13 Things Everyone Should Know About Melanoma
Melanoma is an extremely common form of cancer: It's the second most prevalent for men ages 20 to 39 and the third for women in the same age range. Of the three types of skin cancer, it’s also the most serious. Now for some good news: Melanoma is 98% treatable if you catch it early enough. We share the knowledge you need to protect yourself from melanoma, and to be proactive about your treatment if you are diagnosed.
It’s Cancer of Your Pigment-making Cells
Melanoma happens in your melanocytes, cells that give skin its color by producing a pigment called melanin that helps absorb UV light, protecting your cells from damage. “Think of it like an umbrella that covers your cells,” says Heather Woolery-Lloyd, M.D., director of the skin of color division in the department of dermatology at the University of Miami. But if the melanocytes themselves get damaged, they grow out of control, forming a cancerous tumor (a.k.a. melanoma). On the skin's surface, melanoma typically looks like a dark mole or a pink or colorless bump that doesn’t resemble your other moles.
It’s Can Be the Deadliest of All Skin Cancers
Compared to other types of skin cancers, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), melanoma has a reputation for being the worst of the bunch. “Melanoma can be lethal because it tends to spread very early in its course,” says Darrell S. Rigel, M.D., clinical professor of dermatology at New York University Langone Medical Center in New York City. When melanoma spreads to nearby lymph nodes, the five-year-survival rate is 65%. When it travels to distant organs, it drops to just 25%. Alarming, yes, but click on for some better news.
It’s Highly Curable When Caught Early
When melanoma is detected at an early stage—that is, when it’s only in the top layer of skin and hasn’t yet spread to the lymph nodes and other organs—the only treatment necessary is typically surgical removal. Surgery includes removing the tumor as well as a margin of healthy skin to ensure there are no cancerous cells left lingering. For early-stage melanoma, the five-year-survival rate is 98%, according to The American Cancer Society.
UV Exposure Is the Biggest Culprit
You know this, but it bears repeating: Ultraviolet light, whether from the sun or a tanning bed, is responsible for the majority of melanomas. In fact, 86% of all melanomas stem from UV exposure, a study in the British Journal of Cancer found. “Melanoma is associated with short, intense bursts of sun exposure over time,” says Dr. Woolery-Lloyd. So, sunburns during your annual island vacation, or binge-tanning episodes at the salon back in college can add up to major damage in the DNA of your melanocytes. In fact, just five sunburns in your lifetime doubles your risk of developing melanoma.
Melanoma Can Also Show up Where the Sun Doesn’t Shine
The sun isn’t only to blame for melanoma, because sometimes it appears in areas that rarely see the light of day: the inside of your mouth, your genitals, underneath your nails, on the soles of your feet, and even in organs such as the bladder. How is that possible? Genetics play a strong role. A family history and inherited gene mutations can increase your risk. Those with a first-degree relative with melanoma were 74% likelier to develop it compared to those without one, according to the Journal of the American Academy of Dermatology.
It Affects Men and Women Differently
Both men and women get melanoma, but when, where, and how severe it is may be influenced by your gender. Research has shown that women are more likely than men to get melanoma before the age of 49—most commonly on their legs. But men are more likely to die of it before age 50, according to The Skin Cancer Foundation. That may be because, in males, melanoma often appears on harder-to-monitor areas of the body. After age 50, melanoma is more common in men than women.
There’s More Than One Type of Melanoma
Experts have I.D.’d four categories: Accounting for 70% of all cases, superficial spreading melanoma starts in the skin’s top layer and spreads outwards. It’s thin and flat with an uneven border. Nodular melanoma, which usually shows up as a black, red, pink, or clear raised bump, spreads quickly into the deeper layers of skin. Lentigo maligna melanoma strikes in older people, showing up as a flat, brown splotch that spreads and darkens. Acral lentigo melanoma (ALM) appears on the palms of hands, soles of feet, and inside your nails as black bands.
