What is melanoma?

Melanoma is a kind of skin cancer in which abnormal skin cells grow out of control. It isn't as common as other types of skin cancer, but it is the most serious because it can spread quickly to other parts of the body.

Most melanomas show up as a new spot or skin growth. But they can also form in an existing mole or other mark on the skin. A melanoma usually looks like a flat mole with uneven edges and a shape that isn't the same on both sides. It may be black, brown, or more than one color. Less often, melanoma begins in other places, such as the eye or the intestines. In people with darker skin, some of the most common sites are the palms of the hands, the soles of the feet, or underneath the nails.

You may not have any symptoms in the early stages of melanoma. Or a melanoma may be sore, or it may itch or bleed.

Melanoma usually starts as a new skin growth. But it can develop in an existing mole or other mark. Melanomas can grow anywhere on the body.

The most important warning sign of melanoma is any change in size, shape, or color of a mole or other skin growth. The ABCDE system tells you what to look for.

• A for asymmetry. One half of the mole doesn't match the other half.
• B for border irregularity. The edges are ragged, notched, or blurred
• C for color. The color isn't the same throughout the mole.
• D for diameter. The mole is larger than the size of a pencil eraser
• E for evolution. There's a change in the size, shape, symptoms (such as itching), surface (especially bleeding), or color of a mole.

To check for melanoma, your doctor may:

• Ask you about your medical history and your family history.
• Do a physical exam. This will include checking your skin to look for melanoma.
• Do a skin biopsy. Your doctor will take a sample of your skin and have it tested for melanoma.
• Check your lymph nodes to see if they are larger than normal. This may be followed by a sentinel lymph node biopsy to see if the melanoma has spread to your lymph system.
• Do imaging tests. These tests include PET scan, CT scan, and MRI. These tests can show if the cancer has spread to other parts of your body, such as the lungs, brain, or liver.

Other techniques may include total-body photography. A series of photos of the suspicious lesions may be taken. These photos can be used as a baseline to compare with follow-up photos.

Treatment for melanoma is based on the stage of the cancer and other things, such as your overall health. The main treatment is:

Surgery.

The doctor removes the melanoma and a border of normal tissue.

In some cases, the doctor may remove the first lymph node that the cancer may have spread to. If cancer is found, nearby lymph nodes may be removed and checked for cancer.

Other treatments may include:

Immunotherapy.

This treatment helps your immune system fight cancer.

Targeted therapy.

These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading.

If melanoma has spread (metastatic cancer), treatments may include immunotherapy or targeted therapy. In some cases, options may include surgery, radiation therapy, or chemotherapy. Sometimes a clinical trial may be a good choice.

Your doctor will talk with you about your options and then make a treatment plan.

• Learn the most important warning signs for melanoma—a change in the size, shape, or color of a mole or other skin growth, such as a birthmark.
• Check all the skin on your body once a month for skin growths or other changes, such as changes in color and feel of the skin.
  • Stand in front of a full-length mirror. Look carefully at the front and back of your body. Then look at your right and left sides with your arms raised.
  • Bend your elbows and look carefully at your forearms, the back of your upper arms, and your palms.
  • Look at your feet, the bottoms of your feet, and the spaces between your toes.
  • Use a hand mirror to look at the back of your legs, the back of your neck, and your back, rear end (buttocks), and genital area. Part the hair on your head to look at your scalp.
• If you see a change in a skin growth, contact your doctor. Look for:
  • A mole that bleeds.
  • A fast-growing mole.
  • A scaly or crusted growth on the skin.
  • A sore that will not heal.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• If you have pain, follow your doctor's instructions to relieve it. Pain from cancer can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Do not smoke. Smoking can slow healing. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.

Protect your skin

• Always wear sunscreen on exposed skin. Make sure to use a broad-spectrum sunscreen that has a sun protection factor (SPF) of 30 or higher. Use it every day, even when it is cloudy. While you are outdoors, apply more sunscreen every 2 to 3 hours or anytime your skin gets wet.
• Wear a wide-brimmed hat, a long-sleeved shirt, and pants if you are going to be outdoors for very long.
• Stay out of the sun during the midday hours (10 a.m. to 4 p.m.), when UV rays are strongest.
• Avoid sunlamps and tanning salons.