Melanoma: Types, Symptoms, Causes, Diagnosis and Treatment

We all love a healthy tan, but what if that bronzed glow hides a danger? Melanoma, the most serious type of skin cancer, can develop from seemingly harmless moles. The good news is, when caught early, melanoma is highly treatable. But early detection is key. That’s why knowing what to look for and taking steps to protect your skin are crucial.

This blog post will equip you with the knowledge to become your own skin care detective. We’ll delve into what melanoma is, the different types, and the warning signs to watch out for. We’ll also explore the causes, diagnosis, treatment options, and most importantly, how to prevent this serious disease.

What is Melanoma?

What Is Melanoma Skin Cancer?. Shutterstock Image

Melanoma is a rare but aggressive form of skin cancer that originates in the melanocytes, the cells responsible for producing melanin, which colors our skin. Unlike many other skin cancers, melanoma has the potential to quickly spread beyond the skin to other parts of the body, making early detection and treatment crucial. Despite common misconceptions, melanoma isn’t limited to just dark moles; it can manifest in various hues including brown, black, red, white, and blue. Approximately 1% of skin cancers are melanomas, also known as malignant melanomas or cutaneous melanomas.

The American Cancer Society predicts 100,640 new cases of melanoma in the US in 2024, with about 8,290 fatalities expected, comprising 5,430 men and 2,860 women. However, its ability to spread makes it significantly dangerous. Early-stage melanoma can often be treated effectively, emphasizing the importance of regular skin examinations for early detection. ^[1]

Types of Melanoma

Understanding the types of melanoma is crucial for early detection and treatment. Here is a simplified overview:

• Superficial Spreading Melanoma: The most prevalent type, which spreads across the skin’s surface. It often presents as a mole with uneven borders and color variations, including shades of brown, black, pink, or red.
• Nodular Melanoma: This type grows vertically into the deeper skin layers and may appear as a noticeable bump or growth, which could be an early sign of deeper skin invasion.
• Lentigo Maligna Melanoma: Commonly found in elderly individuals, it usually develops in sun-exposed areas, such as the face. It appears as a large, dark, uneven patch.
• Metastatic Melanoma: Represents the stage where melanoma has spread beyond the skin to other body parts like lymph nodes, organs, or bones, significantly increasing the complexity of treatment.
• Melanoma In Situ: An early-stage melanoma where the cancerous cells are confined to the upper layer of the skin, making it highly treatable if detected early.
• Invasive Melanoma: Indicates deeper skin invasion, where cancer cells have penetrated beyond the top layer, increasing the risk of spreading.

Symptoms of Melanoma:

• Changes in Existing Moles: Watch for alterations in shape, size, or color of moles. Uniformity is common in non-cancerous moles, so any irregularities should be a cause for concern.
• Development of New Growths: Be vigilant about new, unusual growths on the skin, especially those that deviate in coloration, ranging from brown or black to tan, pink, or white.
• Mole Characteristics to Monitor: Irregular shapes or borders, Multicolored or uneven coloring, Size larger than a quarter of an inch, Any changes in size, shape, or color, Itchiness or bleeding
• Common Sites for Melanoma: Although it can start anywhere on the skin, common areas include the chest and back in men, and legs in women, primarily due to sun exposure. However, it’s important to note that melanoma can also develop in less exposed areas like the soles, palms, and under nails.

Sometimes, melanoma might not visibly alter the skin’s appearance initially, making regular skin examinations crucial for early detection.

The ABCDEs of Melanoma: Spotting the Signs

ABCDEs of Melanoma Melanoma Warning Skin Cancer Signs. Shutterstock Image

Knowing how to recognize potential melanoma is crucial for early detection. Use the ABCDE rule as a guide:

• Asymmetry: One half of the mole doesn’t match the other. Imagine drawing a line down the center of the mole. Do the two halves look similar?
• Border: The edges of the mole are irregular, ragged, or blurred.
• Color: The mole has uneven coloring, with shades of brown, black, red, white, or blue all mixed together.
• Diameter: The mole is larger than 6 millimeters (about the size of a pencil eraser tip).
• Evolving: An existing mole is changing in size, shape, or color, or a new mole suddenly appears.

What Causes Melanoma?

The formation of melanoma, a serious form of skin cancer, is primarily attributed to DNA damage within skin cells, which can lead to uncontrolled cell growth and tumor development. A significant risk factor is exposure to ultraviolet (UV) radiation, predominantly from the sun but also from artificial sources like tanning beds and lamps. ^[2]

This exposure is particularly concerning because sunburns experienced during childhood have been shown to drastically elevate the risk. Additionally, individuals who frequently use tanning beds, which emit concentrated UV rays, are at an increased risk.

Other factors contributing to melanoma risk include a weakened immune system, which can result from illness, certain medications, or after undergoing organ transplants. Genetics also play a role; having a family history of melanoma places individuals at a marginally higher risk. The precise mechanisms behind DNA damage in skin cells leading to melanoma may involve a combination of genetic predispositions and environmental exposures, with UV radiation standing out as a leading cause of Melanoma. ^[3]

Diagnosing Melanoma: Getting a Check-Up

Tests For Melanoma Skin Cancer. Shutterstock Image

Physical Examination:
A comprehensive skin check is crucial, where a doctor examines all areas of your skin, including less visible spots like between the buttocks, the scalp, and under the nails. Adults typically have 10 to 40 moles, with normal ones being uniform in color and less than a quarter of an inch in diameter.
Blood Chemistry Studies:
Blood tests measure levels of lactate dehydrogenase (LDH), a marker that can indicate the presence of melanoma, though it’s usually not checked in early-stage disease. ^[4]
Skin Biopsy:
The definitive method for diagnosing melanoma involves removing a sample of the suspicious skin area for microscopic examination. Ideally, the entire area of concern should be biopsied. The findings, detailed in a pathology report, are crucial for confirming the presence of cancer and guiding the next steps.
Staging the Disease:
Determining melanoma’s stage involves measuring the thickness of the tumor and possibly checking lymph nodes for cancer spread. A sentinel node biopsy might be performed if melanoma diagnosis is confirmed, to assess if cancer cells have begun to spread.
Imaging Tests:
Advanced technologies, such as CT scans, MRIs, and PET scans, help in determining if the melanoma has metastasized beyond the skin. These tests are utilized to create detailed images of the body’s interior, with certain substances sometimes administered to improve visibility of cancer cells.

Early detection of melanoma substantially increases the effectiveness of treatment. Regular self-examinations and professional check-ups are vital, especially for those with a higher risk.

Treatment Options for Melanoma

Stages of Melanoma. Shutterstock Image

Melanoma treatment varies based on its stage, ranging from surgical removal in early stages to a combination of therapies for more advanced conditions. Below is a concise guide on the different treatment strategies:

• Surgery: The primary treatment for early-stage melanoma involves excising the tumor along with some normal tissue to ensure all cancer cells are removed. This can often be enough treatment for stages 0, 1, and some stage 2 melanomas.
• Lymph Node Surgery: If melanoma has spread to the lymph nodes, these may be surgically removed to control the spread of the disease. ^[5]
• Immunotherapy: Leveraging the body’s immune system, treatments like checkpoint inhibitors (e.g., ipilimumab, nivolumab, pembrolizumab) help fight the cancer cells more effectively. ^[6]
• Radiation Therapy: This utilizes high-energy rays to target and kill cancer cells, often employed when melanoma has spread or to alleviate symptoms in advanced stages. ^[7]
• Chemotherapy: Though less commonly used for melanoma today due to advancements in targeted therapy and immunotherapy, chemotherapy agents like dacarbazine and temozolomide may be used in specific cases. ^[8]
• Targeted Therapy: Beneficial for melanomas with specific genetic mutations (e.g., BRAF mutations), targeted therapy drugs (e.g., dabrafenib, trametinib) directly act on those mutations to inhibit cancer growth.
• Alternative Approaches: Techniques such as isolated limb perfusion are considered for melanoma confined to a limb. Vaccines and ongoing clinical trials for new treatments offer additional hope and options.

It’s essential to comprehend that while treatments like immunotherapy and targeted therapy have positively shifted the landscape of melanoma management, leading to extended survival, they do not guarantee a cure and come with potential side effects.

Therefore, discussing the risks and benefits with your healthcare provider is critical to making informed decisions about your care. For those interested in exploring innovative treatments, participating in clinical trials might offer access to cutting-edge therapies not yet widely available.

