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Melanoma

The Causes, Symptoms, Treatment and Prevention of Melanoma

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Updated June 26, 2014

Melanoma is a potentially dangerous type of skin cancer. It is diagnosed less frequently than other types of skin cancer (nonmelanoma skin cancer), but has the ability to spread very quickly. Melanoma most often begins on the skin but can develop on the other parts of the body, such as under fingernails, toenails and the eyeball.

Causes and Risk Factors of Melanoma

While we don't know exactly what causes melanoma, we do know that there are risk factors that increase the likelihood that we may develop the disease. Risk factors for melanoma include:
  • unprotected exposure to UV radiation from natural sunlight or artificial sources, such as tanning beds/lamps
  • being white with fair skin and also having naturally red hair
  • family or personal history of melanoma
  • having many moles (more than 50)
  • being older, although it can occur in young people also
  • being male
  • having many freckles
  • a history of sunburns
  • developing freckles easily
Keep in mind that people of all races and complexions can develop melanoma; it is not limited to fair-skinned whites.

Symptoms of Melanoma

Change in an existing mole is usually the first experienced symptom in people with melanoma. A new suspicious skin mole is also something that should raise red flags.

Learning the difference between a normal mole and an abnormal mole can help with self-skin exams at home. The ABCDs of melanoma can help you to discern between what is normal and what may need further evaluation by a dermatologist. The ABCDE rule guidelines instruct you to look for these characteristics in moles:

  • Asymmetry: Normal moles or freckles are completely symmetrical. If you were to draw a line through a normal spot, you would have two symmetrical halves. In cases of skin cancer, spots will not look the same on both sides.

  • Border: A mole or spot with blurry and/or jagged edges.

  • Color: A mole that is more than one hue, color or shade is suspicious and needs to be evaluated by a doctor. Normal spots are usually one color. This can include lightening or darkening of the mole.

  • Diameter: If the mole is larger than a pencil eraser (about 1/4 inch or 6mm), it needs to be examined by a doctor. This includes areas that do not have any other abnormalities (color, border, asymmetry).


Keep in mind that a mole does not have to meet the complete ABCD criteria to be evaluated by a dermatologist. Anything that meets at least one rule should be examined by a health care professional, preferably by a dermatologist.

  • Evolution: Evolution refers to change, and in thw case of melanoma, change to existing moles. Looking for changes in the size, symetry, border, and color.

    Diagnosis of Melanoma

    Diagnosing skin cancer first begins with the discovery of a suspicious mole or change in the appearance of a mole on the skin. Abnormalities can be detected at home through self-skin exams or through a clinical skin exam done by a doctor. A clinical skin exam should be part of your physical, or if you are at a higher risk of melanoma, it should be done more often by a dermatologist.

    If skin cancer is suspected, a biopsy must be done to confirm the presence or absence of cancer. A skin biopsy can be done in several ways, and most of them can be done in-office with a local anesthetic, depending on size and location.

    If biopsy results show the presence of melanoma, more tests may be needed to determine how far the disease has spread. These tests can include chest x-rays, liver function tests and other tests as determined by your physician.

    Treatment of Melanoma

    There are currently four methods of treating melanoma: surgery, chemotherapy, radiation therapy and immunotherapy. Treatment depends on how far the cancer has spread, age and overall general health.

    For those with early stages of melanoma, surgery to remove the area in question, along with a small margin of healthy surrounding tissue, may be all that is needed for treatment. This may also include having a sentinel node biopsy to ensure that the cancer has not spread.

    If the cancer is more advanced and has spread, chemotherapy and immunotherapy may be necessary for treatment. Radiation therapy may be used in select cases.

    Prevention of Melanoma

    Skin cancer may be the most common type of cancer, but it is also the most preventable types as well. The first step in preventing skin cancer is to avoid UV ray exposure. We can do this by:

    Wearing Sunscreen. You have heard it a million times, but sunscreen really is one of your best bets in preventing skin cancer, especially if you spend a lot of time outdoors. Experts recommend choosing a sunscreen that is at least SPF 15 or higher. Don't forget to reapply every two hours, after swimming, and if you become sweaty.

  • Avoiding Mid-Day Sun. Avoid going outdoors from 10 a.m. to 4 p.m. This is when the sun's rays are brightest, causing the most damage to skin. If you have to go outdoors, be sure to lather on sunscreen.
    Wearing Protective Clothing. Wearing hats and clothing that cover the skin are excellent ways to reduce your risk of skin cancer. Eyes are also susceptible to sun damage, so be sure to wear sunglasses that have UV protection.

    Staying Shady. Staying in the shade will not only keep you cooler, it will reduce your risk of UV exposure. Though you are in the shade, you will still need to wear sunscreen.

    Avoiding Tanning Beds/Booths. Artificial UV exposure is not any safer than natural exposure. Some studies even suggest that tanning beds and booths increase your risk of melanoma, a dangerous form of skin cancer.

    Sources:

    "Skin Cancer Symptoms". What You Need to Know About Skin Cancer. National Cancer Institute. 01 Aug 2005. Accessed 21 June 2008.

    "Skin Cancer Prevention". What You Need to Know About Skin Cancer. National Cancer Institute. 01 Aug 2005. Accessed 25 June 2008.

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