to what extent it has affected other regions of the body. Like with most forms of cancer, melanoma has five stages.

  • Stage 0 Melanoma: In this stage, the melanoma is only in the epidermis, or the top layer of skin. It can be removed with a biopsy.
  • Stage 1 Melanoma: Stage 1 melanoma is a low-risk melanoma with no evidence that it has spread. While the cancer may not be removed with a simple biopsy, it is usually curable with different types of surgery.
  • Stage 2 Melanoma: In this stage of melanoma, there may be risk for recurrence, but there is not yet evidence that the melanoma has spread.
  • Stage 3 Melanoma: This stage of melanoma indicates that the cancer has spread to nearby lymph nodes or skin cells.
  • Stage 4 Melanoma: The final stage of melanoma is the most dangerous. In this stage, the cancer has spread to distant lymph nodes or to other organs.

While cancer stages are used to describe the disease’s progression, they can also be helpful in determining treatment. The doctor will assign a stage upon diagnosis, then track the stage as the patient undergoes treatment.

How is melanoma treated?

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The melanoma treatment a doctor prescribes will depend on the cancer’s stage and progression. Early-stage melanoma is typically treated with surgery. Physically removing the cancer, either with a scalpel, a curette, or liquid nitrogen is sometimes enough for a patient to make a full recovery. Common surgeries include Mohs surgery, excisional surgery, and curettage and electrodessication.

Later-stage melanoma will require other types of treatment, often in addition to surgery. Stage 3 and stage 4 melanoma patients will typically undergo radiation therapy and/or immunotherapy. Some doctors may also recommend isolated or systemic chemotherapy to kill cancer cells.

What is the outlook for patients with melanoma?

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A patient’s prognosis will depend on how early they detected the melanoma. Localized melanoma has a 99% survival rate. However, as the disease spreads, the prognosis worsens. To that end, melanoma is diagnosed in later stages around 83% of the time. Late-stage diagnosis has a higher chance of complications and death.

Melanoma prognoses will also depend on a person’s general health and age. Those with weakened immune systems are at increased risk of complications, and older people typically have reduced survival rates.

However, early and aggressive treatment can allow a patient to return to life as normal – just with a few more doctor’s appointments each year than before the diagnosis.

How can I prevent melanoma?

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Prevention is the best form of melanoma treatment. Simple lifestyle changes, like avoiding sun exposure, wearing sunscreen, covering up, wearing wide-brimmed hats, and avoiding tanning beds, can be enough to prevent skin cancer. However, if you are genetically predisposed to skin cancer, regular dermatologist visits should accompany those lifestyle changes.

Additionally, it is important to check the body regularly for new and changing growths. People should take photos and take notes on a mole’s size, shape, and color if they suspect it is changing. Remember to check hard-to-reach areas, like between toes, under nail beds, and between the buttocks. Using a mirror or enlisting the help of a trusted partner can result in a more comprehensive self-check. Report any changes or suspicious growths to your doctor or dermatologist.

Early detection and treatment are essential to reduce the risk of melanoma complications. Whether you suspect you have a cancerous growth or simply want to proactively manage risk, schedule an appointment with a dermatologist.