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Skin Cancer, Melanoma

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What is melanoma?

MelanomaMelanoma is a type of skin cancer. It is the most serious type of skin cancer because melanomas have a tendency to spread quickly to other parts of the body (metastasize).

Melanoma begins when melanocytes (pigment cells) gradually become more abnormal and divide without control or order. These cells can invade and destroy the normal cells around them. The abnormal cells form a growth of malignant tissue (a cancerous tumor) on the surface of the skin.

Most melanomas appear as dark growths similar to moles, but some may be skin-colored.

Melanoma can begin as a as a new growth on the skin, or develop from an existing mole (nevi) that changes size, shape, feeling, or color

Who’s at risk for melanoma?

No one knows the exact causes of melanoma. Doctors can seldom explain why one person gets melanoma and another does not.

However, research has shown that people with certain risk factors are more likely than others to develop melanoma. Still, many people with melanoma have no known risk factors.

Studies have found the following risk factors for melanoma:

  • Dysplastic nevi: Dysplastic nevi are more likely than ordinary moles to become cancerous. Dysplastic nevi are common, and many people have a few of these abnormal moles.
  • Many (more than 50) ordinary moles: Having many moles increases the risk of developing melanoma.
  • Fair skin: Melanoma occurs more frequently in people who have fair skin that burns or freckles easily (these people also usually have red or blond hair and blue eyes) than in people with dark skin.
  • Personal history of melanoma or skin cancer: People who have been treated for melanoma have a high risk of a second melanoma. Some people develop more than two melanomas. People who had one or more of the common skin cancers (basal cell carcinoma or squamous cell carcinoma) are also at increased risk of melanoma.
  • Family history: Melanoma sometimes runs in families. Having two or more close relatives who have had this disease is a risk factor. When melanoma runs in a family, all family members should be checked regularly by a doctor.
  • Weakened immune system: People whose immune system is weakened by certain cancers, by drugs given following organ transplantation, or by HIV are at increased risk of developing melanoma.
  • Severe, blistering sunburns: People who have had at least one severe, blistering sunburn as a child or teenager are at increased risk of melanoma. 
  • Ultraviolet (UV) radiation: Experts believe that much of the worldwide increase in melanoma is related to an increase in the amount of time people spend in the sun. This disease is more common in people who live in sunny climates. Artificial sources of UV radiation, such as sunlamps and tanning booths, also can damage the skin and increase the risk of melanoma.

What are the signs and symptoms of melanoma?

Often, the first sign of melanoma is a change in the size, shape, color, or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new mole. It may be black, abnormal, or “ugly looking.”

In more advanced melanoma, the texture of the mole may change. For example, it may become hard or lumpy. Melanomas may feel different from regular moles. More advanced tumors may itch, ooze, or bleed. But melanomas are not usually painful.

Changes in the skin, such as a change in a mole, should be reported to the health care provider right away. The person may be referred to a dermatologist.

A monthly skin self-exam is very important for people with any risk factors, but routine skin self-exams are a good idea for everyone.

What are the stages of melanoma?

If the diagnosis is melanoma, the doctor needs to learn the extent, or stage, of the disease before planning treatment. Staging is a careful attempt to learn how thick the tumor is, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body.

The following stages are used to describe melanoma:

  • Stage 0: In stage 0, the melanoma cells are found only in the outer layer of skin cells and have not invaded deeper tissues.
  • Stage I: Melanoma in stage I is thin and has not spread to nearby lymph nodes.
  • Stage II: The tumor is at least 1 millimeter thick and may be ulcerated; the melanoma cells have not spread to nearby lymph nodes.
  • Stage III: The melanoma cells have spread to nearby tissues.
  • Stage IV: The melanoma cells have spread to organs, lymph nodes, or skin far away from the original tumor.
  • Recurrent: Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may have come back in the original site or in another part of the body.

How is melanoma treated?

Your doctor can describe treatment choices and discuss the results expected with each treatment option.

Treatment for melanoma depends on the extent of the disease, the patient’s age and general health, and other factors.

People with Stage III or Stage IV melanoma are often treated by a team of specialists. The team may include a dermatologist, surgeon, medical oncologist, radiation oncologist, and plastic surgeon.

Where can I learn more?

For more information, please visit The Skin Cancer Foundation.

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Vivacare public information from The National Cancer Institute

Images courtesy of Gerald Goldberg, M.D.

© 2009 Vivacare.

Last updated December 10th, 2009.

This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.