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Melanoma is a kind of skin cancer in which abnormal skin cells grow out of control. It isn't as common as other types of skin cancer, but it is the most serious because it can spread quickly to other parts of the body.
Most melanomas show up as a new spot or skin growth. But they can also form in an existing mole or other mark on the skin. A melanoma usually looks like a flat mole with uneven edges and a shape that isn't the same on both sides. It may be black, brown, or more than one colour. Less often, melanoma begins in other places, such as the eye or the intestines. In people with darker skin, some of the most common sites are the palms of the hands, the soles of the feet, or underneath the nails.
Too much UV radiation from sun exposure can damage DNA. This can cause normal skin cells to become abnormal. These abnormal cells can quickly grow out of control. Having lighter skin, a family history of melanoma, or many abnormal moles puts you at higher risk for this disease.
You may not have any symptoms in the early stages of melanoma. Or a melanoma may be sore, or it may itch or bleed. Most melanomas start as a new skin growth. But any change in the shape, size, or colour of a mole may be a sign of melanoma.
Source: NCI Visuals Online. Skin Cancer Foundation. www.cancer.gov.
The ABCDEs of melanoma skin cancer are:
Your doctor will check your skin for melanoma. If your doctor suspects melanoma, a sample of tissue (biopsy) will be removed and tested. If your biopsy shows melanoma, you may have more tests to find out if it has spread to your lymph nodes or other places.
Treatment for melanoma is based on the stage of the cancer and other things, such as your overall health. The main treatment is surgery to remove the cancer. Other treatment options may include immunotherapy and targeted therapy. In some cases, chemotherapy and radiation therapy may be used.
The best way to lower your risk for melanoma is to protect your skin whenever you are out in the sun. For example, stay out of the sun during midday hours. Wear sun-protective clothes. Use sunscreen with an SPF of at least 30 every day. Avoid sunbathing and tanning salons.
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What exactly causes melanoma isn't known. But some things, like too much UV radiation from sun exposure, can damage DNA. This can cause normal skin cells to become abnormal. These abnormal cells can quickly grow out of control.
Any of these things can put you at higher risk for this disease:
The best way to lower your risk for melanoma is to protect yourself whenever you are out in the sun.
Check your skin regularly for odd marks, moles, or sores that won't heal. Pay extra attention to areas that get a lot of sun, such as your hands, arms, and back.
You may not have any symptoms in the early stages of melanoma. Or a melanoma may be sore, or it may itch or bleed.
Most melanomas start as a new skin growth on unmarked skin. The growth may change colour, shape, or size. These types of changes are an early sign that the growth is melanoma.
But melanoma can also develop in an existing mole or other mark on the skin. Or it may look like a bruise that isn't healing. Or it might show up as a brown or black streak under a fingernail or toenail.
Melanoma can grow anywhere on the body.
The most important warning sign for melanoma is any change in size, shape, or colour of a mole or other skin growth, such as a birthmark. Watch for changes that occur over a period of weeks to a month. The ABCDE system tells you what changes to look for.
Signs of melanoma in an existing mole include changes in:
With metastatic melanoma, the symptoms may be vague. And any symptoms will likely depend on where the melanoma has spread in the body. Symptoms may include swollen or painful lymph nodes, lumps under the skin, an ongoing cough, swelling or pain in the belly, headaches, or unexplained weight loss.
Melanoma develops when normal cells that produce pigment become abnormal and grow out of control. Then these cells invade surrounding tissues. Melanomas can begin in an existing mole or other skin growth. But most start in unmarked skin.
Melanoma can spread (metastasize). It most often spreads first into nearby lymph nodes. It can also spread through the bloodstream to the skin, liver, lungs, bone, and brain.
When melanoma is found early, it can often be cured by surgery to remove it. But after melanoma spreads, it is harder to cure.
