Skin cancer - melanoma; Malignant melanoma; Lentigo maligna melanoma; Melanoma in situ; Superficial spreading melanoma; Nodular melanoma; Acral lentiginous melanoma
Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease.
Melanoma can also involve the colored part of the eye.
Melanoma is caused by changes in skin cells called melanocytes. These cells make a skin color pigment called melanin. Melanin is responsible for skin and hair color.
Melanoma can appear on normal skin. Or, it can begin as a mole or other area that then changes in appearance. Some moles that are present at birth may develop into melanomas. Larger moles that are present at birth are at higher risk of developing melanoma.
There are four major types of melanoma:
In rare cases, melanomas appear in the mouth, iris of the eye, or retina at the back of the eye. These may be found during dental or eye exams. In very rare cases, a melanoma develops in the vagina, esophagus, anus, urinary tract or small intestine.
Melanoma is not as common as other types of skin cancer, such as basal cell carcinoma. But more and more people are developing melanoma, especially young adults.
The risk of developing melanoma increases with age, though the risk is rising in young people.
You are more likely to develop melanoma if you:
Other risk factors include:
You've noticed a mole, sore, or growth on your skin that doesn't look right. It might be a melanoma and time to see a doctor. Melanoma is skin cancer caused by changes in cells called melanocytes. These cells make a skin pigment called melanin. Melanin's what gives you your skin and hair color. Melanoma can appear on normal skin, or it may begin as a mole or other area that has changed in appearance. Some moles you have when you're born can develop into melanoma. There are four types: superficial spreading melanoma is the most common. It's usually flat and irregular in shape and color, with different shades of black and brown. It's most common in Caucasians. Nodular melanoma usually starts as a raised area that is dark blackish-blue or maybe bluish-red. Lentigo melanoma usually occurs in older adults. It's more common on sun-damaged skin on your face, neck, and arms. It's usually large, flat, and tan, with areas of brown. Lastly, accrual lentiginous melanoma is the least common form. It usually occurs on your palms, soles, or under your nails. And it's more common in African-Americans. The risk of developing melanoma increases with age, but it is often also seen in young people. You are more likely to get melanoma if you have fair skin, blue or green eyes, or red or blond hair. People who live in sunny climates or at high altitudes are also at risk. As are people who spend a lot of time in the sun, or had one or more blistering sunburns during childhood, or use tanning devices. So, how do you know you have melanoma? You may have a mole, sore, lump, or growth on your skin that just doesn't look right. You may notice a sore or growth that bleeds or changes color. One half of the growth may be different from the other. The edges of the growth may be irregular. The color of the growth may change from one area to another. The spot may be larger than 6mm in diameter, about the size of a pencil eraser. The mole may keep changing in appearance. So, what do you do about melanoma? To treat melanoma successfully, you have to recognize the symptoms early. Make sure somebody sees all of your skin at least once a year and pay attention to your own skin. Call your doctor if you notice anything unusual. Your doctor will examine your skin for size, shape, color, and texture of any suspicious areas. If your doctor thinks you may have skin cancer, you'll have a piece of skin removed and sent to a laboratory for testing. This is called a biopsy. You may also have a lymph node biopsy to see if the cancer has spread to nearby lymph nodes. If you are diagnosed with melanoma, you may have other tests to see if the cancer has spread further. You will need surgery if you have melanoma. The doctor will remove the skin cancer and some of the surrounding tissue. If the cancer has spread to nearby lymph nodes they will also be removed. After surgery, you may need medicine called interferon. If the cancer has spread to organs, it may not be able to be cured. Treatment then might focus on shrinking the cancer and making you as comfortable as possible. You may need chemotherapy, immunotherapy, radiation treatment, and more surgery. Caught early, some of the types of melanoma can be cured. Melanoma that is very deep or has already spread to lymph nodes is more likely to return after treatment. And the odds are even worse if it has spread farther to other organs. If you have melanoma and recovered, it's important you continue to examine your body for any unusual changes because the cancer may return many years later. One more reason that the earlier you catch it the better.
A mole, sore, lump, or growth on the skin can be a sign of melanoma or other skin cancer. A sore or growth that bleeds, or changes in color can also be a sign of skin cancer.
The ABCDE system can help you remember possible symptoms of melanoma:
The key to successfully treating melanoma is recognizing symptoms early. You might not notice a small spot if you do not look carefully. Have yearly skin checks by a dermatologist, and examine your own skin once a month. Use a hand mirror to check hard-to-see places. Call your doctor if you notice anything unusual.
Your doctor will check your skin and look at the size, shape, color, and texture of any suspicious areas.
If your doctor thinks you might have skin cancer, a piece of skin from the growth will be removed. This is called a skin biopsy. The sample is sent to a lab for examination under a microscope.
A sentinel lymph node (SLN) biopsy may be done in some people with melanoma to see if the cancer has spread to nearby lymph nodes.
Once melanoma has been diagnosed, CT scans or other types of x-rays may be done to see if the cancer has spread.
Surgery is needed to treat melanoma. The skin cancer and some surrounding area will be removed. How much skin is removed depends on how deep the melanoma has grown.
If the cancer has spread to nearby lymph nodes, these lymph nodes may also be removed. After surgery, you may receive a medicine called interferon.
Treatment is more difficult when the melanoma has spread to other organs. In this case, it usually cannot be cured. Treatment involves shrinking the skin cancer and treating the cancer in other areas of the body. You may receive:
If you have melanoma that is hard to treat, you might consider enrolling in a clinical trial. Ask your doctor for more information. Researchers continue to study new treatments.
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
How well you do depends on many things, including how soon the cancer was diagnosed, and how far it has spread.
If caught early, some melanomas can be cured.
Melanoma that is very deep or has spread to the lymph nodes is more likely to return after treatment. If it is deeper than 4 mm or has spread to the lymph nodes, the cancer is more likely to have spread to other tissues and organs.
Melanoma usually cannot be cured when the cancer has spread beyond the skin and nearby lymph nodes.
If you have had melanoma and recovered, it is very important to examine your body regularly for any unusual changes. Your risk of melanoma increases once you have had this cancer. Melanoma can return years later. Usually, people who have had melanoma are checked by their skin doctor several times a year.
Melanoma can spread to other parts of the body very quickly.
Melanoma treatment can cause side effects, including pain, nausea, and fatigue.
Call your health care provider if you notice a new growth or any other changes in your skin. You should also call if an existing spot becomes painful, swollen, or inflamed, or if it starts to bleed or itch.
Some people should see a dermatologist for regular skin exams. These include people with:
A skin doctor can examine you and tell you whether you need regular skin checks. Sometimes, unusual moles are removed to prevent them from turning into melanoma.
You should also examine your own skin once a month. Use a mirror to check hard-to-see places. Use the ABCDE system when checking your skin. Call your provider if you notice any changes.
The best way to prevent skin cancer is to reduce your exposure to sunlight. Ultraviolet light is most intense between 10 a.m. and 4 p.m. Try to avoid sun exposure during these hours. Protect your skin by wearing a hat, long-sleeved shirt, long skirt, or pants when you have to be outside. The following tips can also help:
Other important facts to help you avoid too much sun exposure:
Gangadhar TC, Fecher LA, Miller CJ, et al. Melanoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 69.
Hui A, Friedlander P, Markowitz O. Malignant melanoma. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier; 2014:chap 143.
National Cancer Institute: PDQ melanoma treatment. Bethesda, MD: National Cancer Institute. Updated February 2, 2016.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: melanoma. Version 2. 2016.
Last reviewed on: 1/31/2016
Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.