Melanoma

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Introduction

What is melanoma?

Melanoma is a common cancer of the skin. Melanoma, also known as malignant melanoma, is the most deadly type of skin cancer because it can spread quickly (metastasize) to other organs of the body. The incidence of melanoma is growing faster than any other type of cancer, primarily because of the popularity of sunbathing and the use of tanning beds.

Melanoma arises in the skin cells that make melanin, the pigment that produces skin color. Normally, when these cells are old or damaged, they stop dividing and die and are replaced by healthy young cells. Melanoma occurs when old or damaged cells continue to divide and multiply uncontrollably. This results in the development of a malignant mass of tissue (tumor) on the skin. Melanoma can develop in an existing pigmented skin lesion, such as a mole or a freckle, or within normal-appearing skin as well.

Melanoma is often preventable by protecting your skin from sunburn and excessive sun exposure. In some cases, melanoma can develop anywhere on the body, even places that are not exposed to sun and sunburns.

Left untreated, melanoma cancer cells can continue to multiply and spread from the skin to other parts of the body such as the lymph nodes. Melanoma can lead to life-threatening complications and be fatal. If you notice any changes in your skin or in the color, shape or texture of a mole, s eek prompt medical care. Early diagnosis and treatment increase the chances that melanoma will be discovered in its earliest, most curable stage.

Symptoms

What are the symptoms of melanoma?

Melanoma can resemble a mole or it can grow within existing moles or freckles. In some cases, melanoma does not produce any change in skin pigmentation or color.

Symptoms of melanoma include:

  • A mole that is asymmetrical or has an irregular border

  • A mole that is growing or enlarging

  • A mole with abnormal coloring or more than one color, such as white, blue, red, black, or brown

  • Appearance of a new mole or a flat black or brown spot

Causes

What causes melanoma?

Melanoma is the result of an uncontrollable growth of abnormal skin cells that make melanin, the pigment that produces skin color. This leads to the development of a malignant mass of tissue (tumor) on the skin. Underlying causes of this process are probably due to a combination of conditions including:

  • Excessive exposure to ultraviolent (UV) radiation from the sun’s rays

  • Specific changes in the genes of skin cells that make melanin

  • Xeroderma pigmentosum (a type of skin disease that can cause melanoma)

What are the risk factors for melanoma?

A number of factors are thought to increase your chances of developing melanoma. Not all people who are at risk for melanoma will develop the cancer.

Risk factors for melanoma include:

  • Excessive sun exposure

  • Exposure to UV radiation in tanning beds

  • Fair skin that is freckled or does not tan

  • Family history of melanoma

  • Large number of moles or more than one abnormal mole (dysplastic mole)

  • Personal history of other types of skin cancer

  • Red or blond hair and blue or green eyes

  • Repeated sunburns, especially blistering sunburns, or just one very bad sunburn in childhood

  • Weakened immune system due to such conditions as HIV/AIDS, cancer, or taking medications that suppress the immune system

Reducing your risk of melanoma

You can lower your risk of melanoma by:

  • Avoiding excessive exposure to the sun throughout your lifetime

  • Avoiding sun exposure during the period of time when the sun’s rays are strongest, generally between 9 a.m. and 4 p.m.

  • Frequently applying sunscreen with a high SPF as directed when in the sun

  • Not using tanning beds

  • Seeking regular medical care so that moles and skin changes can be assessed and monitored

  • Wearing UV-protective clothing during long periods of sun exposure, including long sleeves, pants, and wide-brimmed hats

Treatments

How is melanoma treated?

Treatment of melanoma begins with seeking regular medical care. Regular medical care allows a health care professional to best evaluate your risks of developing melanoma, perform skin exams, and promptly order diagnostic testing for such symptoms as an enlarging or abnormal mole. These measures greatly increase the chances of discovering melanoma in its earliest, most curable stage.

The goal of the treatment of melanoma is to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.

Melanoma treatment plans use a multifaceted approach that is individualized to your age, medical history, coexisting diseases and conditions, and the type of melanoma and its stage of advancement.

Melanoma treatment may include an individualized combination of:

  • Chemotherapy for cases of melanoma that has spread beyond the skin to the lymph nodes and other parts of the body

  • Dietary counseling to help people with cancer to maintain strength and nutritional status

  • Immunotherapy for cases of melanoma that has spread beyond the skin to the lymph nodes and other parts of the body

  • Pain medications as needed

  • Palliative care to improve overall quality of life for families and patients with serious diseases

  • Participation in a clinical trial to test promising new therapies and treatments for melanoma

  • Physical therapy to help strengthen the body, increase alertness, reduce fatigue, and improve functional ability during and after cancer treatment

  • Surgery to remove the cancerous tumor and surrounding skin

  • Testing of nearby lymph nodes for the presence of cancer cells, which indicates that the melanoma has spread

Complementary treatments

Some complementary treatments may help some people to better deal with melanoma and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Massage therapy
  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
  • Yoga

Hospice care

In cases in which melanoma has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment shifts away from curing the disease and focuses on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.

What are the potential complications of melanoma?

Complications of melanoma are life-threatening. Complications are caused by a rapid growth of abnormal cells. These cells can travel through the bloodstream and lymphatic system to other areas of the body, most often the bones, lungs and liver. There they can multiply rapidly and develop new malignant tumors that interfere with the normal organ function. You can best treat melanoma and lower your risk of complications by following the treatment plan you and your health care professional design specifically for you. Complications of melanoma metastasis include:

  • Adverse effects of anticancer treatment
  • Disfigurement from tumor resection
  • Local recurrence of melanoma
  • Skin tissue damage to the deep layer of the skin
  • Spread of cancer to the lymph nodes and other organs where it interferes with normal organ function
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 23
  1. Melanoma. National Cancer Institute. http://www.cancer.gov/cancertopics/types/melanoma/.
  2. Melanoma. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001853.
  3. Melanoma. Skin Cancer Foundation. http://www.skincancer.org/Melanoma/.
  4. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
  5. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
  6. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013; 63:11.
  7. Marghoob AA, Terushkin V, Dusza SW, et al. Dermatologists, general practitioners, and the best method to biopsy suspect melanocytic neoplasms. Arch Dermatol 2010; 146:325.
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