Call your doctor now if you have any of these symptoms:
The most important warning sign for melanoma is a change in size, shape, or colour of a mole or other skin growth (such as a birthmark). Call your doctor if you have:
If you have been diagnosed with cancer, be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
To check for melanoma, your doctor may:
Other techniques may include total-body photography. A series of photos of the suspicious lesions may be taken. These photos can be used as a baseline to compare with follow-up photos.
Skin cancer may be treated more successfully if it is caught early.
Treatment for melanoma is based on the stage of the cancer and other things, such as your overall health. The main treatment is surgery to remove the cancer. Other treatment options may include immunotherapy and targeted therapy.
If melanoma has spread beyond the skin (metastatic cancer), you may have surgery. You'll probably need other treatments too. These may include immunotherapy or targeted therapy. In some cases, radiation therapy or chemotherapy may be used.
Your doctor will talk with you about your options and then make a treatment plan.
The doctor removes the cancer and a border of normal skin (margin) around it. If you have early-stage cancer, the doctor may be able to remove all of it. You may not need more treatment.
If a large melanoma is removed, you may need a skin graft or other repair surgery.
In some cases, one or more lymph nodes may be removed.
After surgery, you may have only regular checkups. Or you may also have other treatments to help prevent a return (recurrence) of the cancer.
Medicines used to treat melanoma include:
Melanoma that has spread to other parts of the body (metastatic cancer) may cause tumours. These can sometimes be removed with surgery. But metastatic melanoma often needs other treatments too. Examples include immunotherapy, targeted therapy, and chemotherapy. These treatments and others may also be used for melanoma that has come back after treatment (recurrent cancer).
Radiation therapy may help relieve symptoms caused by melanoma that has spread to the bones or other organs. Radiation therapy uses high-dose X-rays to destroy cancer cells and shrink tumours.
Clinical trials are research studies that test new treatments to find out how well they work. Your medical team can tell you if there's a clinical trial that might be right for you.
Hospice palliative care is a type of care for people who have a serious illness. It's different from care to cure your illness, called curative treatment. Hospice palliative care provides an extra layer of support that can improve your quality of life—not just in your body, but also in your mind and spirit. Sometimes hospice palliative care is combined with curative treatment.
The kind of care you get depends on what you need. Your goals guide your care. You can get both hospice palliative care and care to treat your illness. You don't have to choose one or the other.
Hospice palliative care can help you manage symptoms, pain, or side effects from treatment. It may help you and those close to you better understand your illness, talk more openly about your feelings, or decide what treatment you want or don't want. It can also help you communicate better with your doctors, nurses, family, and friends.
It can be hard to live with an illness that cannot be cured. But if your health is getting worse, you may want to make decisions about end-of-life care. Planning for the end of your life does not mean that you are giving up. It is a way to make sure that your wishes are met. Clearly stating your wishes can make it easier for your loved ones. Making plans while you are still able may also ease your mind and make your final days less stressful and more meaningful.
Some people use complementary therapies along with medical treatment. They may help relieve the symptoms and stress of cancer or the side effects of cancer treatment. Therapies that may be helpful include:
Talk with your doctor about any of these options you would like to try. And let your doctor know if you are already using any complementary therapies. They are not meant to take the place of standard medical treatment. But they may help you feel better and cope better with treatment.
Relationships take on new importance when you're faced with cancer. Your family and friends can help support you. You may also want to look beyond those who are close to you.
Remember that the people around you want to support you, and asking for help isn't a sign of weakness.
Your friends and family want to help, but some of them may not know what to do. It may help to make a list. For example, you might ask them to:
Places to turn for support include:
CitationsU.S. Preventive Services Task Force (2016). Screening for skin cancer: U.S. Preventive Services Task Force recommendation statement. JAMA, 316(4): 429–435. DOI:10.1001/jama.2016.8465. Accessed July 27, 2016.
Current as of: March 1, 2023
Author: Healthwise StaffClinical Review Board: Kathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineAmy McMichael MD - Dermatology
Current as of: March 1, 2023
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Amy McMichael MD - Dermatology
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