Melanoma

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

Most melanomas start as a new skin growth on unmarked skin. The growth may change color, shape, or size. These types of changes are an early sign that the growth is melanoma.

But melanoma can also develop in an existing mole or other mark on the skin. Or it may look like a bruise that isn't healing. Or it might show up as a brown or black streak under a fingernail or toenail.

Melanoma can grow anywhere on the body.

• It most often occurs on the upper back in men and women and on the legs in women.
• In older people, the face is the most common place for melanoma to grow. And in older men, the most common sites are the neck, scalp, and ears.
• Less often, melanoma grows in other places. These include the soles of the feet, the palms of the hands, nail beds, or mucous membranes such as the mouth, the rectum, and the vagina.

The most important warning sign for melanoma is any change in size, shape, or color of a mole or other skin growth, such as a birthmark. Watch for changes that occur over a period of weeks to a month. The ABCDE system tells you what changes to look for.

• Asymmetrical (newly uneven)
• Border (newly irregular)
• Color (multiple colors)
• Diameter (moles greater than ¼ inch are more likely to become cancerous)
• Evolution (changes in mole)

Signs of melanoma in an existing mole include changes in:

• Elevation, such as thickening or raising of a previously flat mole.
• Surface, such as scaling, erosion, oozing, bleeding, or crusting.
• Surrounding skin, such as redness, swelling, or small new patches of color around a larger lesion (satellite pigmentations).
• Sensation, such as itching, tingling, burning, or pain.
• Consistency, such as softening or small pieces that break off easily.

Too much UV radiation from sun exposure causes normal skin cells to become abnormal. These abnormal cells quickly grow out of control and attack the tissues around them.

You can get melanoma by spending too much time in the sun. You are at higher risk for melanoma if you have any of these:

• Fair skin
• A family history of melanoma
• Many abnormal, or atypical, moles. These moles may fade into the skin and have a flat part that is level with the skin. They may be smooth or slightly scaly. Or they may look rough and "pebbly."  

Your doctor will check your skin for melanoma. If your doctor suspects melanoma, he or she will remove a sample of tissue (biopsy) and have it tested. If your biopsy shows melanoma, you may have more tests to find out if it has spread to your lymph nodes or other places.

How much and what type of treatment you need depends on the stage of the cancer. Melanoma may be cured if it's treated in its early stages, before it has spread.

The most common treatment is surgery to remove the melanoma. The entire melanoma is removed, along with a border of normal-appearing skin. Surgery may be all you need for early-stage melanomas. Other treatments may include:

• Chemotherapy
• Immunotherapy (using medicine to help your immune system fight the cancer)
• Targeted therapy with inhibitors (These medicines inhibit, or prevent cancer cells from growing by blocking signals in the cell. Inhibitors are only given if genetic testing shows that a person has certain gene mutations.)

Your treatment will depend on age, overall health, cancer stage, cancer size and location, and other factors.