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Approximately 70,000 new cases of invasive melanoma are diagnosed in the United States each year. While melanoma accounts for only 3% of all types of the skin cancer, it has the highest death rate of all types and is more likely to spread (metastasize) in the body. It is also one of the most frequently occurring cancers in young adults ages 20 to 30, and is the main cause of cancer death in women 25 to 30 years old.
Melanoma usually appears as an:
- Irregular brown, black and/or red spot or
- Existing mole that begins to change color, size or shape
Melanoma appears most commonly on the trunk area in fair-skinned men and on the lower legs in fair-skinned women. In dark-skinned people, melanoma appears most frequently on the palms, the soles of the feet and the skin under nails. If caught early, melanoma is often curable.
Melanoma is divided into several types. The treatment and outlook for each is different.
There are four major types of cutaneous melanoma:
Superficial spreading melanoma:
- Most common melanoma type
- About 70% of cases
- Usually starts in a pre-existing mole
- Second most common melanoma type
- 15% to 30% of cases
- More aggressive and usually develops quicker than superficial spreading melanomas
Lentigo maligna melanoma:
- Appears as large, flat lesions
- Most commonly found on the faces of light-skinned women over 50
- 4% to 10% of cases
- Lower risk of spreading than other melanoma types
Acral lentiginous melanoma:
- Occurs on the palms, soles of the feet or beneath the nail beds
- 2% to 8% of melanomas in fair-skinned patients
- Up to 60% of melanomas in darker-skinned patients
- Large, with an average diameter of 3 centimeters
- About 1% of melanoma cases
- Occurs in mucosal tissue, which lines body cavities and hollow organs
- Most common sites are head and neck region (including the nasal cavity, mouth and esophagus), rectum, urinary tract and vagina
- Can be very difficult to detect
- Even when diagnosed and treated, prognosis is often poor
Because the eyes contain melanocytes, they can be susceptible to melanoma. Read more about the two types of ocular melanoma:
Some cases of melanoma can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Some people have an elevated risk of developing melanoma. Review the melanoma screening guidelines to see if you need to be tested.
Behavioral and lifestyle changes can help prevent melanoma. Visit our prevention and screening section to learn how to manage your risk.
Melanoma Risk Factors
Anything that increases your chance of getting melanoma is a risk factor.
Sun damage, especially a history of peeling sunburns, is the main risk factor for melanoma. Artificial sunlight from tanning beds causes the same risk for melanoma as natural sunlight.
Other risk factors for melanoma include:
- Fair complexion: People with blond or red hair, light skin, blue eyes and a tendency to sunburn are at increased risk.
- Previous melanoma
- Moles (nevi): Having a lot of benign (non-cancer) moles
- Family history of melanoma
- Atypical mole and melanoma syndrome (AMS): Previously known as dysplastic nevus syndrome, AMS is characterized by large numbers of atypical moles. If you have AMS, you and your family members should be screened regularly
Not everyone with risk factors gets melanoma. However, if you have risk factors, it’s a good idea to discuss them with your health care provider.
Learn more about melanoma:
Why choose MD Anderson for your melanoma treatment?
Our team of internationally recognized experts provides customized treatment for melanoma to ensure you receive the most advanced care with the least impact on your body.
Multidisciplinary Melanoma Treatment
Each person and each melanoma are different, and at MD Anderson's Ben Love/El Paso Corporation Melanoma and Skin Center, we use our unique multidisciplinary approach to tailor treatment for melanoma skin cancer specifically to your unique situation.
More than 10,000 melanoma patients –– among the most of any program in the world –– are evaluated here each year. Caring for this large and diverse patient population has helped us develop an outstanding team of melanoma specialists with wide-ranging expertise and experience in treating all types of melanoma.
Comprehensive, Specialized Melanoma Treatment
Your personal team of experts in melanoma skin cancer may include melanoma surgical oncologists, melanoma medical oncologists, pathologists, dermatologists and dermatologic surgeons, head and neck surgeons, neurosurgeons, plastic surgeons and other surgeons, radiation oncologists, diagnostic radiologists, and other specialists if needed. They work together closely, collaborating and communicating at every step of your treatment.
