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Melanoma

Contents of this page:

Illustrations

Melanoma of the liver - MRI scan
Melanoma of the liver - MRI scan
Skin cancer, malignant melanoma
Skin cancer, malignant melanoma
Skin cancer, raised multi-color melanoma
Skin cancer, raised multi-color melanoma
Skin cancer, melanoma - flat, brown lesion
Skin cancer, melanoma - flat, brown lesion
Skin cancer, melanoma - raised, dark lesion
Skin cancer, melanoma - raised, dark lesion
Benign juvenile melanoma
Benign juvenile melanoma
Skin cancer, melanoma on the fingernail
Skin cancer, melanoma on the fingernail
Skin cancer, close-up of lentigo maligna melanoma
Skin cancer, close-up of lentigo maligna melanoma
Skin cancer, close-up of level III melanoma
Skin cancer, close-up of level III melanoma
Skin cancer, close-up of level IV melanoma
Skin cancer, close-up of level IV melanoma
Skin cancer, melanoma superficial spreading
Skin cancer, melanoma superficial spreading
Melanoma - neck
Melanoma - neck
Melanoma
Melanoma

Alternative Names    Return to top

Skin cancer - melanoma

Definition    Return to top

Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease.

It involves cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair color.

Melanoma can also involve the colored part of the eye. For information about that form of melanoma, see melanoma of the eye.

See also:

Causes    Return to top

There are 4 major types of melanoma:

Melanoma can spread very rapidly. Although it is less common than other types of skin cancer, the rate of melanoma is steadily increasing. It is the leading cause of death from skin disease.

In the United States, 1 in 65 people will be diagnosed with melanoma at some point in their life. The risk of developing melanoma increases with age, but the disease also frequently affects young, otherwise healthy people. Melanoma is the number one cause of cancer death in women aged 25 - 30.

Melanoma may appear on normal skin, or it may begin at a mole or other area that has changed in appearance. Some moles present at birth may develop into melanomas.

The development of melanoma is related to sun exposure, particularly to sunburns during childhood, and is most common among people with fair skin, blue or green eyes, and red or blond hair.

Risk factors include the following:

Symptoms    Return to top

The primary symptom of any skin cancer is usually a mole, sore, lump, or growth on the skin. Any change in appearance of a pigmented skin lesion over time is a warning sign. Also, watch for any bleeding from a skin growth.

The ABCD system may help you remember features that might be a symptom of melanoma:

The key to treating melanoma is recognizing symptoms early. You might not notice a small spot of concern if you don't look carefully, so perform thorough self-examinations monthly, and schedule a formal skin exam with a dermatologist yearly.

Exams and Tests    Return to top

If you notice any suspicious skin markings, see your health care provider as soon as possible.

The American Cancer Society recommends professional skin examinations every year for people older than 40, and every 3 years for people aged 20 - 40. Monthly self-examination is also recommended.

Your health care provider may suspect melanoma based on the appearance of the growth, sore, or lump. A biopsy may be used to confirm the diagnosis. The biopsy may involve removal of a small area of a growth, or the entire growth itself.

Treatment    Return to top

The cancerous skin cells and a portion of the normal surrounding skin usually have to be surgically removed. A procedure called surgical lymph node biopsy may be necessary to check if the cancer has spread to nearby lymph nodes. If it has, these lymph nodes may also need to be removed. A skin graft may be necessary after the surgery if a large area of skin is affected.

Only the smallest and most shallow melanomas can be cured by surgery alone, so early diagnosis is very important. Radiation therapy, chemotherapy, or immunotherapy (use of medications that stimulate the immune system, such as interferon) may be recommended in addition to surgery.

If the skin cancer is deeper than 4 mm or the lymph nodes have cancer, there is a high risk of the cancer spreading to other tissues and organs. Treatment with interferon after surgery may be useful for these patients. Studies have suggested that interferon improves the overall chance of cure by approximately 10%.

However, interferon has many side effects and is sometimes difficult to tolerate. Patients with high-risk melanomas should consider enrolling in clinical trials. These are research studies of new medications or other treatments.

For patients with melanoma that has spread beyond the skin and lymph nodes to other organs, treatment is more difficult. At this point, melanoma is usually not curable. Treatment is usually directed at shrinking the tumor and improving symptoms. Both chemotherapy and use of interferon or interleukin may be tried. These patients also should consider participating in clinical trials.

Support Groups    Return to top

For additional resources, see cancer support group.

Outlook (Prognosis)    Return to top

Treatment success depends on many factors, including the patient's general health and whether the cancer has spread to the lymph nodes or other organs.

If caught early, melanoma can be cured. The risk of the cancer coming back increases with the depth of the tumor -- deeper tumors are more likely to come back. If the cancer has spread to lymph nodes, there is a greater chance that the melanoma will come back.

For melanoma that has spread to other tissues and organs, the cure rate is low. Melanoma that has spread may lead to death.

Possible Complications    Return to top

Complications of melanoma include the following:

When to Contact a Medical Professional    Return to top

Call your health care provider if you notice any symptoms of melanoma, particularly the following:

Prevention    Return to top

Protect yourself from the sunlight's damaging ultraviolet rays. This includes the following:

References    Return to top

Geller AC, et al. Screening, early detection, and trends for melanoma: current status (2000-2006) and future directions. J Am Acad Dermatol. 2007;57(4):555-572.

Update Date: 2/5/2008

Updated by: Kevin Berman, MD, PhD, Associate, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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