Melanoma is an aggressive form of skin cancer that originates in the melanocytes, the pigment-producing cells of the skin. It is the most serious type of skin cancer due to its high potential to spread (metastasize) to other parts of the body if not detected early. Melanoma can develop anywhere on the skin but is most common in areas exposed to the sun, such as the face, arms, and legs. However, it can also occur in less exposed areas, such as the soles of the feet, palms, and under the nails.
Melanoma begins when melanocytes undergo genetic mutations that cause uncontrolled cell growth. The exact cause of these mutations is not always clear, but excessive exposure to ultraviolet (UV) radiation from the sun or tanning beds significantly increases the risk.
Key Points:
Most serious type of skin cancer – Can spread rapidly if untreated.
Early detection is crucial – High survival rates when caught in early stages.
UV exposure is the primary risk factor – Sunlight and tanning beds increase the risk.
Can appear anywhere on the body – Not limited to sun-exposed areas.
ABCDE rule helps in early identification – Asymmetry, Border irregularity, Color variation, Diameter over 6mm, and Evolving shape or color.
While the exact cause of melanoma is unknown, several risk factors contribute to its development:
Excessive UV radiation exposure – Sunlight and tanning beds increase melanoma risk.
Fair skin, light hair, and eye color – Individuals with less melanin have a higher susceptibility.
History of sunburns – Severe blistering sunburns increase melanoma risk.
Weakened immune system – People with suppressed immune systems (e.g., organ transplant recipients) are more vulnerable.
Family history of melanoma – Genetic predisposition plays a significant role.
Many moles or atypical moles – Individuals with a large number of moles are at a higher risk.
Older age – More common in older adults but can occur at any age.
Gender – More common in men than women in older age groups.
Melanoma often presents as an unusual mole or pigmented lesion on the skin. Recognizing changes early can lead to timely treatment.
Common Symptoms:
A new or changing mole
A mole that is asymmetrical
Irregular or poorly defined borders
Multiple colors within the same mole
A mole larger than 6mm in diameter
Itching, tenderness, or bleeding in a mole
A rapidly growing skin lesion
The ABCDE Rule for Identifying Melanoma:
A – Asymmetry (one half differs from the other)
B – Border irregularity (uneven or blurred edges)
C – Color variation (multiple shades in one mole)
D – Diameter greater than 6mm
E – Evolution (changes in size, shape, or color over time)
Melanoma is classified based on its growth pattern and severity:
Superficial Spreading Melanoma (Most Common)
Spreads along the top layer of skin before penetrating deeper.
Often found on the trunk and legs.
Nodular Melanoma
Grows rapidly and penetrates deeper layers of skin.
Appears as a dark, raised bump.
Lentigo Maligna Melanoma
Common in older adults.
Develops on sun-damaged skin, such as the face.
Acral Lentiginous Melanoma
Less common but aggressive.
Appears on the palms, soles, and under nails.
More common in individuals with darker skin.
Early diagnosis significantly improves treatment outcomes. If melanoma is suspected, a doctor may perform the following tests:
Skin Examination – A dermatologist checks for suspicious moles or growths.
Dermoscopy – A special magnifying tool is used to examine skin lesions.
Biopsy – A sample of skin tissue is taken for laboratory analysis.
Sentinel Lymph Node Biopsy – Determines if cancer has spread to nearby lymph nodes.
Imaging Tests (CT, MRI, PET scan) – Used to detect metastasis.
The choice of treatment depends on the stage and extent of melanoma.
Surgery
Excision: Removal of melanoma along with a margin of healthy tissue.
Lymph Node Dissection: Removal of affected lymph nodes if cancer has spread.
Immunotherapy
Helps the immune system recognize and attack melanoma cells.
Common drugs: Pembrolizumab, Nivolumab.
Targeted Therapy
Used for melanomas with specific genetic mutations (e.g., BRAF mutations).
Common drugs: Vemurafenib, Dabrafenib.
Radiation Therapy
Used in advanced cases or after surgery to kill remaining cancer cells.
Chemotherapy
Less commonly used but may be recommended for advanced melanoma.
The prognosis of melanoma depends on the stage at diagnosis:
Stage 0 (In Situ): Nearly 100% 5-year survival rate.
Stage I (Localized): 90-95% survival rate.
Stage II (High-Risk Localized): 70-80% survival rate.
Stage III (Lymph Node Involvement): 40-60% survival rate.
Stage IV (Metastatic): Less than 20% survival rate.
Early detection is key – The earlier melanoma is diagnosed, the higher the chances of successful treatment.
While melanoma cannot always be prevented, these steps can lower the risk:
Limit sun exposure – Avoid direct sunlight between 10 AM and 4 PM.
Use sunscreen – Broad-spectrum SPF 30+ sunscreen reduces UV damage.
Wear protective clothing – Hats, sunglasses, and long sleeves shield the skin.
Avoid tanning beds – Artificial UV radiation increases melanoma risk.
Regular skin checks – Self-examine and consult a dermatologist annually.
Coping with melanoma requires both physical and emotional adjustments. Patients should consider the following:
Regular follow-ups – Monitoring for recurrence or new melanomas.
Healthy diet and exercise – Strengthening the immune system.
Sun protection – Wearing sunscreen and protective clothing.
Emotional support – Joining support groups or seeking counseling.