Most Melanomas Are Brand New Spots
If you’re spending a lot of time tracking existing moles—checking them for any changes in color, texture, or shape—keep doing it, but know this: Melanoma stems from existing moles in less than 30% of cases, research in the Journal of the American Academy of Dermatology has shown. The overwhelming majority are brand new growths. So, scan your body for anything that wasn’t there before; melanomas born from new growths tend to be more aggressive than those that develop in existing moles.
Know Your ABCs (and Ds and Es)
So, how do you spot melanoma? Use the tried-and-trusted ABCDE method.
- A is for asymmetry: An uneven spot is cause for concern.
- B is for border: Irregular borders like jagged edges around the mole are suspicious.
- C is for color: Melanoma can be dark brown or black, red, or even clear bumps or spots.
- D is for diameter: Skin docs should take a closer look at any mole larger than a pencil eraser.
- E is for evolution: If any of your spots are changing in color, size, or texture, make an appointment with a board-certified dermatologist.
Technology Is Making It Easier to Detect Melanoma
Visual skin checks remain the gold standard of melanoma detection, but new technology is making it easier to flag potential problem spots. Imaging apps that rely on artificial intelligence are often used by physicians to catch melanomas. However, “not all melanoma specialists are happy with these because they may provide a false sense of security,” says Dr. Woolery-Lloyd. The best bet: Be vigilant and monitor your own skin, especially if you’re at higher risk of developing skin cancers. Then bring any findings to your doctor’s attention.
Melanoma Is Less Common in Dark Skin, but More Deadly
When it does appear, the prognosis is worse than it is with lighter complexions. Why? “These melanomas tend to show up on the hands or feet, so they’re not always as visible, says Dr. Woolery-Lloyd. “And because melanoma isn’t common in dark skin, this population may not be looking for it, which is why it’s often caught in later stages,” she says. Singer Bob Marley died from ALM in his toenail. “He initially thought it was a soccer injury because it looks like a black-and-blue nail,” Dr. Woolery-Lloyd says.
Bloodwork Can Predict Your Prognosis
Once you’ve been diagnosed, genetic profiling can tell you whether your melanoma is low- or high-risk, and it can be done with a simple blood test, says Joshua Zeichner, M.D., associate professor of dermatology at Mount Sinai School of Medicine in New York City. “This test can give you information on your probability of survival and can help doctors decide whether invasive tests like lymph node biopsies are necessary,” says Dr. Zeichner.
More People Than Ever Are Surviving Melanoma
New cases are on the rise, but deaths from melanoma are expected to decrease by 5.3% this year, according to the American Cancer Society. Sounds hopeful, right? It is. Experts credit recent-ish treatment innovations, including targeted drugs and immunotherapy. Targeted therapies such as BRAF and MEK inhibitors address key proteins that spur melanoma tumors to grow. Immunotherapy boosts one’s supply of T-cells, immune cells that fight cancer. “It’s been unbelievably life-changing,” says Dr. Woolery-Lloyd. Reason for hope!
Five-Year Survival Rates: American Cancer Society. (n.d.). “Survival Rates for Melanoma Skin Cancer.” cancer.org/cancer/melanoma-skin-cancer/detection-diagnosis-staging/survival-rates-for-melanoma-skin-cancer-by-stage.html
Facts and Figures: Skin Cancer Foundation. (n.d.). “Skin Cancer Facts & Figures.” skincancer.org/skin-cancer-information/skin-cancer-facts/
Types of Melanoma: Memorial Sloan Kettering Cancer Center. (n.d.). “Types of Melanoma.” mskcc.org/cancer-care/types/melanoma/types-melanoma
Genetic Profiling: Melanoma Management. (2019). “Prognostic Gene Expression Profiling in Melanoma: Necessary Steps to Incorporate into Clinical Practice.” ncbi.nlm.nih.gov/pmc/articles/PMC6920745/