What Is Melanoma?
Melanoma is a disease of the skin in which cancer cells are found in the melanocytes. Melanocytes are the cells that produce color in the skin through a pigment called melanin. If melanoma is caught and treated early, it is almost always curable.
Any change in the shape, color or size of a mole may be an indication of melanoma.
Melanoma Risk Factors
A risk factor is something that increases your chances of developing a disease. People with fair skin or who sunburn easily are at a greater risk for developing melanoma.
We will conduct a physical examination, especially of any moles or skin lesions, to help diagnose melanoma. We may also order a skin biopsy to confirm the diagnosis.
Once we confirm a diagnosis, we order more tests to determine if the cancer has spread. This process is called staging.
We will design a personalized treatment plan for you. Treatment options include chemotherapy, radiation therapy and surgery.
You can take steps to reduce your risk of developing melanoma. Wearing sunscreen and protective clothing can help lower your risk.
Skin Cancer Program
- Basal cell carcinoma
- Squamous cell carcinoma
- Merkel cell carcinoma
- Cutaneous lymphoma
Melanoma Signs and Symptoms
Like most cancers, melanoma is best treated when it is diagnosed early. Recognizing the warning signs of melanoma can help you know when to seek treatment. Because the symptoms of melanoma may resemble other conditions or medical problems, it’s important to consult your doctor promptly for evaluation.
These are the most common symptoms of melanoma. However, each individual may experience different skin findings or symptoms.
Signs and symptoms may include:
- Change in the size, shape, color or elevation of a mole
- Oozing or bleeding from a mole
- A mole that looks different from your other moles or feels itchy, hard, bumpy, swollen or tender to the touch
Melanoma can spread to other parts of the body through the lymph system, or through the bloodstream. If you have a suspicious mole or skin lesion, make an appointment with Dr. Farrah today.
Because most melanoma cells produce melanin, melanoma tumors are often brown or black in color. However, they can also be flesh-colored, bluish or pink in nature. Melanoma can also appear on the body as a “new” pigmented lesion, not arising in a pre-existing mole.
Where Does Melanoma Appear?
Most melanoma starts in the skin and is called cutaneous melanoma.
- It most often appears on fair-skinned men and women.
- People with darker skin types can also be affected, particularly on the palms, soles or nails.
- In men, melanoma most often appears on the back.
- In women, the legs and trunk are more common sites.
- Melanomas can also develop on the face, neck or other areas of excessive sun exposure.
- Rarely, melanomas can form in parts of the body not covered by skin such as the eyes, mouth, genital region and brain.
Melanoma vs. Benign Mole
To find melanoma early, when it is most treatable, it is important to examine your skin on a regular basis. Familiarize yourself with your moles and other skin lesions, so that you can identify any changes. Moles that are at higher risk for becoming malignant include:
- Nevi, a certain type of mole
- Congenital nevi, moles that are present at birth, particularly when they are large in size
- Atypical moles (dysplastic nevi)
However, the vast majority of melanomas do not arise from a pre-existing mole (common, congenital or dysplastic types). Therefore, we do not recommend the mass removal of benign-appearing, stable nevi.
ABCDE Signs of Skin Cancer
Recognize changes in your moles by following this ABCDE Chart. Checking yourself regularly is helpful in detecting melanoma at its earlier, more curable stages. “E” stands for an evolving lesion, which means one that is different in appearance compared to other moles or that changes in size, shape, or color.
The ABCD warning signs are:
- A: Asymmetry
When half of the mole does not match the other half
- B: Border
When the border (edges) of the mole are ragged or irregular
- C: Color
When the color of the mole varies (multiple hues of brown, black, white, red or blue)
- D: Diameter
If the mole’s diameter is larger than a pencil eraser (generally 5-6 mm in diameter)
- E: Evolving
A mole or skin lesion that looks different from the rest or is changing in size, shape or color
When melanoma is found, more tests may be done to find out if the cancer cells have spread to other parts of the body. This is called staging, and it is necessary to determine the best treatment and management plan.
The American Joint Committee on Cancer (AJCC) stages of melanoma are:
Stage O melanoma
Abnormal cells are found only in the top (outer) layer of skin (epidermal) and have not invaded deeper tissue (dermis or subcutaneous fat). This is termed melanoma in situ.
Stage I (1) melanoma
Cancer invades the superficial portion of the inner layer of skin (dermis), is not ulcerated, has a low mitotic rate (less than 1/mm2), and it has not spread to nearby (regional) lymph nodes. The tumor is less than or equal to 1.0 millimeter in thickness.
The tumor is less than or equal to 1.0 millimeter thick and is ulcerated, or has a high mitotic rate (≥1/mm2), or it is 1.01-2.0 millimeters in depth and not ulcerated. It is only in the skin, and has not spread to nearby lymph nodes. Staging of the regional lymph nodes is generally recommended for skin melanomas that are Stage IB and deeper. This is done through a procedure called the Sentinel Lymph Node Biopsy.
Stage II (2) melanoma
The melanoma has invaded the lower part of the inner layer of skin (dermis), but not into the tissue below the skin (the subcutaneous fat) or into nearby lymph nodes. The tumor is 1.0-2.0 millimeters and ulcerated or 2.0-4.0 millimeters and not ulcerated.
The melanoma is 2.01-4.0 millimeters thick and ulcerated, or greater than 4.0 millimeters and not ulcerated. It is only in the skin, and not in nearby lymph nodes.
The tumor is greater than 4.0 millimeters thick and ulcerated, but only involves the skin and not regional lymph nodes.
Stage III (3) melanoma
The melanoma is not ulcerated on the skin, but has spread to one to three nearby lymph nodes microscopically and the nodes are not enlarged (palpable). There is no distant spread.
The melanoma on the skin is ulcerated and has spread to one to three nearby lymph nodes, but the nodes are not enlarged. There is no distant spread.
The skin melanoma is not ulcerated and has spread to one to three nearby lymph nodes and the nodes are enlarged. There is no distant spread.
The melanoma may or may not be ulcerated and has spread to nearby skin or lymph channels (intralymphatic metastasis, also termed satellite or in-transit disease), but it is not in the regional lymph nodes, and there is no distant spread.
The tumor is ulcerated and has spread to one to three nearby lymph nodes which are enlarged. There is no distant spread.
The skin melanoma may or may not be ulcerated and has spread to four or more nearby lymph nodes or to clumped (matted) lymph nodes or to nearby skin, lymph channels (in-transit disease), and nodes. The nodes are enlarged (palpable), but there is no distant spread.
Stage IV (4) melanoma
The tumor has spread to other organs, or to skin or lymph nodes far away from the original tumor. Substages for distant disease depend on:
- Anatomic sites of involvement (distant skin, subcutaneous tissue, or lymph nodes vs. lungs alone vs. all other distant sites)
- Presence or absence of elevated lactate dehydrogenase (LDH) in the blood