Melanoma

April 24, 2003
Reviewed Oct. 24, 2005

What is melanoma?

Dr. Vercellotti: Melanoma is a form of skin cancer, affecting the pigment-producing cells of the skin, the melanocytes. It is more serious than other common skin cancers because it can spread through the lymph system or the blood to other parts of the body. It accounts for only 4 percent of all skin cancer cases, but is the leading cause of all skin cancer-related deaths. Risk increases with age, but affects all age groups. The incidence rate for melanoma has more than doubled from 5.7 in 1973 to 14.3 per 100 000 today. The good news is that if detected and treated at an early stage, melanoma is often curable.

What causes melanoma?

Dr. Vercellotti: No one knows exactly what causes melanoma but one of the main risk factors is spending too much time in the sun and tanning booths with exposure to ultraviolet radiation.

"Weekend tanners" exposed to intense sun rays over a short period of time are more at risk than those who have a more consistent daily sun exposure. Painful, blistering sunburns especially in childhood or adolescence can put people at risk for the development of melanoma later in life. People with fair skin, blonde or red hair, light eyes, and freckles are at greater risk.

An increased risk of melanoma can also run in families. Dysplastic nevus syndrome is a tendency to develop many abnormally sized or shaped moles all over the body. A family history of two or more relatives with melanoma also implies an increased risk.

A weakened immune system due to certain cancers, immunosuppressive therapy associated with organ transplantations, and HIV/AIDS also are associated with an increased risk of melanoma.

What can I do to reduce my risk?

Dr. Vercellotti: Fortunately, almost all skin cancer and most melanomas can be prevented by minimization of sunlight exposure, particularly in the early years of life, from birth to age 20. Protect yourself by wearing wide-brimmed hats, long-sleeved shirts, and long pants.Use a sunscreen with a sun protection factor (SPF) of 15 or higher on all exposed skin--at all times, even in the winter. Those under 18 should not use tanning booths.

Another key to fighting skin cancer is early detection. People have a 90 percent chance of survival if melanoma is detected in its early stages. The American Cancer Society recommends that people between the ages of 20 and 40 have a skin check-up every three years and people age 40 and older have one every year. A self-examination of the skin is also important to detect new growths or other changes.

How do I detect melanoma?

Dr. Vercellotti: Use a handheld mirror to help you view areas that are difficult to see; examine all moles or markings and look for any changes in the number, size, shape or color of these markings. Any skin changes like oozing, bleeding, a spot that is itchy or hard, or an open sore that lasts for more than four weeks, or heals and then reopens, should be brought to your doctors attention. Contact your doctor immediately if you notice any changes.

Dr. Vercellotti: Infants, children, and teens who get sunburned may not see the long-term damaging effects for many years. Protecting your skin during the first 18 years of life can reduce the risk of some types of skin cancer by up to 78 percent. Special sunscreens are available for babies and children under 6 years of age. Babies 6 months or younger should be kept out of the sun whenever possible.

What should I do if I'm diagnosed with melanoma?

Dr. Vercellotti: If you have been diagnosed with melanoma, make sure you have an open discussion with your doctor. The choice of treatment will be based on your age and general health, as well as how far the cancer has progressed. Removal of the tumor is the first step for all stages. If you have detected melanoma early, minor surgery is often sufficient. Major surgery, including removal of lymph nodes in the neck, groin or armpits, might be needed if detected at a later stage. Other treatments include chemotherapy, radiation therapy, and immunotherapy. University of Minnesota researchers are also attempting to develop a melanoma vaccine, which wouldnt prevent melanoma but would help in destroying the cancer and preventing its return.

For more information on melanoma, click on the following links:

http://www.nlm.nih.gov/medlineplus/tutorials/melanoma/oc199101.html

http://www.mpip.org/guide/suspindex.html

The Most Common Cancer Can be Prevented
by Dr. Peter Lee, University of Minnesota.

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