House Call: Understanding the Basics of Melanoma

From OncoLog, January 2006, Vol. 51, No. 1

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Understanding the Basics of Melanoma

You’ve probably heard of melanoma—a dark-pigmented and usually malignant tumor that commonly occurs in the skin—but you may wonder, What is it exactly? What does it look like? What causes it? What can I do to prevent it?

To start with, the incidence of melanoma is rising faster than any other type of cancer. It can occur at any age and is the most common cancer among young adults. Although the majority of melanoma cases involve the skin, there are rare types of melanomas that occur on other places, such as the lining of the inside of the eye, mouth, or rectum.

What is melanoma of the skin?

Melanoma is the most serious of the common skin cancers. The cancerous cells arise from melanocytes (cells that make melanin), which give skin its color. Everyone has these pigment cells, but they can sometimes change, either spontaneously or when damaged by sun exposure. With time, this damage can result in cancer.

What causes melanoma?

Most melanomas are caused by sun damage. The greatest risk for developing melanoma probably comes from sunburns. People with fair skin or those who tend to burn easily are more at risk for sun damage as well as for melanoma. Other factors may also increase the risk, such as a genetic tendency.

What are the symptoms of melanoma?

Any pigmented lesion that undergoes a change in size, shape, or color should be biopsied. The ABCDEs of early diagnosis provide an easy way to become familiar with the early signs of malignant melanoma.

ABCDEs of Early Melanoma Detection

Asymmetry Look for lesions that look different when one side is compared with the other. If you draw a line down the center of the lesion, do the two sides look different?

Border Look at the edges of the lesion. Are the borders jagged?

Color Look for changes in the color of the lesion. Is it getting darker, is part of it changing color, or does it contain several different colors?

Diameter Look at the size of the lesion. Is it more than 6 mm in diameter (the size of a pencil eraser)?

Elevation Look for signs of the lesion becoming raised. Is it growing in height?

What is the main treatment for melanoma?

Melanoma is often curable if detected and treated early. The main treatment for early-stage melanoma is surgery. A thin melanoma is usually treated with a wide local excision of the skin. In this procedure, an area surrounding the melanoma site is removed. Melanomas 1 mm or more in thickness are considered somewhat more serious than thin melanomas and may spread to nearby lymph nodes. A wide local excision is often done together with a lymph node biopsy to check for possible spread. If the melanoma has spread to the lymph nodes, patients may be offered treatment with interferon-alpha, a cytokine that stimulates the body’s immune system. If the melanoma spreads beyond the lymph nodes, treatment is performed with chemotherapy, immune-stimulating cytokines, or a combination of both. Clinical research is currently being conducted to evaluate other methods to treat melanoma, including vaccines and small molecules that target specific growth pathways in the tumor.

How can I prevent future melanomas?

Prior sun exposure, a natural tendency to develop melanomas, or both, can sometimes cause people who have had melanoma before to develop a separate, new melanoma. You cannot necessarily prevent this. However, with regular skin self-exams, you may be able to identify suspicious moles in a very early stage. Any suspicious moles should be evaluated by a physician. Individuals should also limit their sun exposure and avoid sunburn. It is recommended that you limit your sun exposure during the peak periods of ultraviolet light exposure (10:00 a.m.–3:00 p.m.). When outdoors, wear a sunscreen rated at least SPF 30, a broad-brimmed hat, and a long-sleeved shirt.

How can I learn more about melanoma?

Visit The University of Texas M. D. Anderson Cancer Center at www.mdanderson.org/diseases/melanoma and www.mdanderson.org/departments/melanomamed.
Visit the American Melanoma Foundation at www.melanomafoundation.org.
Visit the Melanoma Patients’ Information Page at www.mpip.org.
Call the Anderson Network at (800) 345-6324 to speak with another melanoma patient.

For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.

Other articles in OncoLog, January 2006 issue:

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