Melanoma (Skin Cancer): Causes, Symptoms, Diagnosis & Treatment

Introduction to Melanoma: What Is It?

Melanoma is a serious type of skin cancer that develops in melanocytes, the cells responsible for producing melanin (the pigment that gives skin its color). While less common than other skin cancers, melanoma is more dangerous because it can spread quickly to other organs if not treated early.

Unlike basal cell or squamous cell carcinomas, melanoma often appears as an unusual mole or dark spot on the skin. It can occur anywhere on the body, including areas not exposed to the sun, such as the soles of the feet or under nails. Early detection is crucial—when caught early, melanoma has a high survival rate.

Risk factors include excessive UV exposure, fair skin, a history of sunburns, and genetic predisposition. Understanding melanoma helps in recognizing warning signs and seeking timely medical intervention.

Causes and Risk Factors of Melanoma

Melanoma develops when DNA damage in melanocytes triggers mutations, leading to uncontrolled cell growth. The primary cause is UV radiation from sunlight or tanning beds, which damages skin cells. However, not all melanomas are sun-related—some arise due to genetic factors.

Key risk factors include:

• Excessive sun exposure: Frequent sunburns, especially in childhood, increase risk.
• Fair skin: Less melanin means less natural protection against UV rays.
• Family history: A family history of melanoma raises susceptibility.
• Weakened immune system: Immunosuppressed individuals are at higher risk.
• Moles: Having many moles or atypical moles (dysplastic nevi) increases risk.

While some factors (like genetics) can’t be changed, minimizing UV exposure and regular skin checks can significantly reduce risk.

Signs and Symptoms: How to Recognize Melanoma

Melanoma often appears as a new or changing mole. The ABCDE rule helps identify suspicious spots:

• A (Asymmetry): One half doesn’t match the other.
• B (Border): Irregular, blurred, or jagged edges.
• C (Color): Uneven shades of brown, black, red, or white.
• D (Diameter): Larger than 6mm (about the size of a pencil eraser).
• E (Evolving): Changes in size, shape, or texture over time.

Other warning signs include:

• A sore that doesn’t heal.
• Spread of pigment beyond a mole’s border.
• Itching, tenderness, or bleeding in a mole.

If you notice any of these signs, consult a dermatologist immediately. Early detection saves lives.

Diagnosis: Tests and Procedures for Detection

Diagnosing melanoma involves a combination of physical exams and medical tests:

1. Skin Examination: A dermatologist checks moles using the ABCDE criteria.

2. Dermoscopy: A handheld device magnifies the skin for detailed analysis.

3. Biopsy: If a mole looks suspicious, a sample is taken for lab testing. Types include:

• Shave biopsy: Shaving off the top layers of the mole.
• Punch biopsy: Removing a small cylindrical sample.
• Excisional biopsy: Cutting out the entire mole and some surrounding tissue.

4. Imaging Tests (if needed): CT scans, MRIs, or PET scans check for cancer spread.

Early and accurate diagnosis is key to effective treatment.

Stages of Melanoma: Understanding Progression

Melanoma is staged from 0 to IV based on thickness, ulceration, and spread:

• Stage 0 (In situ): Cancer is only in the top skin layer.
• Stage I & II: Localized to the skin but may be thicker.
• Stage III: Spread to nearby lymph nodes.
• Stage IV: Metastasized to distant organs (lungs, liver, brain).

Staging determines treatment options and prognosis. Early-stage melanoma (I/II) has a 5-year survival rate of over 90%, while advanced stages require aggressive therapy.

Treatment Options: Surgery, Therapy & More

Treatment depends on the stage and location of melanoma:

1. Surgery: The primary treatment for early-stage melanoma. Options include:

• Excision: Removing the tumor and some healthy tissue around it.
• Lymph node dissection: If cancer has spread to lymph nodes.

2. Immunotherapy: Boosts the immune system to fight cancer (e.g., checkpoint inhibitors like pembrolizumab).

3. Targeted Therapy: For melanomas with specific genetic mutations (e.g., BRAF inhibitors).

4. Radiation/Chemotherapy: Used in advanced cases to shrink tumors or relieve symptoms.

Personalized treatment plans improve outcomes and quality of life.

Prevention Tips: How to Reduce Your Risk

Preventing melanoma involves sun safety and regular skin checks:

• Avoid peak sun hours (10 AM–4 PM).
• Use broad-spectrum SPF 30+ sunscreen daily.
• Wear protective clothing (hats, sunglasses, long sleeves).
• Avoid tanning beds.
• Check your skin monthly for new/changing moles.
• Get annual dermatologist exams if you’re high-risk.

Sun protection isn’t seasonal—UV damage accumulates over time, so make these habits year-round.

Living with Melanoma: Recovery and Follow-Up Care

After treatment, ongoing care is essential to monitor recurrence and manage side effects:

• Follow-up visits: Regular skin and lymph node exams.
• Scar care: Proper wound healing post-surgery.
• Emotional support: Counseling or support groups for mental health.
• Healthy lifestyle: Balanced diet, exercise, and stress management aid recovery.

Survivors should remain vigilant about sun protection and report any new symptoms promptly.

FAQs About Melanoma (Skin Cancer)