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Q&A: What to Know About Melanoma

CancerWise - May 2007

The number of people diagnosed with melanoma is increasing at the highest rate of any type of cancer. This lethal skin cancer affects all genders and age groups, and is the most common cancer among young adults.

Answering questions about symptoms, prevention and other specifics about melanoma is Susan Chon, M.D., an assistant professor in M. D. Anderson’s Department of Dermatology.

What is melanoma?

Melanoma is an aggressive type of skin cancer. It usually appears as a pigmented growth on the skin. In rare cases, melanomas are skin-colored and not pigmented. Melanomas can appear as flat or raised growths.

Less common types of melamona may occur in the eyes and mouth. If you notice any discoloration or changes in vision, seek out an ophthalmologist. If you notice any new growths or non-healing sores in the mouth, see your dentist or primary care physician.

What causes melanoma?

Everyone has melanocytes, cells that make the melanin that gives skin its pigment or color. Sometimes melanocytes change, either spontaneously or when damaged by sun exposure. With time, this damage can result in melanoma.

Risk factors include:

  • History of blistering sun burns
  • Family history of melanoma
  • Fair skin type
  • High number of moles
  • Atypical moles
  • Immune suppression

What are the symptoms of melanoma?

Any pigmented growth that changes in size, shape, color or sensitivity needs to be examined and possibly may be biopsied by a physician. Remember the ABCDE method of skin cancer self-examination.

See a dermatologist if skin lesions have irregularities in:

  • Asymmetry – Different on one side than the other
  • Border – Jagged edges
  • Color – Changes in color or more than one color
  • Diameter – Larger than the tip of a pencil eraser
  • Evolution – Any change such as:
    • Itching
    • Bleeding
    • Pain
    • Scaling

How can melanoma be prevented?

To reduce melanoma risk, Chon recommends people:

  • Limit sun exposure:
    • Avoid sunburn
    • Avoid peak periods (10 a.m.-3 p.m.)
    • Use a sunscreen sun protection factor (SPF) of 30
    • Wear protective clothing when possible:
      • Broad-brimmed hat
      • Long-sleeved shirt
      • Pants
  • Conduct regular skin self-exams
  • Report suspicious moles to a physician
  • Visit a dermatologist at least annually if they have a:
    • History of intense sun exposure
    • Family history of melanoma
    • Large number of pigmented moles

What is the main treatment for melanoma?

Remember that the first defense against skin cancer is always prevention, especially against intense sun damage.

Treatment varies widely depending on the size, type and stage of the cancer.

If detected in the early stages, melanoma is often treatable. The main treatment for early-stage melanoma is surgery. A thin melanoma is usually treated with a wide local excision of the skin.

Melanomas that are 1 millimeter or more in thickness are considered more aggressive than thin melanomas and may spread to nearby lymph nodes. These melanomas are treated with wide local excisions of the skin, and lymph node biopsy may be considered. If the melanoma has spread to the lymph nodes, patients may be offered additional treatment.

What new treatments are being studied?

A great deal of research is being carried out on melanoma, especially in academic medical centers. Clinical trials include studies of vaccines and small molecules that target specific growth pathways in the tumor.

No major breakthroughs have been made yet, but it may not be too far in the future. In the meantime, people should continue to limit sun exposure and be aware of changes in any pigmented moles.

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© 2014 The University of Texas MD Anderson Cancer Center