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Everything You Need To Know About Melanoma

Arming yourself with knowledge about this type of skin cancer can help you spot the signs and take action to help protect your health.

Melanoma is a serious form of skin cancer. People who spend a lot of time in the sun, have lighter skin tones, or have many moles are at an increased risk of developing the condition.

Protect yourself from sun exposure, check for any changes to moles, and follow up with your doctor if you notice anything unusual. Prompt diagnosis and treatment can improve the outlook for this form of skin cancer.

Here's everything you need to know about melanoma.

Melanoma is a specific kind of skin cancer. It begins in skin cells called melanocytes. Melanocytes produce melanin, the substance that gives your skin color.

Only about 1% of skin cancers are melanomas. Melanoma is also called malignant melanoma or cutaneous melanoma.

When people receive a melanoma diagnosis in the early stages, they mostly respond well to treatment. But when not caught early, it spreads easily to other parts of the body.

Types of melanoma

There are six main types of melanoma:

Superficial spreading melanoma: This is the most common type of melanoma. It tends to spread across the surface of the skin, has uneven borders, and varies in color from brown to black, blue, or pink.

Nodular melanoma: This type of melanoma grows down into deeper layers of the skin and may appear as a raised bump or dark brown or black growth.

Acral-lentiginous melanoma: This is more common in darker skin tones. It looks like a large, uneven, dark patch on the surface of the skin, typically on the palms of the hand, soles of the feet, or nail beds.

Lentigo maligna melanoma: This type tends to appear on parts of the body that get more sun, especially the face. It looks like a large, uneven, dark patch on the surface of the skin.

Amelanotic melanoma: This type can be difficult to spot, as it involves an absence of color, but it can also cause changes in mole sizing, borders, and symmetry.

Desmoplastic melanoma: This rare type of melanoma typically affects the head and neck, making it more difficult to diagnose.

There are also other, more rare types of melanoma. While melanoma most commonly affects the skin, some less common types affect internal tissues and the eyes.

Melanoma may also be known as metastatic melanoma when the cancer metastasizes (spreads) to other parts of the body, possibly including the lymph nodes, organs, or bones.

Where can melanoma show up on my body?

Melanoma can appear anywhere on the skin.

In lighter skin tones, melanoma is more likely to start on the chest and back for men or the legs for women. The neck and face are also common places.

In darker skin tones, melanoma is more likely to develop in other areas.

Here's what melanoma may look like on different parts of the body:

Early signs and symptoms of melanoma are:

changes to an existing mole

the development of a new, unusual growth on your skin

If melanoma cells are still making melanin, the tumors tend to be brown or black. Some melanomas don't make melanin, so those tumors can be tan, pink, or white.

Clues that a mole might be melanoma are:

irregular shape

irregular border

multicolored or uneven coloring

larger than a quarter of an inch

changes in size, shape, color, or surface

itchiness, oozing, or bleeding

Melanoma can start anywhere on your skin but are most likely to develop on the:

chest and back for men

legs for women

neck

face

This may be because these areas have more exposure to the sun than other parts of the body. Melanoma can form in areas that don't receive much sun, such as the soles of your feet, palms of your hands, and fingernail beds.

Sometimes, the skin will appear as usual even though melanoma has begun to develop.

It's not entirely clear what causes melanoma.

Typically, healthy new skin cells nudge older skin cells toward the surface, where they die. However, DNA damage within the melanocytes can cause new skin cells to grow out of control. As the skin cells build up, they form a tumor.

We don't know exactly why DNA in skin cells becomes damaged. But a combination of factors may come into play and increase your risk of developing melanoma, such as:

UV light: Exposure to UV radiation is a leading risk factor. UV radiation can come from natural sunlight, tanning beds, and tanning lamps.

Race: Melanoma is more common in people with lighter skin tones and facial features. However, keep in mind that this data may be due to inequities in healthcare and other contributing factors.

Moles: Besides skin with less pigment, having many moles may also be a risk factor.

Genetics/family history: If a parent or sibling has had melanoma in the past, you may have a higher chance of developing melanoma.

Age: Anyone can develop melanoma, but the risk of melanoma increases as you age. The average age at diagnosis is 65 years, even though it's also one of the most common cancers among young adults.

Biological sex: Generally speaking, men are more likely to develop melanoma than women. However, before 50 years old, women are at a higher risk. After age 50, men are at a higher risk.

A weakened immune system: People who have certain health conditions or have undergone treatments that affect the immune system are more likely to develop melanoma.

Previous history of skin cancer: If you've received a melanoma diagnosis or another type of skin cancer in the past, that increases your risk of getting it again.

Cancer staging tells you how far the cancer has grown from its origin. Cancer can spread to other parts of the body through tissue, the lymph system, and the bloodstream.

Doctors stage melanoma as follows:

Stage 0

You have abnormal melanocytes, but only on the outermost layer of skin (epidermis). This is also called melanoma in situ.

Stage 1

Stage 1 melanoma has two distinct categories:

1A: The tumor is less than 1 millimeter (mm) thick and may be with or without ulceration.

1B: The tumor is between 1 mm to 2 mm thick with no ulceration.

