Patient education: Melanoma skin cancer (The Basics)

What is melanoma? — 

This is a serious form of skin cancer. It happens when normal cells in the skin change into abnormal cells and grow out of control.

Melanoma can occur anywhere on the skin, including the back and other hard-to-see areas. It can also occur on the skin lining the mouth, nose, and genitals.

When it is not treated, melanoma can spread to organs inside the body. Melanoma can run in families.

What are the symptoms of melanoma? — 

Melanoma often looks like a brown or black mole or birthmark. But melanoma has features that make it different from normal moles and birthmarks.

One way to remember the abnormal features of melanoma is to think of the letters A, B, C, D, and E (picture 1):

●Asymmetry – One half can look different than the other half.

●Border – It can have a jagged or uneven edge.

●Color – It can have a mix of colors (like brown, black, and red).

●Diameter – It is larger than the eraser on the end of a pencil.

●Evolution – Its size, color, or shape can change over time.

Melanomas can also turn into sores that bleed.

Many moles and birthmarks are normal and are not melanoma. But if you have a mole or birthmark you think might be abnormal, show it to your doctor or nurse.

Is there a test for melanoma? — 

Yes. Your doctor or nurse will do an exam and check the skin all over your body.

If they think you have melanoma, you will have a follow-up test called a biopsy. During a biopsy, a doctor usually removes the whole abnormal area. In some cases, they might instead take a small sample of skin from the abnormal area. Either way, another doctor then looks at the removed skin under a microscope to see if the cells are melanoma.

What is melanoma staging? — 

Staging is a way to find out how deep in the skin and how far inside the body the melanoma has spread.

The right treatment for you depends a lot on the stage of your melanoma, as well as your age and other medical problems.

How is melanoma treated? — 

Most people have 1 or more of the following treatments, depending on the stage of their melanoma:

●Surgery – Melanoma is usually treated with surgery to remove the cancer. Most people need more surgery even if the biopsy seemed to have removed the whole abnormal area. During surgery, the doctor might also check nearby lymph nodes to see if the melanoma spread inside the body. Lymph nodes are bean-shaped organs under the skin that store infection-fighting cells.

●Immunotherapy – These are medicines that work with the body's infection-fighting system (the immune system) to stop cancer growth.

●Targeted therapy – This is a group of medicines that work only on cancers with certain characteristics. These medicines usually work by blocking a specific protein or molecule.

●Radiation therapy – This kills cancer cells.

●Chemotherapy – These are medicines that kill cancer cells or stop them from growing.

What happens after treatment? — 

You will be checked regularly to see if the melanoma comes back or if new melanomas appear. Your doctor will do an exam and check your skin all over. They might also order follow-up imaging tests. These create pictures of the inside of the body and can show abnormal growths.

Most doctors also recommend you check your skin every month to look for any changes. It might also help to have a partner, friend, or relative help you. They can check parts of your body that are hard for you to see, like your back. Tell your doctor or nurse if you find any new moles or birthmarks, or if the ones you have look different.

What happens if the melanoma comes back or if a new melanoma appears? — 

You might have more surgery, radiation therapy, chemotherapy, or immunotherapy.

Can melanoma be prevented? — 

You can help prevent it by protecting your skin from the sun. Sun exposure and sunburn are a big cause of melanoma.

To stay safe in the sun and reduce your chance of getting melanoma:

●Stay out of the sun in the middle of the day (from 10 AM to 4 PM).

●Wear sunscreen, and reapply it often.

●Wear a wide-brimmed hat, long-sleeved shirt, or long pants when outside.

●Do not use tanning beds.

Some people are at higher risk for melanoma than others. You might be at higher risk if you have family members who had melanoma or if you had certain abnormal moles in the past. In this case, your doctor might recommend checking your skin yourself every month to look for any changes, plus getting an exam once a year.

What else should I do? — 

Follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Always tell your doctors and nurses how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

●What are the downsides of this treatment?

●Are there other options besides this treatment?

●What happens if I do not have this treatment?

More on this topic

Patient education: Non-melanoma skin cancer (The Basics)
Patient education: Moles (The Basics)
Patient education: Skin lesion removal (The Basics)
Patient education: Chemotherapy (The Basics)
Patient education: Staying safe in the sun (The Basics)

Patient education: Melanoma treatment; localized melanoma (Beyond the Basics)
Patient education: Melanoma treatment; advanced or metastatic melanoma (Beyond the Basics)
Patient education: Sunburn prevention (Beyond the Basics)
Patient education: Sunburn (Beyond the Basics)