Melanoma

Melanoma is the most serious form of skin cancer. However, if it is recognized and treated early, it is nearly 100 percent curable.

Melanoma is a malignant tumor that originates in melanocytes, the cells which produce the pigment melanin that colors our skin, hair, and eyes. The majority of melanomas are black or brown. However, some melanomas are skin-colored, pink, red, purple, blue or white.

Signs and Symptoms
Thinking of "ABCD" can help you remember what to watch for:
Asymmetry - the shape of one half does not match the other
Border - the edges are ragged, blurred or irregular
Color - the color in uneven and may include shades of black, brown and tan
Diameter - there is a change in size, usually an increase

click here for interactive tutorials about melanoma


Doctors recommend that people take steps to help prevent and reduce the risk of melanoma caused by UV radiation:

Avoid exposure to the midday sun (from 10 a.m. to 4 p.m.) whenever possible.
When your shadow is shorter than you are, remember to protect yourself from the sun.
If you must be outside, wear long sleeves, long pants, and a hat with a wide brim.
Protect yourself from UV radiation that can penetrate light clothing, windshields, and windows.
Protect yourself from UV radiation reflected by sand, water, snow, and ice.
Help protect your skin by using a lotion, cream, or gel that contains sunscreen.

Many doctors believe sunscreens may help prevent melanoma, especially sunscreens that reflect, absorb, and/or scatter both types of ultraviolet radiation. These sunscreen products will be labeled with "broad-spectrum coverage." Sunscreens are rated in strength according to a sun protection factor (SPF). The higher the SPF, the more sunburn protection is provided. Sunscreens with an SPF value of 2 to 11 provide minimal protection against sunburns. Sunscreens with an SPF of 12 to 29 provide moderate protection.

Those with an SPF of 30 or higher provide the most protection against sunburn.
Wear sunglasses that have UV-absorbing lenses. The label should specify that the lenses block at least 99 percent of UVA and UVB radiation. Sunglasses can protect both the eyes and the skin around the eyes.

Learn how to perform skin self-exam


Diagnosis
A biopsy is the only way to make a definite diagnosis. In this procedure, the doctor tries to remove all of the suspicious-looking growth. This is an excisional biopsy. If the growth is too large to be removed entirely, the doctor removes a sample of the tissue. The doctor will never "shave off" or cauterize a growth that might be melanoma.
A biopsy can usually be done in the doctor's office using local anesthesia. A pathologist then examines the tissue under a microscope to check for cancer cells. Sometimes it is helpful for more than one pathologist to check the tissue for cancer cells.

Staging
If the diagnosis is melanoma, the doctor needs to learn the extent, or stage, of the disease before planning treatment. Staging is a careful attempt to learn how thick the tumor is, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body. The doctor may remove nearby lymph nodes to check for cancer cells. (Such surgery may be considered part of the treatment because removing cancerous lymph nodes may help control the disease.) The doctor also does a careful physical exam and, if the tumor is thick, may order chest x-rays, blood tests, and scans of the liver, bones, and brain.

Stages of melanoma
The following stages are used for melanoma:

Stage 0: In stage 0, the melanoma cells are found only in the outer layer of skin cells and have not invaded deeper tissues.

Stage I: Melanoma in stage I is thin:
The tumor is no more than 1 millimeter (1/25 inch) thick. The outer layer (epidermis) of skin may appear scraped. (This is called an ulceration).
Or, the tumor is between 1 and 2 millimeters (1/12 inch) thick. There is no ulceration.The melanoma cells have not spread to nearby lymph nodes.

Stage II: The tumor is at least 1 millimeter thick:
The tumor is between 1 and 2 millimeters thick. There is ulceration.
Or, the thickness of the tumor is more than 2 millimeters. There may be ulceration.The melanoma cells have not spread to nearby lymph nodes.

Stage III: The melanoma cells have spread to nearby tissues:
The melanoma cells have spread to one or more nearby lymph nodes.
Or, the melanoma cells have spread to tissues just outside the original tumor but not to any lymph nodes.

Stage IV: The melanoma cells have spread to other organs, to lymph nodes, or to skin areas far away from the original tumor.

Recurrent: Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may have come back in the original site or in another part of the body.