Melanoma

What is melanoma?

Melanoma originates in the cells (melanocytes) that create melanin, the pigment that gives your skin its colour. It is the most dangerous type of skin cancer. Melanoma can also develop in the eyes and, in rare cases, inside the body, such as the nose or throat.

Although the specific aetiology of all melanomas is unknown, ultraviolet (UV) radiation from the sun, tanning lights, and beds increases your risk of acquiring melanoma. Melanoma risk can be reduced by limiting your exposure to UV light.

Melanoma risk appears to be rising in those under the age of 40, particularly among women. Knowing the signs and symptoms of skin cancer will help guarantee that malignant changes are discovered and treated before the disease spreads. Melanoma can be successfully treated if caught early.

The largest organ in the body is the skin. It shields you from the sun, heat, harm, and infection. Water, fat, and vitamin D are all stored in the skin, which also serves to regulate body temperature. The epidermis (upper or outer layer) and the dermis (inner layer) are the two primary layers of the skin (lower or inner layer). The epidermis, which is made up of three types of cells, is where skin cancer develops.

Squamous cells are thin, flat cells that make up the epidermis’ top layer. Basal cells are the round cells that lie beneath the squamous cells. Melanocytes are cells that produce melanin and are present in the epidermis’ bottom layer. Melanin is the pigment responsible for the skin’s natural hue. Melanocytes produce more pigment and cause the skin to darken when exposed to the sun or artificial light.

Over the last 30 years, the number of new instances of melanoma has risen. Melanoma is more commonly detected in adults, however it can also occur in children and adolescents. 

Types of melanoma

Melanoma and nonmelanoma are the two most common types of skin cancer.

Melanoma is a type of skin cancer that is extremely rare. It is more likely than other types of skin cancer to invade surrounding tissues and spread to other parts of the body. Melanoma that begins in the skin is known as cutaneous melanoma. Melanoma can develop in the mucous membranes as well (thin, moist layers of tissue that cover surfaces such as the lips). This PDQ covers cutaneous (skin) melanoma as well as melanoma of the mucous membranes.

Basal cell carcinoma and squamous cell carcinoma are the two most frequent kinds of skin cancer. They’re skin tumours that aren’t melanoma. Skin tumours that aren’t melanoma seldom spread to other parts of the body. (For further information on basal cell and squamous cell skin cancers.

Melanoma is most commonly found on the trunk (the area between the shoulders and hips) or the head and neck in men. Melanoma more commonly develops in the arms and legs in women.

Intraocular or ocular melanoma is melanoma that develops in the eye. 

Symptoms of melanoma

Melanomas can appear on any part of the body. They most commonly appear on regions of the body that have been exposed to the sun, such as the back, legs, arms, and face.

Melanomas can also develop in locations that aren’t exposed to the sun, such as the soles of your feet, palms of your hands, and the beds of your fingernails. People with darker skin are more likely to have concealed melanomas.

The following are common melanoma signs and symptoms:

1. A modification in a mole that already exists.
2. A new pigmented or unusual-looking growth appears on your skin.
3. Melanoma isn’t necessarily the result of a mole. It can also emerge on skin that appears to be normal.

Causes of melanoma

Melanoma develops when something goes wrong in the cells that produce melanin (melanocytes), which give your skin its colour. Skin cells normally develop in a controlled and orderly manner, with healthy new cells pushing out older cells to the surface, where they die and fall off. However, when certain cells sustain DNA damage, new cells may proliferate uncontrollably, eventually becoming a mass of malignant cells.

It’s unclear what causes DNA damage in skin cells and how this leads to melanoma. Melanoma is most likely caused by a mix of factors, including environmental and hereditary factors. Despite this, experts believe that UV radiation from the sun, tanning lights, and beds is the most common cause of melanoma.

All melanomas are not caused by UV light, especially those that develop in areas of your body that aren’t exposed to sunshine. This suggests that other factors may play a role in your melanoma risk.

Treatment of melanoma

The best treatment for your melanoma depends on the size and stage of cancer, your overall health, and your personal preferences.

Treatment for small melanomas

Treatment for early-stage melanomas usually includes surgery to remove the melanoma. A very thin melanoma may be removed entirely during the biopsy and require no further treatment. Otherwise, your surgeon will remove the cancer as well as a border of normal skin and a layer of tissue beneath the skin. For people with early-stage melanomas, this may be the only treatment needed.

Treating melanomas that have spread beyond the skin

If melanoma has spread beyond the skin, treatment options may include:

• Surgery to remove affected lymph nodes. If melanoma has spread to nearby lymph nodes, your surgeon may remove the affected nodes. Additional treatments before or after surgery also may be recommended.

• Immunotherapy. Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process.

  Immunotherapy is often recommended after surgery for melanoma that has spread to the lymph nodes or to other areas of the body. When melanoma can’t be removed completely with surgery, immunotherapy treatments might be injected directly into the melanoma.

• Targeted therapy. Targeted drug treatments focus on specific weaknesses present within cancer cells. By targeting these weaknesses, targeted drug treatments can cause cancer cells to die. Cells from your melanoma may be tested to see if targeted therapy is likely to be effective against your cancer.

  For melanoma, targeted therapy might be recommended if the cancer has spread to your lymph nodes or to other areas of your body.

• Radiation therapy. This treatment uses high-powered energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy may be directed to the lymph nodes if the melanoma has spread there. Radiation therapy can also be used to treat melanomas that can’t be removed completely with surgery.

  For melanoma that spreads to other areas of the body, radiation therapy can help relieve symptoms.

• Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Chemotherapy can be given intravenously, in pill form or both so that it travels throughout your body.

  Chemotherapy can also be given in a vein in your arm or leg in a procedure called isolated limb perfusion. During this procedure, blood in your arm or leg isn’t allowed to travel to other areas of your body for a short time so that the chemotherapy drugs travel directly to the area around the melanoma and don’t affect other parts of your body.