Melanoma

Melanoma is a type of skin cancer that develops when melanocytes (the cells that give the skin its tan or brown color) start to grow out of control.ⁱⁱ

Melanoma skin cancer can develop anywhere on the skin surface, including areas that receive little or no sun exposure, such as the palms of the hands, soles of the feet, nailbeds, scalp and genitals.^ii,vii In men, it is often found on the trunk (the area from the shoulders to the hips) or the head and neck. In women, it often forms on the arms and legs.^v

Melanoma skin cancer happens when normal cells in the skin change into abnormal cells and grow out of control. The exact cause as to why this happens is unknown. There are several risk factors, however, that can make a person more likely to develop melanoma, including:^viii

• Having fair skin, which includes having blue or green eyes, red or blond hair, and fair skin that freckles and burns easily. Although being white or having a fair complexion increases the risk of melanoma, anyone can have melanoma, including people with dark skin.
• Too much exposure to ultraviolet (UV) light from natural sunlight or artificial sunlight (such as from tanning beds).
• History of one or more severe, blistering sunburns, especially as a child or teenager.
• Having many or unusual moles.
• Family or personal history of melanoma.
• Weakened immune system.

The first melanoma signs and symptoms often include a new mole or pigmented (colored) area on the skin or a change in the way a mole or pigmented area looks or feels.^v,ix

The ABCDE rule is one guide to the usual signs of melanoma.^vii

A—Asymmetry: Does one half of the mole or spot look different than the other half?

B—Border: Is the border irregular, blurred or jagged?

C—Color: Is the color uneven?

D—Diameter: Is the mole larger than a pea?

E—Evolving: Has the mole changed its size, color or shape during the past few weeks or months?

Another important sign is a spot that looks different from all of the other spots on your skin, known as the ugly duckling sign.^vii

Some melanomas don’t fit these rules.^vii It can also appear as a new mole.ⁱ Skin affected by melanoma can also bleed or become swollen, red, or crusty.^vi

Other warning signs include:^ix

• A sore that doesn’t heal
• Spread of pigment from the border of a spot into surrounding skin
• Redness or a new swelling beyond the border of the mole
• Change in sensation, such as itchiness, tenderness, or pain

A physical exam of the skin is usually conducted. If melanoma is suspected, a follow-up test called a biopsy is typically done. During a biopsy, a doctor will usually remove the whole abnormal area. In some cases, the doctor might instead take a small sample of skin from the abnormal area. The sample is usually sent to a laboratory for examination under a microscope.^v

Melanoma is treated in one or more of the following ways:^x

• Surgery. Melanoma is usually treated with surgery to remove the cancer.
• Immunotherapy. This is the use of medicines that work with the body's infection-fighting system to stop cancer growth.
• Targeted therapy. This describes a group of medicines that target parts of melanoma cells that make them different from normal cells.
• Chemotherapy. Chemotherapy uses drugs that kill cancer cells. The drugs are usually injected into a vein or taken by mouth as a pill. They travel through the bloodstream to all parts of the body and attack cancer cells that have already spread beyond the skin.
• Radiation. Radiation therapy uses high-energy rays (such as x-rays) or particles to kill cancer cells.