Michael I. Jacobs, M.D.

Although it is less common than other forms of skin cancer, melanoma (also call malignant melanoma) will grow and spread if left untreated, making it the most dangerous form of skin cancer. However, when detected early, melanoma is highly treatable.

Early detection
Melanomas often develop in existing moles, but they can also appear as a new, unusual-looking pigment or growth on the skin. Especially for people who have a high occurrence of moles, regular self-exams are an important part of early detection. Other symptoms of melanoma can include itching, pain, or bleeding.

If anything is detected that looks like it could possibly be melanoma, an appointment with a dermatologist should be scheduled immediately. Again, early detection is crucial to successful treatment.

Causes
The clearest cause of melanoma is ultraviolet (UV) rays from direct exposure to sunlight or from tanning beds. UV rays can damage the DNA in skin cells, causing them to form abnormal cells that continue to multiply and grow out of control until they form a mass of cancerous cells.

While the exact manner in which this damage takes place and transforms into cancerous cells is not known, there are definite risk factors that increase a person’s chance of forming melanoma:

• Excessive ultraviolet (UV) light exposure from the sun, tanning beds, or sunlamps
• A history of sunburn
• Unusual or numerous moles
• Light-colored skin, hair, or eyes
• Living at a high elevation or close to the equator where the sun’s rays are more direct
• A history of melanoma in the family
• A weakened immune system such as those caused by diseases or by organ transplants

While anyone can get melanoma, the risk of getting melanoma increases in people with these characteristics.

Diagnosis and Treatment
Diagnosis of melanoma begins with a careful examination of the patient’s skin and any suspicious moles or spots, but melanoma cannot be diagnosed accurately without a biopsy, during which a sample or all of the growth is removed and sent to a pathologist to be analyzed.

If melanoma is diagnosed, treatment options will vary depending on the size and stage of the cancer and the patient’s overall health. The first step is the removal of the melanoma through surgery. If the cancer has not spread, a small outpatient or office surgery can be sufficient to remove all of the cancerous cells.

When caught early when the melanoma grows only in the outer layer of the skin, these surgeries are highly successful with a cure rate near 100%.

If the melanoma grows deeper and spreads, treatment becomes more aggressive and complex and can involve immunotherapy, chemotherapy, radiation therapy, or the removal of the lymph nodes.