Melanoma
What Is Melanoma?
Melanoma is the most serious type of skin cancer.
Melanoma is the most serious type of skin cancer. It begins in skin cells called melanocytes.
Melanocytes are the cells that make melanin, which gives skin its color. Melanin also protects the deeper layers of the skin from the sun’s harmful ultraviolet (UV) rays.
When people spend time in the sunlight, the melanocytes make more melanin and cause the skin to tan. This also happens when skin is exposed to other forms of ultraviolet light (such as in a tanning booth). If the skin receives too much ultraviolet light, the melanocytes may begin to grow abnormally and become cancerous. This condition is called melanoma.
How and where does melanoma appear?
The first sign of melanoma is often a change in the size, shape, or color of a mole. But melanoma can also appear on the body as a new mole.
In men, melanoma most often shows up:
- On the Upper Body, Between the Shoulders and Hips
- On the Head and Neck
In women, melanoma often develops on the lower legs.
In dark-skinned people, melanoma often appears:
- Under the Fingernails or Toenails
- On the Palms of the Hands
- On the Soles of the Feet
Although these are the most common places on the body for melanomas to appear, they can appear anywhere on the skin. That’s why it is important to always examine your skin to check for new moles or changes in moles.
With early diagnosis and treatment, the chances of recovery are very good.
The chance of getting melanoma increases as you get older, but people of any age can get melanoma. In fact, melanoma is one of the most common cancers in young adults. Each year, more than 50,000 people in the U.S. learn that they have melanoma.
Melanoma is a serious and sometimes life-threatening cancer. If melanoma is found and treated in its early stages, the chances of recovery are very good. If it is not found early, melanoma can grow deeper into the skin and spread to other parts of the body. This spread is called metastasis.
Once melanoma has spread to other parts of the body beyond the skin, it is difficult to treat.
Diagnosing Melanoma
Are you wondering whether a mole or funny-looking spot of skin is melanoma? Melanomas usually look different from ordinary moles. The best way to find any suspicious moles on your body is to do a skin self-examination.
If you notice a mole that looks unusual or that has grown or changed color or shape in the last few months, you should tell your doctor. If your doctor also thinks the mole looks suspicious, he or she will refer you to a dermatologist (a physician who specializes in diseases of the skin). The dermatologist may do a biopsy. The dermatologist will remove a small piece of the mole or the entire mole. A Dermatopathologist (another special doctor) then looks at the sample under a microscope to check for cancer cells.
If the mole turns out to be melanoma, your dermatologist will need to find out more about the disease, based on:
- How Thick the Tumor Is
- How Far it May Have Spread
This process is called staging. Staging the melanoma is a very important step because the choice of treatment has a lot to do with the stage of the melanoma.
To find out how thick the melanoma is, the dermatologist or a surgeon will remove the entire tumor along with some skin around it (if this wasn’t already done during diagnosis). At the same time, or in a later step, the surgeon may do a procedure called a sentinel lymph node (SLN) biopsy. This will help your doctor find out whether, and where, the melanoma has spread.
Other tests may also play a role in staging. These include:
- Blood Tests
- Chest X-rays
- CT (Computed Tomography)
- MRI (Magnetic Resonance Imaging)
- PET Scan (Positron Emission Tomography Scan)
After all traces of the tumor have been removed, you may see an oncologist, a cancer specialist. If the melanoma has spread to other areas or if there is a good chance the melanoma might come back, the oncologist may prescribe additional treatment.
Typical Steps in the Diagnosis of Melanoma
- You find a suspicious mole or growth on your skin. You report it to your doctor.
- The doctor refers you to a dermatologist, a skin specialist.
- The dermatologist does an excisional biopsy and sends a sample of the growth to the lab. The Dermatopathologist at the lab checks the sample under a microscope to see if it is melanoma.
- If it is melanoma, the dermatologist refers you to a surgeon for a sentinel lymph node or SLN biopsy. (Sometimes, the surgeon will remove the entire tumor and do the SLN biopsy at the same time, combining steps 3 and 4.)
- If the dermatologist or surgeon has not yet removed the entire tumor and some surrounding skin, that happens next.
- If tests show that melanoma has spread to nearby lymph nodes, the surgeon may remove those lymph nodes to help stop the cancer from spreading further.
- If the melanoma has spread to the lymph nodes, you may have more tests including: blood tests, ultrasound, chest x-rays, or Magnetic Resonance Imaging (MRI) to check if the cancer has also spread to other organs.
- After all surgery is completed, an oncologist (a doctor who specializes in cancer) may prescribe other treatments. These are called adjuvant treatments, and they may be in the form of immunotherapy, chemotherapy, or radiation therapy.