Melanoma (Skin Cancer) Signs, Risks and Treatment

Of all the skin cancers, melanoma represents the most serious threat to your health.

WHAT IS A MELANOMA?

Melanoma is a type of skin cancer that starts in cells called ‘melanocytes.’ Melanocytes produce ‘melanin,’ which is a pigment that can range in color from tan to dark brown. Melanin serves an important function: It helps protect your deeper skin cells from some of the damaging effects of sunlight.

A mole is one type of benign (non-cancerous) tumor that can arise from the melanocytes. And melanoma is a cancerous tumor that arises in the melanocytes. Like all cancers, melanoma results from a problem in the way cells reproduce. In melanoma, the melanocytes become damaged and begin reproducing at a rapid rate.

MELANOMA RISK FACTORS

The risk factors for melanoma share many characteristics in common with the risk factors for most skin cancers. Any or all of the following things may put you at higher risk for developing melanoma:

  • Personal history of melanoma. If you’ve had one melanoma, you’re much more likely to experience it again.
  • Age. Melanoma used to be a middle-aged person’s condition, but melanoma rates are rising among people under age 30. Still, your likelihood of developing melanoma begins to rise after age 40.
  • Exposure to ultraviolet (UV) light. Anyone who has experienced excessive exposure to UV rays, either from the sun or from tanning beds, is at higher risk for melanoma.
  • Fair skin, light hair, freckled skin. Melanoma rates are higher in the fair-skinned population than in people with darker pigmentation.
  • Lots of moles. People who develop many moles, especially beginning at an early age, have a greater risk of melanoma.
  • Specific types of moles (nevi). If you were born with one or more moles (called ‘congenital melanocytic nevi’), your risk of developing melanoma is somewhat higher. If you have been diagnosed with ‘atypical nevi syndrome,’ your risk of melanoma also may increase.
  • Family history of melanoma. Gene mutations may be responsible for the development of melanoma, which means your risk may be higher if you have at least one direct relative (parent, sibling) who had melanoma.
  • Xeroderma pigmentosum. This rare condition puts you at much higher risk of developing melanoma.
  • Immunosuppressive therapy. Anyone taking immune-suppressing medication runs a slightly higher risk of melanoma.

DIAGNOSIS: THE ABCDE OF MELANOMA

Only a doctor can positively diagnose melanoma, because it requires a biopsy. However, everyone should know the A-B-C-D-E of melanoma in order to know when to have a skin mole or lesion checked out by a medical professional. Examine your body (and your children’s) regularly to scan for changes in skin lesions. Use your cell phone camera to document changes in moles or other skin lesions. Here’s what to look for:

  • A for asymmetry. This means the mole or lesion is not the same size or shape on one side as the other.
  • B for borders. Melanomas often have blurry or ragged edges, rather than the typical, smooth edge of a normal mole.
  • C for color. Most moles exhibit even pigmentation throughout the lesion. A melanoma may have uneven coloring that includes shades of black, brown, tan or even dark blue.
  • D for diameter. Melanomas often grow rapidly, so the diameter of the lesion increases over time.
  • E for evolving. This means the mole or lesion has changed in some way over the past few weeks or months. The mole may bleed, itch, grow, turn crusty, ooze or make any number of other changes.

MELANOMA TREATMENT

Melanoma is a serious form of cancer that can spread to other body areas (‘metastasize’). Because of this, surgery represents the first line of treatment for all melanomas. During melanoma surgery, your physician will perform a ‘wide excision,’ meaning he or she will remove a large area of skin surrounding the lesion to make sure all the cancer is contained in the excised tissue. Sometimes surgery alone will cure your melanoma cancer.

If the melanoma has spread to other tissues, you may undergo chemotherapy, radiation therapy or other forms of cancer treatment. Your medical provider will develop a treatment plan tailored to your specific situation.

MELANOMA PREVENTION

As with all types of skin cancers, prevention consists primarily of avoiding excessive exposure to UV rays. UV rays can damage the DNA of skin cells, causing them to become cancerous. Here’s how to avoid UV ray exposure:

  • Use sunscreen. Read the directions on your sunscreen and follow them precisely. Most sunscreens need to be applied at least 30 minutes before sun exposure. You then should re-apply the sunscreen as directed. Some sunscreens need to be re-applied frequently. You also should re-apply sunscreen after coming out of water (such as after swimming, snorkeling, and so on).
  • Be sure your children use sunscreen. Because sun exposure early in life can be the most damaging to skin cell DNA, you should be vigilant about limiting your children’s sun exposure and making sure to apply sunscreen whenever they will be exposed.
  • Use UV-blocking clothing. A typical cotton t-shirt does not offer much protection from UV rays. If you are planning a sunny vacation, invest in some clothing with built-in UV protection — and then wear it as often as possible.
  • Wear hats. Wide-brimmed hats and caps help keep the sun’s rays off your face and neck.
  • Combine different types of sun protection. For the best effect, combine hats with sunscreen, and so on. Layers of protection will help you avoid the damaging effects of UV rays.

You also should avoid tanning beds, which are another primary source of UV exposure.

MELANOMA: PREVENTION FIRST

You can’t entirely eliminate your risk of developing melanoma. But carefully avoiding sun exposure and reducing your other risk factors can help you minimize your chances of developing this deadly form of skin cancer.