Melanoma, is one of the more serious types of skin cancer. It develops in the cells (melanocytes) that produce melanin — the pigment that gives your skin its color. Melanoma can also form in your eyes and, rarely, in internal organs, such as your intestines.
The exact cause of all melanomas is not clear, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds increases your risk of developing melanoma. Limiting your exposure to UV radiation can help reduce your risk of melanoma.
The risk of melanoma seems to be increasing in people under 40, especially women. Knowing the warning signs of skin cancer can help ensure that cancerous changes are detected and treated before the cancer has spread. Melanoma can be treated successfully if it is detected early.
Ask your doctor whether you should consider periodic screening for skin cancer. You and your doctor may consider screening options such as:
Some medical organizations recommend periodic skin exams by your doctor and on your own. Others do not recommend skin cancer screening exams because it is not clear whether screening saves lives. For example, finding an unusual mole could lead to a biopsy. If that mole is found to not be cancerous, the whole process could lead to unnecessary pain, anxiety and cost. Talk to your doctor about what screening is right for you based on your risk of skin cancer.
The only way to accurately diagnose melanoma is with a biopsy. In this procedure, all or part of the suspicious mole or growth is removed, and a pathologist analyzes the sample.
Biopsy procedures used to diagnose melanoma include:
The type of skin biopsy procedure you undergo will depend on your situation. Doctors prefer to use punch biopsy or excisional biopsy to remove the entire growth whenever possible. Incisional biopsy may be used when other techniques cannot easily be completed, such as if a suspicious mole is very large.
If you receive a diagnosis of melanoma, the next step is to determine the extent (stage) of the cancer. To assign a stage to your melanoma, your doctor will:
During a sentinel node biopsy, a dye is injected in the area where your melanoma was removed. The dye flows to the nearby lymph nodes. The first lymph nodes to take up the dye are removed and tested for cancer cells. If these first lymph nodes (sentinel lymph nodes) are cancer-free, there is a good chance that the melanoma has not spread beyond the area where it was first discovered. Cancer can still recur or spread, even if the sentinel lymph nodes are free of cancer.
Other factors may go into determining the aggressiveness of a melanoma, including whether the skin over the area has formed an open sore and how many dividing cancer cells are found when looking under a microscope.
Melanoma is staged using the Roman numerals I through IV. A stage I melanoma is small and has a very successful treatment rate. But the higher the numeral, the lower the chances of a full recovery. By stage IV, the cancer has spread beyond your skin to other organs, such as your lungs or liver.
The best treatment for you depends on the size and stage of cancer, your overall health, and your personal preferences.
Treating early-stage melanomas
Treatment for early-stage melanomas usually includes surgery to remove the melanoma. A very thin melanoma may be removed entirely during the biopsy and require no further treatment. Otherwise, your surgeon will remove the cancer as well as a border of normal skin and a layer of tissue beneath the skin. For people with early-stage melanomas, this may be the only treatment needed.
Treating melanomas that have spread beyond the skin
If melanoma has spread beyond the skin, treatment options may include: