Melanoma 101

Melanoma 101

Medically reviewed by Elisabetta Liotta, MD

Your skin is the largest organ in the body, so it makes sense that skin cancer is the most common type of cancer. But did you know that rates of melanoma, the deadliest form of skin cancer, are on the rise for women?

More than 39,000 women will be diagnosed with melanoma this year. And if these stats have you reaching for sunscreen, here’s more on what you need to know about melanoma symptoms and how to protect your skin.

What is melanoma and what causes it?

Melanoma, also called cutaneous melanoma, is the more serious type of skin cancer. It happens when melanocytes, the cells that give your skin its color, get damaged and grow out of control. Unlike other types of skin cancer, it can spread rapidly to other parts of the body.

There are three types of cells that make up the top layer of skin, known as the epidermis: squamous cells, basal cells, and melanocytes. Squamous cell carcinoma it is cancer on the top layer of skin. It usually occurs in areas of the body that get the most sun. It can metastasize or spread to other parts of the body. Basal cell carcinoma is the most common type of skin cancer. It grows slowly and does not tend to spread to other areas. Melanocytes are the bottom layer and, in addition to producing melanin, the substance in your body that produces the color of your hair, eyes and skin, they also help protect the deeper layers of your skin from the sun’s ultraviolet (UV) radiation .

There are four types of melanoma:

  • Superficial spreading melanoma: The most common form, typically found on the legs and upper back in women. It usually looks flat and discolored.
  • Lentigo maligna melanoma: Typically appears in older adults and looks similar to a superficial spreading form, appearing flat with blotchy blue-black, tan, or brown patches.
  • Acral lentiginous melanoma: The most common melanoma in black people, appearing black or brown in color. It can develop under the nails, on the palms or soles of the feet.
  • Nodular melanoma: This is the most aggressive form of melanoma and tends to grow rapidly. It appears as a bump, reddish or blue-black in color.

Researchers aren’t exactly sure how melanoma forms, but genetics and the environment could play a role. Exposure to UV rays from the sun or tanning beds increases the risk of developing melanoma.

What are the risk factors for melanoma?

Risk factors that can lead to melanoma include:

  • A personal or family history of melanoma, as melanoma can be hereditary
  • Past breast or thyroid cancer
  • Having fair skin, blond or red hair, freckles or blue eyes
  • Extensive sun exposure, including sunburn that causes blisters
  • Use of tanning beds
  • Having numerous moles on the body, especially if they are large or irregularly shaped around the edges
  • Having a weak immune system
  • Be over 50 years old

Race also plays a role in risk factors. Whites are more at risk of melanoma compared to people of color because they have less protective melanin in lighter skin. However, people of color are more likely to die from the disease because they often develop melanoma in parts of their body that don’t get sun exposure and are delayed in diagnosis.

What are the symptoms of melanoma?

Melanoma most commonly occurs on the back, arms, legs and face. It can also appear on the palms of the hands, soles of the feet, nail beds, inside the mouth and genitals, particularly in those with darker skin.

Early-stage melanoma usually appears initially as a new, rapidly growing bumpy mole or a change in a mole you already have. Most melanomas are new growths rather than from an established new one. You may also notice unusual growth or pigmented areas that weren’t there before. For the warning signs of melanoma, follow up ABCDE:

  • Asymmetrical: Moles or spots have an irregular shape
  • Edge: The edge or outline of the area is jagged or jagged
  • Color: There is an uneven amount of color
  • Diameter: A mole or spot larger than the size of a pea
  • Evolving: A mole or spot that has changed in the last few weeks or months

How is melanoma diagnosed?

If a mole or spot looks suspicious, your healthcare professional (HCP), often a dermatologist who specializes in skin conditions, will order a biopsy. A biopsy is when a small part of the affected area is removed and studied under a microscope. If cancer cells are found, your doctor may want to stage the cancer, including finding out if the cancer has metastasized or spread.

For a deeper tumor, you may need to obtain images to help your doctor stage the tumor, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan.

There are five stages of melanoma:

  • Phase 0: Also known as melanoma in situ, the cancer is found only in the epidermis (the outer layer of skin)
  • Phase 1: The cancer has not spread to other areas and can be treated with surgery
  • Phase 2: The cancer has not spread but is more likely to come back
  • Phase 3: The cancer has spread to nearby lymph nodes or skin
  • Stage 4: The cancer has spread to distant lymph nodes, skin, or other organs

What are the treatment options for melanoma?

Surgery to remove melanoma tends to be the most successful treatment. In the early stages of cancer, your doctor will remove the cancerous area and some of the surrounding skin. A lymphadenectomy it is a surgery that can also be done if lymph nodes need to be removed.

Chemotherapy might be done to kill the remaining cancer cells, but more often the doctor may use immunotherapy or targeted therapy instead. Immunotherapy uses your own immune system to kill cancer cells and could be used in addition to surgery. In targeted therapy, some drugs kill cancer cells and shrink the cancer.

Radiotherapy it could also be used to destroy cancer cells and prevent new cancer cells from growing.

Can melanoma be prevented?

Some cases of melanoma can be prevented. Steps you can take to prevent melanoma to include:

  • Avoid the sun during the most intense hours of the day, typically between 10am and 4pm, even when it’s cloudy.
  • Use sunscreen with an SPF of 30 or higher year-round, and be sure to apply it every two hours.
  • Wear sunglasses that block UVA and UVB rays.
  • Make sure your skin is covered in protective clothing when you are outside and wear a hat with a brim.
  • Do not use tanning beds.
  • Regularly inspect your skin and check for new moles or moles that have changed in appearance.

Talk to your healthcare professional if you notice anything suspicious about your skin, and consider seeing a dermatologist for regular skin checkups. And try not to panic if there is something worrying. Not all moles or suspicious spots are cancerous, so practice your ABCDEs.

This resource was created with support from Merck.

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