Several innovative treatments for melanoma skin cancer are offered at MD Anderson, and many of them were discovered here. Your personalized treatment may include:
- Lymphatic mapping and sentinel node biopsy
- Minimally invasive limb perfusion
- Targeted therapies that capitalize on our improved understanding of the molecular alterations within melanoma tumor cells
- Adjuvant radiation therapy to help reduce the risk of melanoma coming back after surgery
- Treatments for rare forms of melanoma, such as those that begin in the eye (uveal melanoma) or mucosa (for example, vaginal, rectal or sinonasal)
And we're constantly researching ways to help the body fight
- Immunotherapy, including the latest agents such as ipilimumab, PD-1 and PDL-1 inhibitors, interleukin-2 and adoptive T-cell therapy
- Targeted therapies such as BRAF, MEK, multikinase and KIT inhibitors
Since 2004, the National Cancer Institute has awarded MD Anderson a multimillion-dollar Specialized Programs of Research Excellence (SPORE) grant. This means we are able to offer a broad array of clinical trials for melanoma skin cancer.
“The biggest thing cancer has done for me is encourage me to go for it.
In 2011, golf professional Randy Jones had a satisfying career and a loving wife with three kids. Life was good.
But a series of seemingly unrelated events eventually brought him to MD Anderson.
“I really believe in fate and divine intervention moments,” Randy says. “To this day, the whole thing still kind of gives me chills.”
Magazine article prompts dermatologist visit
The journey began with Randy’s wife, Mackie, urging him to see a dermatologist.
“I’m a fair-skinned guy with a lot of freckles,” he says. “It’s my job to be outside, but I’d never been to a dermatologist in my life.”
After the birth of their third child, Randy spied an article on melanoma while flipping through a parenting magazine. He began reading the story, which was about a mother of two young children whose husband suddenly passed away from skin cancer.
“Something about it just hit home, so I called my wife and got the name of her dermatologist,” Randy says.
Randy’s melanoma diagnosis
The dermatologist told Randy his skin looked great, but did shave biopsies on two or three moles just to be safe. He also performed a punch biopsy on a fourth mole that looked abnormal.
“I thought, ‘Alright. I’m finally doing my due diligence. This should get my wife off my back,’” Randy says.
Only the punch biopsy turned out to be melanoma.
“Man, I really didn’t know what to do,” Randy says. “I think ‘cancer’ must be the scariest word in the English language. I got the shakes.”
Second opinion brings Randy to MD Anderson
Randy was referred to a surgical oncologist, who removed the mole and a sentinel lymph node to be on the safe side.
But the lymph node tested positive for cancer, too. Randy was referred to another doctor for additional surgery, but he didn’t feel comfortable with that physician. His wife encouraged him to seek a second opinion at MD Anderson.
A family decision
At MD Anderson, Jeffrey Gershenwald, M.D., performed a groin dissection, removing 22 additional lymph nodes. Only one showed evidence of cancer, and it was microscopic.
“We decided as a family, with my pastor’s help, not to take the interferon I was offered after surgery,” Randy says. “People who take it can feel really sick, and if the melanoma returned, I wanted to have a good quality of life with my wife and kids now.”
Gershenwald kept a sharp eye on Randy, with regular checkups every three months. Those were gradually bumped back to four-month intervals, then five and six. At his January 2015 checkup, Gershenwald said he could move to an every-12-month schedule if his scans came back clear.
Then Randy got home and noticed blood in his urine. The melanoma had metastasized to his right kidney.
“That’s what I consider a divine intervention moment,” Randy says. “Stage IV melanoma doesn’t usually give you a symptom until it’s too late. But I peed blood.”
Paying it forward
Three days later, Randy was back at MD Anderson. Under the care of Adi Diab, M.D., a tumor in his kidney was removed and Randy started an eight-week clinical trial combining chemo and an immunotherapy called Ipilimumab. When an additional tumor was found on his brain, he switched to Taflinar. A few months later, Mekinist was added. Randy took those drugs until February 2016, then stopped them and began an IV immunotherapy called Keytruda, which he’s still on. He also had cryoablation, which froze another tumor near his kidney, and gamma knife radiation applied to the brain tumor.
Today, Randy shows no evidence of disease. But because of his experience, he encourages fellow golf pros to use sunscreen daily and to get their skin checked regularly.
“I wouldn’t want my worst enemy to have to go through what I have,” he says. “If I can save even one life, it will be worth it.”
Melanoma Moon Shot
MD Anderson’s Melanoma Moon Shot® aims to rapidly and dramatically improve the disease’s survival rates and reduce suffering through prevention, early detection, research and new treatments.Learn more about the Melanoma Moon Shot