Melanoma

What is melanoma?

Melanoma is the most serious type of skin cancer.

What increases my risk for melanoma?

Healthcare providers do not know exactly what causes melanoma. The following increases your risk of melanoma:

• Sun exposure.
• A family member has had melanoma.
• At least one blistering sunburn as a child or teenager.
• Light colored skin, hair or eyes.
• Freckles or moles that increase or change.
• Skin that burns rather than tans when you are in the sun.
• Skin diseases, such as xeroderma pigmentosum.

What can I do to reduce the risk of developing melanoma?

• Protect your skin from the sun’s ultraviolet (UVA UVB) rays:
  • Wear sunscreen that has sun protectant factor (SPF) of 15 or higher and make sure it has UVA and UVB protection. Follow directions when you use sunscreen. Put on more sunscreen if you swim, sweat or are in the sun for longer than an hour. Protect your lips by using lipsticks and lip balms that contain sunscreen.
  • Stay out of the sun between 10 a.m. and 4 p.m. This is when the sun is strongest and most damaging to your skin.
  • Wear protective clothing. Long-sleeved shirts and pants will protect your arms and legs when you are out in the sun. A wide brimmed hat can protect both your face and neck. Wear sunglasses with UVA and UVB protection.
• Do not use tanning booths: These can damage your skin as much as the sun can.
• Look for new bumps on your skin once a week: Check your entire body, including your scalp. Look for moles that change in shape, size, color, or texture. Know what your regular birthmarks and moles look like.

What are the signs and symptoms of melanoma?

Melanoma may appear as a new mole, or in moles you already have. Men often get new moles between the shoulder and hip. Women usually get new moles on their arms and legs. Moles may also be found on the palms of the hands, the soles of the feet or under the nail bed. Healthcare providers look for melanoma based on the “ABCDE” system:

• Asymmetry: If a line is drawn through the middle of the mole, the two halves are unequal.
• Border: The edges of the mole are not smooth.
• Color: The color can be blue, black, brown or red.
• Diameter: The size of the mole is larger than a pencil eraser.
• Evolution: The mole changes in appearance and in symptoms such as bleeding and changes in shape, size or color. The area may also itch or feel hard, lumpy, swollen, or tender.

How is melanoma diagnosed?

Your healthcare provider will examine your skin and look at the size, shape, and color of your moles. You may need more than one of the following tests:

• Skin biopsy: A biopsy removes part or all of the mole, sore or lump. You will be given medicine to numb the skin. After the biopsy, you may need stitches and a bandage to close the wound. The tissue sample is then sent to a lab for tests.
• Chest X-ray: An X-ray may be done to see if the melanoma has spread to your lungs.
• CT scan: This test, also called a CAT scan, is done with an x-ray machine that uses a computer to take pictures. The pictures may show if the melanoma has spread. You may be given contrast dye to help the pictures show up better. Tell your healthcare provider if you have ever had an allergic reaction to contrast dye.
• Sentinel node biopsy: This procedure may be done to see if the melanoma has spread to lymph nodes close to the mole.

How is melanoma treated?

• Biological therapy: Biological therapy is used to help your immune system fight the cancer.
• Chemotherapy: Chemotherapy is used to kill cancer cells.
• Radiation therapy: Radiation uses X-rays to kill cancer cells.
• Surgery: You may need surgery to remove melanoma from a larger area of skin. Surgery may also be done if the cancer has spread into the lymph nodes or other parts of your body.

What are the risks of treating melanoma?

During treatment for melanoma, you could get an infection or bleed more than expected during surgery. Treatment may also not be able to kill all the melanoma and even with treatment, the melanoma may come back. If not treated, the melanoma will spread to other parts of your body. Once cancer spreads, it is more difficult to treat, and may become life-threatening.

What questions should I ask my provider about melanoma?

You should talk to your provider about screening options for melanoma. Anyone can get melanoma and melanoma is aggressive, so early detection is critical. By performing a thorough self-skin examination each month and visiting a dermatologist each year for a professional examination, you will be one step ahead in catching melanoma early.

When should I contact my healthcare provider?

• You have a mole that changes in shape, size, color or texture.