What is melanoma? Melanoma is the most dangerous type of skin cancer. It begins in skin cells called melanocytes, which make the pigment that colors skin. Most melanomas are brown or black, resembling moles. In fact, melanomas can grow out of moles. However, melanomas can also be pink, red, purple, or even the same color as the skin. Malignant melanoma is another name for this cancer. What are the different types of melanoma? Most people think of melanoma as one type of skin cancer. In reality, there are several types of melanoma including: Superficial spreading melanoma is the most common type of melanoma. It accounts for about 70% of cases. It grows across the skin for some time before becoming invasive. These cancers are usually flat and vary in color. They typically show up on the trunk for men, legs for women, and upper back, head, and neck for both, but can be anywhere. Nodular melanoma is the second most common type, accounting for about 15% of cases. It is the most aggressive form of melanoma and has usually spread at diagnosis. It typically looks like a bump or dome and is black, but can be other colors. It can appear on just about any skin area. Acral lentiginous melanoma represents about 8% of melanomas. It is the most common form affecting dark-skinned people. It shows up under the nails and on the palms of the hands and soles of the feet. This form is also very aggressive. Lentiginous melanoma accounts for 5% of melanomas. It is similar to superficial spreading melanoma. It can grow across the skin for a while before invading deeper. It also has a similar appearance to the superficial type. However, it usually appears on skin with chronic sun exposure, such as the face, ears, arms, and upper trunk. Who gets melanoma? In the United States, nearly 100,000 people find out they have melanoma each year. This represents about 5% of all new cancer diagnoses and 1% of all skin cancer diagnoses. The rate of melanoma has been steadily increasing and has doubled in the last 30 years. Here are some additional melanoma statistics and trends: The average age at diagnosis is 63. It is more common in women before age 50. By age 65, men are twice as likely to get melanoma and by age 80, they are three times as likely to get it. It is the most common cancer in adults age 25 to 29. It is 20 times more common in Caucasians than African Americans. For Caucasians, the lifetime risk is 2.6% or 1 in 38. In African Americans, it is 0.1% or 1 in 1,000. In Hispanics, it is 0.58% or 1 in 172. About 10% of people with melanoma have a family history of the cancer. Can you die from melanoma? Melanoma is highly treatable and commonly curable when found early. It becomes much more dangerous and life threatening once it has spread. About 7,000 people will die of melanoma this year. However, death rates from melanoma are falling and have decreased over the last 10 years. Doctors describe melanoma survival using a five-year relative survival rate. This rate looks at people with the same type and stage of cancer five years after the original diagnosis. It compares them to the overall population of the same age and sex. This comparison shows how much a disease can shorten life. When melanoma has not spread at all, the five-year relative survival rate is 98%. With regional spread to nearby structures or lymph nodes, the rate is 64%. With spread to distant body sites, the rate drops to 23%. Keep in mind survival rates are only statistics. They can’t tell you how long a person will live. Prognosis depends on many factors, including age and overall health. Melanoma treatments are also continually improving, which will improve survival as well. How does melanoma affect quality of life? Melanoma has a similar effect on quality of life (QoL) as other cancers. However, there can be differences between people with early, highly curable disease and those with regional or distant spread. Overall, about one-third of patients experience very high levels of distress, which decreases QoL. Levels are highest at the time of diagnosis and level out over time. This is important because decreased QoL can affect recovery and possibly even disease progression. Predictors of low QoL include poor overall health, poor psychological health, and low levels of social support. Women also report higher levels of anxiety than men. Trends in health-related quality of life for melanoma include: About 41% of melanoma patients report emotional health issues including worry, concern, embarrassment, self-consciousness, fear, and thoughts of death. About 28% report lifestyle limitations including leisure and social activities, physical functioning, general functioning, and personal care. About 20% report that having to make changes, such as modified clothing choices or avoidance or protection from sun exposure, lowered their QoL. Research shows cognitive behavioral therapy can greatly relieve distress related to melanoma. Identifying melanoma patients with poor QoL at diagnosis and offering them counseling may improve their treatment journey and well-being. What causes melanoma? Nearly 90% of melanoma cases are the result of exposure to ultraviolet (UV) light. This includes exposure to natural sunlight and tanning bed lights. UV light damages skin cells, including healthy pigment-generating melanocytes, which can cause them to grow uncontrollably. While anyone can get melanoma, certain things increase the risk. Melanoma risk factors include: Complexion: Having blue or green eyes, light hair, and light skin that freckles or burns easily Family history: Having a first-degree relative with melanoma increases the risk by 50% Genetics: Having a BRAF mutation, which is present in about half of all melanomas Moles: Having 50 or more Personal history: Having melanoma once increases the risk of recurrence Sun exposure: Having five or more blistering sunburns during teenage years increases the risk by 80% Weakened immune system: Having HIV/AIDS or taking medicines that suppress the immune system How are you diagnosed with melanoma? Doctors need to biopsy suspicious skin lesions to find out if they are melanoma. Techniques include shaving off a layer of skin, punching out a core of deeper skin layers, and cutting out a wedge of skin. A pathologist will examine the samples under a microscope to see if melanoma is present. Information from the pathology report helps doctors stage the cancer. There are five stages of melanoma: 0, I, II, III and IV. Higher stages are more advanced disease and generally have a poorer prognosis. Up to stage II, cancer is only in the skin and has not spread to lymph nodes. Melanoma treatment for these stages involves removing the cancer and some healthy skin around it. Other treatment options include chemotherapy, radiation therapy, targeted therapy, and immunotherapy. In later stages, targeted therapy and immunotherapy for melanoma can help people live longer.