Stage 2

There are three distinct categories for stage 2 melanoma:

2A: The tumor is between 1 mm and 2 mm thick with ulceration. Or, it's between 2 mm and 4 mm thick without ulceration.

2B: The tumor is between 2 mm and 4 mm and is ulcerated. Or it's thicker than 4 mm without ulceration.

2C: The tumor is over 4 mm thick and is ulcerated.

Stage 3

You have a tumor of any size that may or may not be ulcerated. At least one of these is also true:

tests have found cancer in at least one lymph node

lymph nodes are joined together

cancer is in a lymph vessel between the tumor and the closest lymph nodes

there are cancer cells more than 2 centimeters (cm) from the primary tumor

doctors discovered other tiny tumors on or under your skin within 2 cm of the primary tumor

Stage 4

Cancer has spread to distant sites, such as the:

lungs

liver

brain

spinal cord

muscle and other soft tissue

digestive tract

distant lymph nodes

Stage 4 melanoma is also known as metastatic melanoma.

Doctors use a variety of exams and tests to help confirm a melanoma diagnosis.

Physical examination

First, you'll need a thorough examination of your skin. As adults, most of us have between 10 and 40 moles.

A regular mole usually has a uniform color and a clear border. They can be round or oval, and are generally less than a quarter of an inch in diameter.

A thorough skin examination will involve looking in less obvious places, such as:

between the buttocks

genitals

palms and under your fingernails

scalp

soles of your feet, between your toes, and under your toenails

Blood chemistry studies

Your doctor can check your blood for lactate dehydrogenase (LDH). When you have melanoma, levels of this enzyme can be higher than usual.

A doctor may not check LDH levels in early stage disease.

Skin biopsy

A skin biopsy is the only way to confirm melanoma. A biopsy involves removing a sample of the skin and, if possible, the entire suspected area. Then, the tissue is sent to a lab for examination under a microscope.

Your doctor will receive the pathology report and explain the results.

If you receive a melanoma diagnosis, it's important to determine the stage. This will provide information on your overall outlook and help guide treatment.

The first part of staging is to find out how thick the tumor is. This can involve measuring the melanoma under a microscope.

Lymph node biopsy

If you have a diagnosis, your doctor may need to find out if cancer cells have spread, though they won't do this for melanoma in situ. The first step is to perform a sentinel node biopsy.

This surgery will involve injecting into the area where the tumor was. This dye will naturally flow to the nearest lymph nodes, which the surgeon will remove to test for cancer.

If the test doesn't find cancer in the sentinel nodes, it probably hasn't spread outside the original area under investigation. If the biopsy does detect cancer, a doctor may test the next set of nodes.

Imaging tests

Imaging tests help determine whether cancer has spread beyond the skin to other parts of the body.

Ultrasound: This test uses sound waves and echoes to create imagery of the lymph nodes near the tumor.

CT scan: A medical professional will inject a dye into your vein before the scan, which takes a series of X-rays at different angles. The dye helps highlight organs and tissues.

MRI: For this test, a medical professional will inject a substance called gadolinium into a vein. The scanner uses magnet and radio waves to take pictures, and the gadolinium causes cancer cells to brighten.

PET scan: This test requires injecting a small amount of radioactive glucose into a vein. Then, the scanner will rotate around your body. Cancer cells use more glucose and will show up on the screen.

What tests stage melanoma?

Your doctor may review the results from all of your tests — from a physical exam to a biopsy, blood test, and imaging results — to help determine the stage of melanoma.

the depth of the original melanoma tumor

other pathological features

whether the cancer has spread to nearby lymph nodes or beyond

Surgical removal, known as excision, is the primary treatment for all stages of melanoma, particularly localized melanoma. Doctors will also remove a margin of healthy tissue to ensure no cancer cells are left behind.

A complete excision along with a lymph node biopsy (or elective lymph node removal) is considered standard treatment for primary melanoma.

More advanced stages of melanoma may involve additional treatment after surgery with:

immunotherapy

targeted therapy

radiation

chemotherapy

vaccine therapy

Each type of therapy comes with its own set of side effects, some of which can be serious. It's important to discuss these with your doctor so you can make an informed choice.

However, exact treatment recommendations vary based on the stage of melanoma.

Stage 0

Treatment for stage 0 melanoma involves surgical removal of the suspicious tissue. It's usually possible to completely remove the entire area during the biopsy for diagnosis. If not, your surgeon can remove it afterward, along with a border of regular skin.

You may not need further treatment.

Stage 1

Treatment for stage 1 melanoma involves surgical removal of the cancer along with a margin of healthy skin and a layer of tissue underneath the skin. It may also include lymph node biopsy or removal.

Stage 1 melanoma typically doesn't usually require additional treatment.

Stage 2

This type of melanoma is treated by removing the tumor, along with a margin of healthy skin and a layer of tissue below. The procedure may also include lymph node biopsy or removal.

If there's a high risk of recurrence, you may receive immunotherapy after surgical removal.

Stages 3 and 4

Stage 3 melanoma has spread away from the primary tumor or into nearby lymph nodes. An excision procedure removes the tumor and any affected lymph nodes. You may also have a skin graft to cover the surgical wound.

