Health Conditions and Diseases

What Is Melanoma? Types, Stages, Symptoms, Causes, And Treatment

Medically reviewed by Dr. Ramon Andrade de Mello, MD, FACP, PhD and Joel Kahn, MD
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What Is Melanoma? Types, Stages, Symptoms, Causes, And Treatment Hyderabd040-395603080 June 10, 2019

Melanoma is the 19th most common type of cancer worldwide. Cutaneous melanoma is the most common subtype of melanoma that accounts for more than 90% of the cases (1).

Did you notice a new mole on your skin while taking a shower? Does this mole look abnormal? And did you panic, wondering if this is a sign of skin cancer? If you want to know if this mole is cancerous and the different treatments available for treating melanoma, read on!

Table Of Contents

What Is Melanoma?

Melanoma is one of the most serious types of skin cancer. It develops in the cells responsible for producing melanin. Melanin is the pigment that determines the color of your skin.

Melanoma can also form in your eyes. In rare cases, it may also affect your internal organs, such as your intestines.

The risk of melanoma is increasing in individuals below 40 years of age. This is especially true in the case of women.

There are mainly four types of melanoma.

Types Of Melanoma

The different types of melanoma are (2):

  • Superficial Spreading Melanoma – This is the most common type of melanoma that commonly affects the arms, legs, chest, and back.
  • Nodular Melanoma – It is the second most common type of melanoma and can spread quickly compared to other melanomas. Nodular melanoma is likely to lose color as it grows, turning red from black.
  • Lentigo Maligna Melanoma – It is often found in older people who have had a lot of exposure to the sun over the years. It is less common and is mostly found on the face and neck. It is a result of a progressing precancerous condition called lentigo maligna or Hutchinson’s melanotic freckle and looks like a stain on the skin.
  • Acral Lentiginous Melanoma – This is the rarest type of melanoma that may be found on the palms, soles of the feet, or under the nails. This type is more common among people whose skin tone is brown or black.

Depending on how far the cancer has spread and what kind of treatment is best suited to cure it, melanoma can be classified into different stages.

Melanoma Facts

  • Melanoma is the deadliest form of skin cancer.
  • Melanoma does not just affect the skin. It can also occur in your eyes, scalp, nails, feet, mouth, etc.
  • Melanoma is the leading cause of death in young women aged 25-30.
  • About 90% of melanomas are believed to be caused by exposure to the sun.
  • Just one blistering sunburn can double a person’s risk of developing melanoma later in life.

Stages Of Melanoma

Melanoma can be classified into five stages (3). They are:

  • Stage 0 – The cancer is confined to the outermost layer of the skin. It is known as melanoma in situ.
  • Stage 1 – The cancer has progressed to Stage 1 if it is 2 mm thick. It has not spread to the lymph nodes or other sites, and the cancer may or may not be ulcerated.
  • Stage 2 – In this stage, the cancer will at least be 1.01 mm thick and may progress to being thicker than 4 mm.
  • Stage 3 – By the time cancer reaches this stage, it would have spread to one or more of the lymph nodes or the lymphatic channels nearby. The original cancer may not be visible anymore. But if it is visible, it will be thicker than 4 mm and may even be ulcerated.
  • Stage 4 – In this stage, the cancer progresses and would have spread to the nearby as well as distant lymph nodes or organs like the brain, lungs, and/or liver.

As in the case of almost all other cancers, melanoma can be quite difficult to detect in its early stages. Hence, it is important to keep checking your skin actively for changing signs.

The common signs and symptoms that may be exhibited in those who have melanoma are discussed below.

