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Melanoma is a type of skin cancer. It is not the most common, but it is the most serious, as it often spreads. When this happens, it can be difficult to treat, and the outlook may be poor. Risk factors for melanoma include overexposure to the sun, having fair skin, and a family history of melanoma, among others.


Receiving an early diagnosis and getting prompt treatment can improve the outlook for people with melanoma.


For this reason, people should keep track of any changing or growing moles. Using adequate protection against sun exposure can help a person prevent melanoma altogether.


This article covers the symptoms of melanoma, how a doctor would diagnose it, and ways to treat it. We also explain how best to prevent melanoma.


What is melanoma?

Melanoma is a type of skin cancer that occurs when pigment producing cells called melanocytes mutate and begin to divide uncontrollably.


Most pigment cells develop in the skin. Melanomas can develop anywhere on the skin, but certain areas are more at risk than others. In men, it is most likely to affect the chest and back. In women, the legs are the most common site. Other common sites of melanoma include the face.


However, melanoma can also occur in the eyes and other parts of the body, including — on very rare occasions — the intestines.


Melanoma is relatively rare in people with darker skin.


The American Cancer Society (ACS) estimate that there will be about 96,480 new diagnosesTrusted Source of melanoma in 2019. They also estimate that around 7,230 people will die due to melanoma in 2019.


Stages

The stage of a cancer at diagnosis will indicate how far it has already spread and what kind of treatment will be suitable.


One method of assigning a stage to melanoma describes the cancer in five stagesTrusted Source, from 0 to 4:


Stage 0: The cancer is only present in the outermost layer of skin. Doctors refer to this stage as “melanoma in situ.”

Stage 1: The cancer is up to 2 millimeters (mm) thick. It has not yet spread to lymph nodes or other sites, and it may or may not be ulcerated.

Stage 2: The cancer is at least 1 mm thick but may be thicker than 4 mm. It may or may not be ulcerated, and it has not yet spread to lymph nodes or other sites.

Stage 3: The cancer has spread to one or more lymph nodes or nearby lymphatic channels but not distant sites. The original cancer may no longer be visible. If it is visible, it may be thicker than 4 mm and also ulcerated.

Stage 4: The cancer has spread to distant lymph nodes or organs, such as the brain, lungs, or liver.

The more advanced a cancer is, the harder it is to treat and the worse the outlook becomes.



Types

There are four typesTrusted Source of melanoma. Learn more about each type in the sections below.


Superficial spreading melanoma

This is the most common type of melanoma, and it often appears on the trunk or limbs. The cells tend to grow slowly at first before spreading across the surface of the skin.


Nodular melanoma

This is the second most common type of melanoma, appearing on the trunk, head, or neck. It tends to grow quicker than other types, and it may appear as a reddish or blue-black color.


Nodular melanoma is also the most aggressive type. Learn more about it here.


Lentigo maligna melanoma

This is less common and tends to develop in older adults, especially in parts of the body that have had excessive sun exposure over several years, such as the face.


It starts as a Hutchinson’s freckle, or lentigo maligna, which looks like a stain on the skin. It usually grows slowly and is less dangerous than other types of melanoma.


Acral lentiginous melanoma

This is the rarest kind of melanoma. It appears on the palms of the hands, soles of the feet, or under the nails.


Since people with darker skin do not typically get other types of melanoma, these tend to be the most common type of melanoma in those with darker skin types.



Risk factors

Research into the exact causes of melanoma is ongoing.


However, scientists do know that people with certain skin types are more prone to developing melanoma.


The following factors may also contribute to an increased risk of skin cancer:


a high density of freckles or a tendency to develop freckles following exposure to the sun

a high number of moles

five or more atypical moles

the presence of actinic lentigines, also known as liver spots or age spots

giant congenital melanocytic nevi, a type of brown birthmark

pale skin that does not tan easily and tends to burn

light eyes

red or light hair

high sun exposure, particularly if it produces blistering sunburn, and if sun exposure is intermittent rather than regular

older age

a family or personal history of melanoma

a previous organ transplant

Of these risk factors, only sun exposure and sunburn are avoidable. Avoiding overexposure to the sun and preventing sunburn can significantly lower the risk of skin cancer. Tanning beds are also a source of damaging ultraviolet (UV) rays.


Being able to tell the difference between normal moles or freckles and those that indicate skin cancer can support an early diagnosis.


Superficial spreading melanoma

Nodular melanoma

Lentigo maligna melanoma

Acral lentiginous melanoma

Skin changes due to cancer

Normal mole


Symptoms

In its early stages, melanoma can be difficult to detect. It is important to check the skin for any signs of change.


Alterations in the appearance of the skin are vital indicators of melanoma. Doctors use them in the diagnostic process.


The Melanoma Research Foundation offer pictures of melanomas and normal moles to help a person learn how to tell the difference.


They also list some symptoms that should prompt a person to visit the doctor, including:


any skin changes, such as a new spot or mole or a change in the color, shape, or size of an existing spot or mole

a skin sore that fails to heal

a spot or sore that becomes painful, itchy, or tender

a spot or sore that starts to bleed

a spot or lump that looks shiny, waxy, smooth, or pale

a firm, red lump that bleeds or looks ulcerated or crusty

a flat, red spot that is rough, dry, or scaly

ABCDE examination

The ABCDE examination of moles is an important method for revealing potentially cancerous lesions. It describes five simple characteristics to check for in a mole that can help a person either confirm or rule out melanoma:


Asymmetric: Noncancerous moles tend to be round and symmetrical, whereas one side of a cancerous mole is likely to look different to the other side.

Border: This is likely to be irregular rather than smooth and may appear ragged, notched, or blurred.

Color: Melanomas tend to contain uneven shades and colors, including black, brown, and tan. They may even contain white or blue pigmentation.

Diameter: Melanoma can cause a change in the size of a mole. For example, if a mole becomes larger than one-quarter of an inch in diameter, it might be cancerous.

Evolving: A change in a mole’s appearance over weeks or months can be a sign of skin cancer.

In this article, learn about the differences between the appearance of rashes and skin cancer.


Treatment

The treatment of skin cancer is similar to that of other cancers. However, unlike many cancers inside the body, it is easier to access the cancerous tissue and remove it completely. For this reason, surgery is the standard treatment option for melanoma.


Surgery involves removing the lesion and some of the noncancerous tissue around it. When the surgeon removes the lesion, they send it to pathology to determine the extent of the involvement of the cancer, and to make sure that they have removed all of it.


If melanoma covers a large area of skin, a skin graft may be necessary.


If there is a risk that the cancer has spread to the lymph nodes, a doctor may request a lymph node biopsy.


They may also recommend radiation therapy for treating melanoma, especially in the later stages.


Melanoma may metastasize to other organs. If this happens, a doctor will request treatments depending on where the melanoma has spread, including:


chemotherapy, in which a doctor uses medications that target the cancer cells

immunotherapy, in which a doctor administers drugs that work with the immune system to help fight the cancer

targeted therapy, which uses medications that identify and target particular genes or proteins specific to melanoma

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