Melanoma
What is Melanoma?
Melanoma is the most serious type of skin cancer. It develops in melanocytes, the cells that produce melanin, the pigment that gives your skin its color. Melanoma can spread to other parts of your body if not caught early.
This cancer often starts as an unusual mole or dark spot on your skin. It can also develop in areas that get little sun exposure, such as the soles of your feet or under your nails. Early detection is critical because melanoma is highly treatable when found in its early stages.
About 50 percent of melanomas have mutations in a gene called BRAF. These mutations cause cells to grow and divide uncontrollably. Knowing your BRAF mutation status can help your doctor choose the most effective treatment for your specific cancer.
Symptoms
- A new mole or growth on your skin
- A change in the size, shape, or color of an existing mole
- A mole with irregular borders or multiple colors
- A mole that bleeds, itches, or becomes crusty
- A dark streak under a fingernail or toenail
- A sore that does not heal
- Unusual spots that look different from other moles on your body
Many people with early melanoma have no symptoms other than changes in their skin. Regular skin checks help you spot changes before the cancer spreads.
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Causes and risk factors
Melanoma develops when DNA damage in skin cells triggers mutations that cause cells to grow out of control. Ultraviolet radiation from the sun or tanning beds is the leading cause of this DNA damage. A history of severe sunburns, especially in childhood, increases your risk significantly. Fair skin, light hair, blue or green eyes, and a tendency to freckle also raise your risk.
Other risk factors include having many moles, a family history of melanoma, a weakened immune system, and being over age 50. People with atypical mole syndrome, where moles are large and irregular, face higher risk. Living in areas with intense sun exposure or at high altitudes also increases melanoma risk.
How it's diagnosed
Your doctor will examine any suspicious spots on your skin and check your entire body for other unusual moles. If a spot looks concerning, your doctor will perform a biopsy. This involves removing all or part of the spot and examining it under a microscope to check for cancer cells.
If melanoma is confirmed, genetic testing can identify specific mutations in your tumor tissue. BRAF mutation analysis looks for changes in the BRAF gene, which are found in about half of all melanomas. This specialized genetic testing requires a tissue sample from your biopsy or surgery. Talk to your doctor about testing options if you have been diagnosed with melanoma.
Treatment options
- Surgery to remove the melanoma and surrounding tissue
- Immunotherapy drugs that help your immune system fight cancer cells
- Targeted therapy drugs for melanomas with BRAF mutations
- Radiation therapy to kill cancer cells in specific areas
- Chemotherapy for advanced cases that have spread
- Regular skin checks every few months after treatment
- Sun protection with SPF 30 or higher sunscreen daily
- Avoiding tanning beds and limiting midday sun exposure
- Wearing protective clothing like hats and long sleeves
Frequently asked questions
Melanoma often appears as a dark brown or black spot with irregular borders. It may have multiple colors including tan, red, white, or blue. The spot may be asymmetrical, meaning one half looks different from the other. Any mole that changes in size, shape, or color should be checked by a doctor.
Melanoma is more dangerous than other skin cancers because it can spread quickly to other organs. It develops in melanocytes, the pigment-producing cells in your skin. Basal cell and squamous cell carcinomas, the other common skin cancers, rarely spread beyond the skin and are easier to treat.
Yes, melanoma is highly curable when caught early. If the cancer is found before it spreads beyond the skin surface, the five-year survival rate is about 99 percent. Early detection through regular skin checks is the key to successful treatment. Once melanoma spreads to distant organs, treatment becomes more challenging.
BRAF mutation testing checks tumor tissue for specific genetic changes in the BRAF gene. About 50 percent of melanomas have a BRAF mutation, most commonly the V600E mutation. Knowing your mutation status helps doctors choose targeted therapies that work specifically against melanoma cells with these changes. This testing requires a tissue sample from your biopsy or surgery.
Everyone should check their skin monthly and see a dermatologist yearly for a full skin exam. People at higher risk should be checked more often. This includes those with fair skin, many moles, a family history of melanoma, or a history of severe sunburns. Anyone who notices a new or changing mole should see a doctor right away.
Yes, melanoma can appear anywhere on your body, including areas rarely exposed to the sun. It can develop on the soles of your feet, palms of your hands, under your nails, or even inside your mouth or eyes. While sun exposure is the main risk factor, other factors can also contribute to melanoma development.
The speed at which melanoma spreads varies greatly. Some melanomas grow slowly over months or years, while others can spread rapidly within weeks. Early stage melanoma that is only in the outer layer of skin has not spread yet. Once melanoma grows deeper into the skin or reaches lymph nodes, it can spread to other organs more quickly.
Targeted therapy uses drugs that attack specific genetic changes in melanoma cells. If your tumor has a BRAF mutation, drugs called BRAF inhibitors can block the abnormal protein that causes cells to grow uncontrollably. These drugs often work quickly and can shrink tumors in people with advanced melanoma. They are usually combined with MEK inhibitors for better results.
Protect your skin from UV radiation by wearing sunscreen with SPF 30 or higher every day. Avoid tanning beds completely, as they significantly increase melanoma risk. Wear protective clothing, hats, and sunglasses when outdoors, and seek shade during peak sun hours between 10 a.m. and 4 p.m. Check your skin monthly and see a dermatologist yearly for professional screening.
After treatment, you will need regular follow-up visits to check for recurrence. Your doctor will examine your skin and lymph nodes every few months. You may need imaging tests to check for signs of cancer in other parts of your body. People who have had melanoma have an increased risk of developing new melanomas, so lifelong skin monitoring and sun protection are essential.