Prevention is Key: Protecting Yourself from Melanoma

How to Prevent Melanoma? Shutterstock Image

The good news is that there are simple steps you can take to significantly reduce your risk of melanoma:

• Sun protection is key: Seek shade, especially during peak sun hours (10 am to 4 pm).
• Cover up: Wear sun-protective clothing, such as hats, long sleeves, and pants, whenever possible.
• Sunscreen is your friend: Choose a broad-spectrum sunscreen that blocks both UVA and UVB rays, with a minimum SPF of 30. The Skin Cancer Foundation recommends applying sunscreen generously every two hours and even more frequently if swimming or sweating heavily. ^[9]
• Ditch the tanning bed: Tanning beds emit harmful UV rays that can increase your risk of melanoma.
• Know your skin: Perform regular skin self-checks and pay attention to any changes in your moles or freckles.

Incorporating these measures into daily routines can significantly reduce the risk of developing melanoma. It’s these simple, but powerful, habits that create a solid foundation for preventing melanoma and safeguarding your skin’s health. Always remember, prevention is better than cure.

Conclusion

In wrapping up, it’s clear that melanoma poses a serious challenge to public health, given its aggressive nature and ability to spread. However, there’s reason for optimism in our ability to prevent, detect early, and treat this disease effectively.

Taking proactive steps like protecting our skin from the sun, regularly checking for any changes, and avoiding artificial tanning can significantly lower the risk of melanoma. Additionally, advancements in medical treatments such as surgery, immunotherapy, and targeted therapy offer promising options, especially when the disease is caught early.

With ongoing research and clinical trials, there’s a real sense of hope for those impacted by melanoma. By staying informed, remaining vigilant, and actively participating in preventive measures, we can all make a meaningful difference in reducing the occurrence of melanoma and improving outcomes for those facing this diagnosis.

9 Sources

We review published medical research in respected scientific journals to arrive at our conclusions about a product or health topic. This ensures the highest standard of scientific accuracy.

[1] "Melanoma Skin Cancer Statistics." 11 Mar. 2024, www.cancer.org/cancer/types/melanoma-skin-cancer/about/key-statistics.html.
[2] "Radiation: Ultraviolet (UV) radiation and skin cancer." 6 Mar. 2024, www.who.int/news-room/questions-and-answers/item/radiation-ultraviolet-(uv)-radiation-and-skin-cancer.
[3] "Melanoma - Symptoms and causes - Mayo Clinic." Mayo Clinic, 30 Dec. 2023, www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884.
[4] Xu J, Zhao J, Wang J, Sun C, Zhu X. Prognostic value of lactate dehydrogenase for melanoma patients receiving anti-PD-1/PD-L1 therapy: A meta-analysis. Medicine (Baltimore). 2021 Apr 9;100(14):e25318. doi: 10.1097/MD.0000000000025318. PMID: 33832106; PMCID: PMC8036123.
[5] "Lymph Node Surgery in Melanoma." National Cancer Institute, 9 Mar. 2024, www.cancer.gov/news-events/cancer-currents-blog/2017/lymph-node-surgery-melanoma.
[6] Knight A, Karapetyan L, Kirkwood JM. Immunotherapy in Melanoma: Recent Advances and Future Directions. Cancers (Basel). 2023 Feb 9;15(4):1106. doi: 10.3390/cancers15041106. PMID: 36831449; PMCID: PMC9954703.
[7] Shi, Wenyin. "Cutaneous Melanoma: Etiology and Therapy [Internet]." Radiation Therapy for Melanoma. Codon Publications, 21 Dec. 2017, doi:10.15586/codon.cutaneousmelanoma.2017.ch8.
[8] Luke JJ, Schwartz GK. Chemotherapy in the management of advanced cutaneous malignant melanoma. Clin Dermatol. 2013 May-Jun;31(3):290-7. doi: 10.1016/j.clindermatol.2012.08.016. PMID: 23608448; PMCID: PMC3709980.
[9] "Sunscreen." Skin Cancer Foundation, 30 Nov. 2023, www.skincancer.org/skin-cancer-prevention/sun-protection/sunscreen.

Dr. Anna Yusim, M.D., B.S.

Dr. Anna Yusim is an award-winning Psychiatrist and author of the best-selling book-Fulfilled: How the Science of Spirituality Can Help Read Full Bio