Melanoma, also called malignant melanoma cancer, is a type of skin cancer that originates in the melanocytes, the cells responsible for giving skin its color. The American Cancer Society estimates that more than 100,000 new cases of melanoma will be diagnosed in 2024 alone.
While less common than some types of skin cancer, melanoma is considered more serious because it’s more likely to spread to other parts of the body. This type of skin cancer is also the deadliest, causing thousands of U.S. deaths each year.
There are four primary types of melanoma:
- Acral lentiginous melanoma typically appears as a black or brown area on the skin, often in hard-to-spot locations, such as the sole of the feet. It’s the most common type of melanoma in people of color.
- Lentigo maligna may appear as a flat or slightly raised, blotchy patch of skin that’s usually blue-black in color. The invasive form of this cancer is called lentigo maligna melanoma.
- Nodular melanoma usually appears as a bump on the skin, ranging from blue-black to pink or red. It’s the most aggressive form of melanoma, accounting for up to 15 percent of cases.
- Superficial spreading melanoma may appear as a flat or slightly raised, discolored patch with uneven shape and borders. This type of melanoma is the most common.
All forms of melanoma are treatable and often curable when detected and treated in an early stage. In fact, the five-year survival rate for those with early-stage melanoma is 99 percent. As melanoma spreads into other layers of the skin or other parts of the body, known as metastatic melanoma, it becomes more difficult to treat.
What causes melanoma?
Melanoma occurs when melanocytes, the cells that produce melanin, begin to grow abnormally. Exposure to ultraviolet (UV) radiation from either the sun or artificial sources like tanning beds is the leading cause of melanoma.
Certain factors can increase a person’s risk of developing melanoma:
- A family history of melanoma
- A personal history of melanoma
- Blond or red hair
- Blue or green eyes
- Fair or freckled skin
- Many moles, especially abnormal or “atypical” moles
- UV exposure from living near the equator or in high elevations
- Weakened immune system
While melanoma is more common among those with pale skin, it can affect people of all skin colors and types. Those with darker skin, including people of color, are prone to melanoma in less-noticeable places, such as the palms, soles, or underneath fingernails.
What are the signs and symptoms of melanoma skin cancer?
Up to 30 percent of melanomas develop in an existing mole, while the other 70 percent develop as new skin spots on previously normal-looking skin.
The Skin Cancer Foundation and other health organizations recommend using the acronym ABCDE to remember melanoma symptoms:
- Asymmetry – If you divide a common (or typical) mole in half, it will be even on both sides. Melanomas, on the other hand, are usually asymmetrical, meaning the two halves don’t match.
- Border – Skin spots or moles with uneven, scalloped, or notched edges are more likely to be melanoma than those that have smooth, even borders.
- Color – Common moles are usually a single color, while a melanoma may contain multiple colors, including brown, tan, black, red, white, or even blue.
- Diameter – A skin spot that’s bigger than a pencil eraser (or a pea) can be a warning sign of melanoma.
- Evolving – Any changes in an existing skin spot, including changes in size, shape, color, or texture can be symptoms of melanoma skin cancer. This also includes any spot that is bleeding, oozing, itching, or painful.
In addition to the ABCDEs of melanoma, the Skin Cancer Foundation also recommends using the “ugly duckling” method to detect melanoma. This strategy is based on the fact that most common moles on a person’s body are similar in appearance. A melanoma, on the other hand, will stand out like an ugly duckling.
How is melanoma diagnosed?
If you have a suspicious skin spot or mole on your skin, your primary care provider or a dermatologist will perform a biopsy to determine if the spot is cancerous. This includes taking a small sample of the skin spot—or all of it, in some cases—and examining it under a microscope to detect cancer cells.
If melanoma is detected, several other tools may be used to determine the cancer’s staging:
- Sentinel lymph node biopsy to determine if a melanoma has spread
- Imaging, such as CT scans, MRI scans, or PET scans
In cases of rare melanomas, such as ocular melanomas that occur inside the eye, additional tools will be used to help with diagnosis and staging.
Melanoma treatment at NGMC
If you’re diagnosed with melanoma, your care team will recommend a treatment plan based on the specific type of melanoma you have, as well as its stage. Melanoma treatment may include:
Surgery for melanoma
Surgery is the most common treatment for all types of skin cancer, including melanoma. During melanoma skin cancer surgery, a dermatologist or surgeon will remove as much of the melanoma as possible. This is done in two primary ways:
- Excision removes the cancer and a small area of normal-looking skin around the melanoma, then examines the “normal” skin, looking for cancer cells. If cancer cells are detected in the normal-looking skin, more excision or Mohs surgery may be needed.
- Mohs surgery removes the melanoma and a small amount of normal-looking skin in tiny, thin layers. Each layer removed is analyzed, and if cancer cells are found, another layer of skin will be removed. This process is followed until no cancerous cells are detected.
If melanoma has spread into nearby lymph nodes, they may also be removed using a surgical procedure known as a lymphadenectomy.
Radiation therapy for melanoma
In cases where cancer can’t be fully removed surgically, radiation for melanoma may be used to kill remaining cancer cells or keep new ones from forming. This involves using doses of radiation to target the area where melanoma has developed.
Chemotherapy for melanoma
Chemotherapy may also be an option alongside surgery, either before a surgical procedure to shrink melanoma or after surgery to fully eradicate cancer cells. Chemotherapy uses powerful medications taken orally or intravenously to target cancer cells in the body.
Immunotherapy for melanoma
Similarly to chemotherapy, immunotherapy uses powerful medications to target cancer cells. Unlike chemotherapy, however, these medications target only cancer cells, using medications to help a person’s immune system destroy cancer cells.
Melanoma research
Clinical trials offer access to new and innovative ways of diagnosing and treating many different types of cancer. We connect our patients with appropriate clinical trials when they are available. Learn more about the current clinical trials we are participating in.
Cancer rehabilitation
You may experience a number of different side effects depending on the type(s) of melanoma treatment you have, including skin irritation, easy bruising, and fatigue. We offer specialized rehabilitation services designed to help those who are undergoing cancer treatment overcome those challenges.
Patient Navigation
A cancer diagnosis can feel overwhelming, no matter the stage or type of cancer. Our team of cancer care navigators is here to help you through each stage of the process, from diagnosis through survivorship. Reach out to our patient navigation program today to connect with a navigator.
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