If there is a high risk of recurrence, a doctor may follow up this procedure with immunotherapy or targeted therapy. You may also receive radiation or vaccine therapy.

In stage 4 melanoma, cancer has spread to distant parts of the body. Your surgical options depend on the number, size, and location of tumors.

Treatment for stage 3 melanoma that surgery cannot remove, stage 4 melanoma, and recurrent melanoma may also include:

immunotherapy

targeted therapy

radiation

chemotherapy

vaccine therapy

palliative therapy

Clinical trials can help you get innovative therapies not yet approved for general use. If you're interested in joining a clinical trial, talk with your doctor.

It's natural to want to research survival rates, but it's important to understand that they're generalizations. Your circumstances are unique, so it's advisable to speak with your doctor about your own outlook.

100% for localized melanoma

74.8% for regional spread

35% for distant metastasis

Doctors diagnose approximately 83% of melanoma cases at the local stage.

When it comes to your individual outlook, survival rates are only rough estimates. Your doctor can offer you a more individualized assessment.

Some factors that can affect your outlook are:

Age: Older people tend to have shorter survival times.

General health: Treatment may be less effective if you have a weakened immune system or other underlying health problems.

As you can see from the relative survival rates above, many people survive melanoma. Later-stage melanoma is more challenging to treat, but it's possible to survive many years after diagnosis.

Every year in the United States, 21.2 out of every 100,000 people receive a diagnosis of melanoma. The sooner you receive a diagnosis and treatment, the better your outlook.

While you can't completely eliminate your risk, certain strategies can help prevent melanoma and other skin cancers from developing:

Avoid the midday sun whenever possible: The strongest UV rays are between 10 a.M. And 4 p.M. If you go outside during these hours, try to stay in the shade. Remember that the sun still affects your skin on cloudy days and throughout winter.

Use sunscreen: Use a broad-spectrum sunscreen with an SPF of at least 30. Reapply every 2 hours or more often if you sweat a lot or go in the water. Do this regardless of the season.

Cover up: When spending time outdoors, keep your arms and legs covered. Wear a broad-brimmed hat to protect your head, ears, and face. Wear sunglasses that protect from UVA and UVB rays.

Minimize unnecessary UV exposure: Avoid indoor tanning beds or tanning lamps to reduce your risk.

Following a healthy lifestyle — for example, eating a nutrient-rich diet, limiting alcohol intake, and exercising regularly — may also help minimize your risk of melanoma.

Above all else, checking your skin regularly and reporting any unusual moles or suspicious skin changes to your doctor can help you address it quickly.

Check your body regularly for new growths

Note size, shape, and color changes to existing moles, freckles, and birthmarks.

Remember to check the bottoms of your feet, between your toes, and nail beds.

Use a mirror to check hard-to-see areas such as your genitals and between your buttocks.

Take photos to make it easier to spot changes.

Report any suspicious findings to your doctor right away.

Bravo Star Reveals Melanoma Diagnosis: Captain Jason Chambers Says 'Early Detection Is Key'

Below Deck Down Under star Jason Chamber is opening up about his health after being diagnosed with melanoma. The captain, 52, took to social media on Monday, Dec. 16 to encourage people to be safe in the sun and keep an eye on any changing spots on their skin.

"For someone that spent their life in the sun, as a child playing sport to working on the ocean, I thought I was resistant to the damaging effects of the sun," he wrote on Instagram. "I love the sun and its health benefits are evident, but be wise and like everything in life, it's all about balance, choose your battles. With a diagnosed melanoma biopsy, I now have an anxious wait and what I thought was a skin spot turned in just 6 months, early detection is the key."

In a video accompanying his post, Chambers shared the results of a recent biopsy he had done in Bali, which came back positive for the most serious type of skin cancer. Once he returned to his native Australia to seek more information from Australian doctors, Chambers revealed the next steps. "The Australian doctors, which are fantastic in Australia, they weren't happy with what the indications told them to go to," Chambers said in the video. "The stage two, which would be to cut out a bigger section and test the glands."

The Bravo star explained that he is currently waiting for the biopsy specimen to be sent from Bali to Australia for further testing, revealing that he may have to wait until after the holidays to get more information about the extent of the melanoma.

"It's a bit of a wait, fingers crossed," Chambers said while crossing his fingers. "Look Australia, two out of three people suffer from melanoma. It's a big thing."

The TV personality admitted he "never" used to wear sunscreen when he was out on the water, saying, "I used to put zinc on my nose, the reason being the chemicals. But there's so many products out there that are chemical-free now, which is great."

He encouraged his followers to be careful in the sun and use protection to avoid a similar health scare. "Make sure you throw on some sunscreen, get some shade and cover yourself up and enjoy your day out in the sun," he said.

Non Melanoma Skin Cancer

Moles

Basal cell carcinoma (BCC) risk is 60% higher in people with moles, compared with people without moles, a meta-analysis showed.[1]

Most moles are genetically determined, appearing during childhood or adolescence.[2-4] Sun exposure can increase the number of moles, with chronic sun exposure more influential than number of sunburn episodes.[2]

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