Signs And Symptoms

Any change in the appearance of your skin is one of the main indicators of melanoma. This may include (4):

  • Appearance of a new spot or mole
  • Changes in the shape, color, or size of an existing spot/mole
  • The spot or mole has become painful, itchy, tender, or has started bleeding
  • Any spot/lump that has begun to look shiny, waxy, smooth, or pale
  • Appearance of a red lump that either bleeds or appears ulcerated/crusty
  • A spot that is flat and red with a rough, dry, or scaly surface

The above symptoms do not necessarily mean that you have melanoma. They could also be a result of other conditions. However, it is better to consult a doctor to rule out the possibility of melanoma.

Research is ongoing to find out the exact cause of melanoma. However, some factors are associated with an increased risk of skin cancer.

Causes And Risk Factors

Abnormal melanocytes are one of the main causes of melanoma. These melanin-producing cells are responsible for giving your skin its color.

Usually, your skin cells develop in an orderly way, where the new cells push the old ones to the surface. The old cells die and eventually fall off the surface of your skin. However, when cells act abnormally, they can grow out of control, eventually forming a mass of cancerous cells.

While what exactly damages the DNA in skin cells and how this can lead to melanoma isn’t clear, it is quite likely that a combination of environmental and genetic factors could be triggering it.

Some factors that can increase your risk of developing melanoma are (4):

  • Fair Skin: Fair complexion is an indication that your skin has less melanin. If you have blonde or red hair and light-colored eyes and develop a sunburn easily, you are at a higher risk of developing melanoma as compared to those with darker complexions.
  • History of sunburn
  • Excessive exposure to UV radiation from the sun or tanning lights/beds
  • If you live at a high altitude or closer to the equator, your chances of developing melanoma are higher.
  • A family history of melanoma
  • A weakened immune system
  • Advancing age

If you can relate to any of the above risk factors and have developed any of the symptoms discussed here, waste no time in seeing a doctor or dermatologist to find out the root cause of these changes.

Diagnosis

The ABCDE examination is a popular way to assess the suspected lesions for malignancy. It includes five characteristics to look out for to detect melanoma. They are (5):

  • Asymmetric – Normal moles are often round and symmetrical. But a cancerous mole may look different from one of the sides and is almost never round or symmetrical.
  • Border – It is quite likely to be irregular than smooth. It might be blurred, ragged, or notched.
  • Color – Melanomas are almost never in a single color. They may be present in uneven shades and colors like varying black, brown, or tan. Some may even have white or blue pigmentation.
  • Diameter – Moles that become larger in diameter, say, more than a quarter inch, are another indication of skin cancer.
  • Evolving – Changes in the appearance of a mole over a few weeks or months can also be an indication of skin cancer.

Other than the ABCDE examination, your doctor may also conduct an overall physical examination to look for changes in the skin in areas like your back, chest, etc.

Microscopic or photographic tools may be used to view a lesion. If skin cancer is suspected, you may be referred to a cancer specialist. Following this, a biopsy may be arranged to test the suspected lesion. A biopsy involves taking a sample of the suspected tissue and sending it to the laboratory for further examination.

If you have been diagnosed with melanoma, your doctor will discuss the available treatment options with you, depending on the stage of the cancer.

How To Treat Melanoma

Treatment for melanoma is more or less similar to the treatments for other cancers. However, melanoma is rather easy to treat, unlike many internal cancers.

Surgery is the most common treatment for skin cancer (4). It involves removing the lesion along with the normal tissue surrounding it.

If the cancer has spread to a large area of the skin, it may become necessary to do a skin graft, in which healthy skin is transplanted onto the site of the surgery. If melanoma ends up penetrating the lymph nodes, a lymph node biopsy may be conducted.

Other less common treatment procedures for melanoma include (4):

  • Chemotherapy
  • Biological Therapy – Involves the use of drugs that work with the immune system
  • Targeted Therapy – Uses drugs to turn off the genes in the abnormal melanoma cells. However, this treatment was observed to stop working with time.
  • Photodynamic Therapy – May be prescribed in rare cases. This involves using a combination of light, drugs, and radiation.

These treatments have certain side effects (6). They are discussed below.

