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Malignant Melanoma

Melanoma can be a very lethal form of skin cancer. It begins in the melanocytes, the pigment producing cells of the skin, that give skin its color. Most melanomas (70%+) begin in or near an existing mole or dark spot on the skin. Anyone can get a melanoma. Risk factors include fair skin, a history of sunburns, having more than 50 moles, having atypical moles and a family history of melanoma. Melanomas tend to occur in sun-exposed areas in fair skinned individuals. In skin of color, melanoma can occur on the hands, feet, or under the nails. Very rarely, melanoma can even begin in the eyes, in the mouth, in the genital area or in internal organs.

Most melanomas are successfully treated,  if they are detected at an early stage. In advanced melanoma, the cancerous cells spread to other parts of the body (metastasize) and are potentially life threatening. Having a total body skin exam can be a truly life saving doctor’s visit. Patients should also conduct regular self- examination.  During self-examinations, suspicious moles can be recognized using the following algorithm.

A is for asymmetry, meaning a mole is not the same on one side as the other

B is for border irregularity, which refers to a border that is not straight

C is for color variation, meaning more than one color in the same mole

D is for diameter greater than 6mm, roughly the size of a pencil eraser

E perhaps the most important, stands for evolution – a changing mole is a cause for concern.

If a mole has any of the above characteristics, you should bring it to the attention of your dermatologist. Early detection, in most cases,  equates easy cure so it is imperative that you make your doctor aware. Once examined by your dermatologist a biopsy, or sampling of the lesion will be performed. The specimen is then sent to a dermatopathologist that will analyze it under the microscope.  Most melanomas are amenable to treatment by surgical excision with a margin of normal skin surrounding the original biopsy site.  In some cases, where the melanoma is advanced, additional testing including scans and testing of lymph nodes will be performed to determine the extent of spread. If a patient is diagnosed with metastatic melanoma additional surgery, chemotherapy, immunotherapy or radiation may be required.