Melanoma is a type of skin cancer that occurs in the pigment producing cells in the skin. It can be caused by excessive sun exposure, especially in fair skinned people, and can also be inherited. People with a greater than average number of moles are also at increased risk of developing Melanoma. These cancerous cells can grow, spread and invade other tissues. If given time, the Melanoma can grow deep into the skin, reaching the blood and lymphatic vessels, and spread throughout the body causing a life threatening illness. It is curable when detected early, so the goal is to detect it early when it is still only on the surface of the skin.
Melanoma can occur anywhere on the skin, even in areas not usually exposed to the sun. It is most common on the legs and back. Melanoma is usually brown or black. It may arise from an existing mole, or appear on normal skin. When looking at a spot on the skin, it is helpful to use the ABCDE guidelines.
- Asymmetry of the lesion
- Border irregularity
- Color variability or unusually dark
- Diameter 6 mm or greater
- Evolution - change in appearance
Melanomas grow slowly; therefore any slight change should arouse suspicion and be examined by a physician.
If Melanoma is suspected, it should be promptly biopsied to confirm diagnosis. If Melanoma is detected, treatment depends on how deep the melanoma penetrates the skin. Treatment begins with excision of the visible lesion as well as a specific amount of surrounding, normal looking tissue. The specimen is then sent out to a lab for confirmation that the margins are clear meaning all of the cancer has been removed. If it is found to be an early Melanoma limited to the outermost layer of the skin, it is known as melanoma-in-situ and is easily cured by excision. If the melanoma is found to extend deeper into the tissues, additional tissue will need to be taken before final reconstruction of the defect.
If the melanoma goes very deep into the skin and has likely spread, further testing will need to be done. Specialized tests, such as an MRI, CT scan, PET scan, or a Sentinel lymph node biopsy, may need to be ordered to determine if the cancer has indeed spread (metastasized). Once the melanoma has metastasized and the lymph nodes have been evaluated, it requires a different treatment plan which may include surgical removal, radiation therapy, chemotherapy or immunotherapy.
Prevention is best done by using proper sun protection, doing routine self-examinations, and having routine examinations by a physician. This is especially important if risk factors are present, such as a family history of melanoma or a greater than average number of atypical moles. Early detection is best. If a mole is changing, or appearing on your body after age 30, a physician should be seen.