Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease.
It involves cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair color.
Melanoma can also involve the colored part of the eye. For information about that form of melanoma, see melanoma of the eye.
Melanoma can appear on normal skin, or it may begin as a mole or other area that has changed in appearance. Some moles that are present at birth may develop into melanomas.
There are four major types of melanoma:
Rarely, melanomas appear in the mouth, iris of the eye, or retina at the back of the eye. They may be found during dental or eye examinations. Although very rare, melanoma can also develop in the vagina, esophagus, anus, urinary tract, and small intestine.
Melanoma can spread very rapidly. Although it is less common than other types of skin cancer, the rate of melanoma is steadily increasing. It is the leading cause of death from skin disease.
The risk of developing melanoma increases with age. However, the disease also frequently affects young, otherwise healthy people.
The development of melanoma is related to sun exposure or ultraviolet radiation, particularly among people with fair skin, blue or green eyes, and red or blond hair.
Risks for melanoma include the following:
Other risk factors include:
The primary symptom of any skin cancer is usually a mole, sore, lump, or growth on the skin. Any change in appearance of a pigmented skin sore over time is a warning sign. Also, watch for any bleeding from a skin growth.
The ABCD system may help you remember features that might be symptoms of melanoma:
The key to treating melanoma is recognizing symptoms early. You might not notice a small spot of concern if you don't look carefully, so perform thorough self-examinations monthly, and schedule a formal skin exam with a dermatologist yearly.
If you notice any suspicious skin markings, see your health care provider as soon as possible.
Your health care provider will look at the appearance of the growth, sore, or lump. A biopsy may be used to confirm the diagnosis. The biopsy may involve removing a small area of a growth, or the entire growth.
A procedure called sentinel lymph node (SLN) biopsy may be used for some people with melanoma to see if the cancer has spread to nearby lymph nodes.
Once melanoma has been diagnosed, CT scans or other types of x-ray tests may be done to see if the cancer has spread.
The cancerous skin cells and some normal tissue that surrounds the cancer will need to be surgically removed. How much normal tissue is removed depends mostly on how deep the melanoma has grown.
If the cancer has spread to nearby lymph nodes, these lymph nodes may also need to be removed. Treatment with interferon after surgery may be useful for these patients.
For patients with melanoma that has spread beyond the skin and nearby lymph nodes to other organs, treatment is more difficult. At this point, melanoma is usually not curable. Treatment is usually directed at shrinking the tumor and improving symptoms:
Patients with high-risk melanomas may consider enrolling in clinical trials. These are research studies of new medications or other treatments.
For additional resources, see cancer support group.
Treatment success depends on many factors, including the patient's general health and whether the cancer has spread to the lymph nodes or other organs.
If caught early, some melanomas can be cured. Deeper tumors are more likely to come back. If the skin cancer is deeper than 4 mm or the lymph nodes have cancer, there is a high risk of the cancer spreading to other tissues and organs. If the cancer has spread to the lymph nodes, there is a greater chance that the melanoma will come back.
For patients with melanoma that has spread beyond the skin and nearby lymph nodes to other organs, treatment is more difficult. At this point, melanoma is usually not curable.
Complications of melanoma include the following:
Call your health care provider if you notice any symptoms of melanoma, particularly the following:
Anyone who has recovered from melanoma should carefully follow preventive guidelines and watch closely for suspicious marks. Your risk for developing a new melanoma is increased, even if the first one was cured. The disease may return years after the original diagnosis.
The American Cancer Society recommends professional skin examinations every year for people older than 40, and every 3 years for people ages 20 - 40.
Self-examination is also recommended. You should examine your skin once a month, using a mirror to check hard-to-see places. Call your doctor if you notice any suspicious skin changes.
Protect yourself from the sunlight's damaging ultraviolet rays by doing the following:
Skin cancer - melanoma