Although melanoma is much less common than other types of skin cancer, it is the most serious type of skin cancer that can be life-threatening if not properly treated before it spreads to other organs. If untreated, melanoma can spread to organs such as the lungs, liver, brain, bone or gastrointestinal tract. Melanoma begins when a melanocyte (skin cells found in the upper layer of skin) mutates and experiences uncontrolled cellular growth. Most often, this process is triggered by UV radiation in the form of sunburns or tanning that causes DNA damage.
Melanoma is preventable in most cases, and if detected early, completely curable. Like most cancers, there are certain risk factors and warning signs of melanoma that should be understood to best ensure early detection. An annual skin cancer check at your dermatologist's office is the best way to determine if any spots on your skin are at risk of becoming cancerous.
How to Identify Melanoma
Melanoma can be easily mistaken for a harmless mole or brown spot on the skin. The following "ABCDEs of melanoma" can help determine if a mole or lesion could be melanoma:
A is for Asymmetry
Draw a line through the middle of your suspected melanoma. If the two halves do not match, it could be melanoma, as common moles are generally symmetrical.
B is for Border
If your mole has an uneven border, such as having scalloped or notched edges, it could be a warning sign for melanoma.
C is for Color
Multiple colors are a warning sign. A melanoma may have different shades of brown, tan or black. As it grows, the colors red, white or blue may also appear.
D is for Diameter or Dark
While melanomas can be quite small, they are usually larger than the size of a pencil eraser when detected. They also tend to appear to be darker in color when compared to other moles, although in some cases they can be pink or light in color.
E is for Evolving
Melanomas tend to change in shape, size, color or elevation on the skin. They can also develop changing symptoms like itching, crusting or bleeding.
Risk Factors for Melanoma
Some people are at a higher risk of developing melanoma than others. Most notably, people with fair skin are more likely to develop melanoma due to having less melanin in their skin to protect from UV radiation. People who freckle or sunburn easily and have light-colored eyes and hair are at the highest risk of developing melanoma. However, people with darker complexions, including Hispanic and African Americans, can also develop melanoma.
Other risk factors for melanoma include a family history of melanoma or a weakened immune system. Having several moles or unusual moles also increases the risk of melanoma. Additionally, living close to the equator or at high elevations where greater amounts of UV radiation are experienced increases the risk of melanoma development. To reduce your risk of melanoma, you should wear sunscreen daily, wear protective clothing like hats and sunglasses, avoid peak rays of the sun and never use tanning beds.
Stages and Treatments of Melanoma
Dermatologists diagnose melanoma by conducting a biopsy of the suspicious tissue. The biopsy will reveal the type of melanoma, but further tests may be needed to determine the stage of the cancer. Treatments will vary depending on the stage of the melanoma as outlined below:
Early Melanomas
Early melanomas are classified as Stage 0, meaning the growth is localized in the outermost layer of skin, or Stage I, meaning the cancer is still extremely small but has penetrated beneath the top layer of skin into the next layer of skin. These melanomas are treated by excisional surgery where a scalpel is used to remove the tumor along with a "safety margin" of surrounding normal tissue.
Intermediate or High-Risk Melanomas
Intermediate or high-risk melanomas are classified as Stage II. They are deeper than 1mm and are at a high risk of spreading. A sentinel lymph node biopsy is often recommended to ensure the cancer has not spread nearby. In addition, surgery will be needed to remove the tumor. Additional treatment after surgery may be recommended to decrease the chance of the melanoma returning, including immunotherapy or radiation.
Advanced Melanomas
Advanced melanomas are classified as Stage III or Stage IV. Stage III melanomas have spread through a lymph vessel to nearby lymph nodes or to small areas of nearby skin. In fact, the metastases could be so tiny that they are only visible by microscope. In Stage IV melanoma, the cancer has spread to distant body areas including lymph nodes or organs. Fortunately, new immunotherapies and targeted therapies have been developed in recent years that can achieve positive outcomes for patients with advanced melanomas in addition to surgical removal of the tumor and affected lymph nodes. These therapies work by shrinking tumors and halting or slowing the disease progression.
Patients of Dermatology Associates of Plymouth Meeting are cared for by board-certified dermatologists who are subspecialists in dermatologic surgery and experts in melanoma treatment. Our fellowship-trained Mohs surgeon has performed more than 25,000 Mohs cases, making our practice one of the best choices for receiving this advanced method of skin cancer removal offering the highest cure rate available.
Schedule your appointment at Dermatology Associates of Plymouth Meeting for a professional skin check in which any suspicious lesions can be identified. Many skin cancers can be treated at your appointment in the comfort of our office. We are eager to help you achieve optimal health by reducing your risks of developing melanoma or other types of skin cancer through prevention, diagnosis and treatment.