Side Effects Of Melanoma Treatment

  • Nausea
  • Hair loss
  • Increased sensitivity to hot/cold climate
  • Risk of recurrence
  • Mouth sores
  • Bruising
  • Bleeding
  • Infections
  • Fatigue
  • Changes in your appetite
  • Constipation or diarrhea
  • Itchiness
  • Rashes

As we are aware, synthesis of vitamin D is largely associated with sun exposure. However, if you are diagnosed with melanoma, you may be asked to stay away from the sun. Why?

Vitamin D And Sun Protection After Melanoma

Those diagnosed with melanoma are often advised to avoid too much exposure to the sun. This is mainly because of two reasons:

  • It reduces the risk of recurrence of melanoma.
  • It can lead to sunburn in those with lighter skin tone, thus causing the immune system to function abnormally.

But, vitamin D is important for many functions of your body. Hence, you should avoid intense sun exposure but get enough to facilitate your body to produce enough vitamin D.

You can achieve this by:

  • Avoiding sun exposure for long periods.
  • Avoiding unprotected exposure to the sun between 10 am and 4 pm.
  • Using a sunscreen with SPF 30 or above.
  • Using appropriate clothing whenever you are out in the sun to minimize exposing your skin to the sun.

Melanoma can also recur post-treatment in some individuals. The following are some tips that can help prevent the recurrence of melanoma.

Tips To Lower Your Risk For Melanoma

  • Wear sunscreen all year round. Use a broad-spectrum sunscreen with an SPF of at least 30.
  • Apply the sunscreen at least 30 minutes before sun exposure and reapply every two hours and immediately after swimming.
  • Wear protective clothing.
  • Avoid exposure to the sun between 10 am and 4 pm.
  • Avoid using tanning lamps and/or beds.
  • Pay close attention to any changes in your skin.
  • Avoid getting sunburns.

Melanoma is indeed scary. One of the best ways to reduce the risk of this cancer is to steer clear of the sun and/or UV rays. So, as tempting as it may be to bask under the sun, don’t overdo it.
Did you find this post helpful? Let us know in the comments below.

Expert’s Answers For Readers’ Questions

When to see a doctor for melanoma?

If you notice any of the symptoms associated with melanoma like changes in the shape, size, or color of an existing mole, see a doctor immediately to rule out the possibilities of melanoma.

How long do you live after being diagnosed with melanoma?

The life expectancy of an individual depends on the stage at which melanoma is diagnosed. About 90% of the affected individuals survive for 5-10 years or more if melanoma is diagnosed at an early stage. This percentage may drop to 10-20% if melanoma is detected at an advanced stage.

What is the most effective treatment for melanoma?

Surgery is one of the best and most common treatments for melanoma. This may be used in combination with immunotherapy or targeted therapy to prevent the recurrence of the cancer.

Can melanoma be cured if caught early?

Yes, most melanomas can be cured if caught early.

Can you get skin cancer from lack of vitamin D?

While vitamin D is associated with the prevention of certain cancers, its association with skin cancer remains unclear.

Does melanoma itch?

One of the many symptoms associated with melanoma is itching of the affected area or lesion.

Does melanoma spread?

If left untreated for too long, melanoma can progress to the advanced stages and spread to the nearby as well as distant lymph nodes and organs.

References

  1. Melanoma epidemiology, biology and prognosis” EJC Supplements, US National Library of Medicine.
  2. Malignant Melanoma: A Pictorial Review” The Ulster Medical Journal, US National Library of Medicine.
  3. Melanoma Skin Cancer Stages” American Cancer Society.
  4. Melanoma Treatment (PDQ®)” National Cancer Institute, US National Library of Medicine.
  5. Precision Diagnosis Of Melanoma And Other Skin Lesions From Digital Images” AMIA. Joint Summits on Translational Science Proceedings, US National Library of Medicine.
  6. Side Effects of Cancer Treatment” National Cancer Institute, National Institutes of Health.

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