Childhood Melanoma
Melanoma is a type of skin cancer that primarily occurs in adults but also is found occasionally in children. In the United States, approximately 500 children are diagnosed with pediatric melanoma a year according to the National Cancer Institute, and there is evidence that incidence is on the rise.
Melanoma may grow faster in children than in adults. Children may fare better than adults, and if caught early, most do not require treatment beyond surgery. Accurate diagnosis and surgery by an experienced surgeon are vital for better outcomes in children. Among children, sun exposure plays less of a role in the development of melanoma. Researchers believe it is a combination of genetic predisposition and other unknown triggers.
Children with fair skin, freckles or red or blond hair have a higher risk of melanoma. Previous studies have shown that children who have been treated for melanoma are at an increased risk of recurrence later in life
Symptoms
- A bump that itches and bleeds
- A wart-like spot, typically non-pigmented or a pinkish color
- An amelanotic lesion – meaning they aren’t black or darkly pigmented like many adult melanomas
- Odd-looking moles, especially large ones
- A mole that looks completely different from a child’s other moles
Remember the ABCD’s when studying moles:
- Asymmetry
- Border irregularity
- Color (although many pediatric melanomas are non-pigmented)
- Diameter (larger than ¼ inch)
Tests & Procedures
If a spot looks suspicious, parents should go to a specialist such as a dermatologist to have the place checked. Most melanomas are diagnosed with a biopsy. Once the biopsy is done, surgeons will perform another surgery to ensure the melanoma is completely removed. Based on the first biopsy sentinel node mapping may be required, and depending on pathology from that biopsy, a lymph node resection may be performed. Misdiagnosis or mistreatment may lead to a higher staging or worse prognosis.
Finding an experienced team that diagnoses and treats children with melanoma is important. A qualified team should include a pediatric oncologist, an experienced melanoma dermatopathologist who knows how to do sentinel node analysis and a surgical oncologist who is experienced in sentinel node mapping and biopsy.
Treatment
Surgery is the primary form of treatment for pediatric melanoma. Low-stage melanomas just need observation after surgery. Thicker, ulcerated or melanomas that have spread to the lymph nodes may necessitate additional medical treatment including biologic therapy, chemotherapy or both.
Once a child has been diagnosed with melanoma, he/she needs to have lifelong skin checks and follow-up with an experienced melanoma oncologist. Follow-up is important since children with melanoma have a higher risk of getting a second melanoma later in life.
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