Melanoma

Did you know that one person dies of melanoma every hour, every day?

Melanoma is the most serious of all skin cancers. Last year, roughly 7,230 people died from melanoma, and around 192,000 people were diagnosed with this skin cancer. According to the CDC, the incidence of melanoma has doubled in the past three decades in the US. It is the most common of all cancers diagnosed in young adults (ages 25-29) in the US, and it is one of the most common cancers diagnosed in young women.

 

 

What is melanoma?

Melanoma is the most dangerous form of skin cancer. It develops from a certain kind of skin cell found in the upper layer of the skin, called a melanocyte. Melanocytes produce a pigment called melanin, which gives our skin its color. Mutations in melanocytes from DNA damage (typically from UV radiation – either the sun OR tanning beds) results in uncontrolled cellular growth and division, resulting in the development of a melanoma.

 

What are the risk factor for developing melanoma?

Though anyone can develop melanoma at any stage of life, if you fall into one of these following categories, your risk of developing a melanoma is significantly increased:

  • Fair skin
    • This includes skin that freckles or burns easily
  • Light features
    • Including light eyes (blue or green)
    • Light hair (red or blonde)
  • Excessive UV exposure, including:
    • Spending increased amounts of time in the sun
    • History of tanning bed use (this increases your risk of developing a melanoma by 75%)
    • History of sunburns, especially blistering sunburns
  • Personal history of previous skin cancer, both non-melanoma (BCC or SCC) or a previous melanoma
  • Family history of melanoma
    • If a first-degree relative of yours has had a melanoma, you are more likely to develop a melanoma in your lifetime – roughly 10% of all people diagnosed with melanoma have a family history of melanoma
  • Weakened immune system
    • This includes any disease or medication that suppresses your immune system, or having an organ transplant
  • Having more than 50 moles
  • Personal or family history of having atypical moles (what healthcare providers call “dysplastic nevi”)

 

What does melanoma look like?

Melanomas come in all shapes, colors, and sizes. They can arise from within a mole you have, and they can also arise in clinically normal skin with no associated mole. Like non-melanoma skin cancers (BCC & SCC), there are different types of melanomas, which can look very different from one another. Most melanomas are dark in color, with very dark brown or even black pigment. However, some more rare forms of melanoma lack color, or appear as very light tan to pink.  Some are completely flat, and others are nodular, or elevated from the skin. Follow this helpful pneumonic as a guide for recognizing the possible signs of melanoma:

 

The ABCDE’s of Melanoma

A is for Asymmetry: Look for any mole or growth that is asymmetrical – meaning if you cut the lesion in half, the two halves don’t match up

B is for Border: Most melanomas have borders that are jagged and irregular, or “notched” and scalloped. The borders of regular moles will typically be smooth and even.

C is for Color: Most melanomas have more than a single color – they tend to have a few different shades of brown or black. Some melanomas even present as red, white, tan, or blue.

 
D is for Diameter: Typically, regular moles are less than 6mm (think the size of a pencil eraser). If any mole or lesion presents larger than that, it may be a warning sign.

 
E is for Evolving: Any spot that is changing in shape, size, color, or behavior (i.e. bleeding, itching, crusting), in addition to any new spots, need to be evaluated by your provider at Pacific Dermatology & Cosmetic Center.

 

 
How is melanoma removed?

Typically, melanoma is completely curable if it is detected in its early stages. In fact, the five-year survival rate for patients in the U.S. whose melanoma was detected in the early stages is roughly 98%.  However, once melanoma has grown thicker and deeper into the skin or has spread to other parts of the body, it becomes more difficult to treat, and survival rate decreases.  Removal and subsequent procedures / additional treatments are all based on the “stage” of the melanoma. For thin melanomas that are confined to the skin (Stage 0 “in situ” and Stage 1), an excisional surgery to remove the melanoma in its entirety is typically all that is needed. For melanomas with advanced thickness, typically above 0.75mm in depth, a sentinel lymph node biopsy (SLNB) in addition to an excisional surgery may be warranted. A SLNB is a way to determine if the cancer has spread to local lymph nodes. For advanced melanomas (Stages 2,3, and 4), immunotherapies, radiation, and / or chemotherapy may be utilized as “adjuvant” treatment in addition to excisional surgery. In advanced melanoma cases, Seattle Cancer Care Alliance (SCCA) will be a part of your team, to make sure you get the best and most up-to-date treatment for your melanoma.

 
What can I do to prevent melanoma?

  • Limit UV exposure / protect against UV radiation
    • Do not use tanning beds
    • Wear UV protective clothing, sunglasses, and hats
    • Wear a sunscreen daily with at least SPF 30 containing a physical block, re-apply every 2 hours, and immediately re-apply after sweating or swimming
    • Stay in the shade, and avoid the outdoors when the sun’s rays are the strongest (10am-2pm)
  • See your provider at Pacific Dermatology and Cosmetic Center for your full body skin examination (FBSE) at their suggested intervals – most of the time, this is annually – however, it may be as often as every 3 months
  • Do your own monthly self-skin check

Remember, people of all races develop melanoma – though darker-skinned people have a lower overall risk of developing melanoma in their lifetime, they are at higher risk for developing certain types – including melanoma on the palms, soles, and genitalia; in the mouth; and under the nails.

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