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About Melanoma Frequently Asked Questions
What is melanoma?
Melanoma is a malignancy, or cancer, of the cells called melanocytes, which produce the melanin pigment that gives skin its color. Melanoma is often darkly colored and is referred to as a pigmented lesion. The first indication of disease is normally a tumor on the skin, or occasionally in the mucous membrane, that has changed shape, size, and/or color. If untreated, melanoma can be fatal.

What are the most common symptoms of melanoma?
The American Cancer Society's ABCDE rule can help distinguish a normal mole, spot, or freckle from a melanoma:
  • Asymmetry: One half of the mole does not match the other half.
  • Border irregularity: The edges of the mole are ragged or notched.
  • Color: The color of the mole is not uniform. Areas are tan, brown, black, red, blue, and/or white.
  • Diameter: The mole is wider than six millimeters.
  • Evolution: anything that changes over time.

Any changes in the size, shape, or color of your moles, spots, and/or freckles should be considered a warning sign. A cancer-related checkup, including skin examination, is recommended every three years for people between 20 and 40 years of age and every year for anyone age 40 and older.

What causes melanoma?
Melanoma may be caused by changes in DNA. These changes or mutations can be inherited or they can be acquired during a lifetime. Acquired risks can be the result of either bad luck during natural cell replication or by exposure to cancer-causing factors. People at higher risk for melanoma are:
  • Individuals who are age 50-plus. This group represents over half of the melanoma population.
  • Individuals with excessive exposure to ultraviolet radiation. Sun exposure is recognized as one of the leading causes of melanoma; however, some melanomas do occur in areas rarely exposed to sunlight (under nails, in the mouth, vagina, and anus, and in the armpit). Melanoma in such locations may be caused by other cancer-causing factors.
  • Individuals with a personal or family history of melanoma.
  • Individuals with blond/red hair, fair complexions, or excessive moles and/or freckles. Although genetic investigations are still under way, these specific family characteristics are known to be linked with melanoma.
How does melanoma spread?
Melanoma grows outward on the surface of the skin (horizontal growth phase) and/or downward into the layers of the skin (vertical growth phase). During the horizontal growth phase, melanoma can remain on the skin surface for a number of months (stage I melanoma), but eventually it will often grow deep into the skin (stage II melanoma). This descent is potentially very dangerous. If unchecked, melanoma can spread, progressing to lymph nodes near the primary site (stage III melanoma). Ultimately, melanoma may metastasize into other organs, most commonly the lungs or liver, or to lymph nodes far away from the original tumor (stage IV melanoma).

How is melanoma diagnosed?
Physical examination: External study of the size, shape, color, and texture of the skin and determination of any bleeding or scaling may be conducted. The rest of the body may be checked for suspicious moles, spots, and/or freckles. A doctor may also examine nearby lymph nodes to check for swelling.
  • Skin biopsy: Tissue is surgically removed and analyzed under a microscope to determine whether the characteristic plump, dark, melanoma cells are present and how deep the tumor is in the skin. This important information is used often to determine the most effective course of treatment in preventing the advancement of melanoma.
  • Blood tests: Preliminary studies are underway to determine whether tumor-associated antigens shed by melanoma can be identified in the bloodstream and whether they are accurate indicators of disease.
I think I have melanoma. What should I do?
Report any suspicious changes in your moles, spots, and/or freckles to your doctor immediately. Do not rely on advice from relatives or friends. If your diagnosis is positive, ask to be referred to an oncologist specializing in melanoma. Become informed. Research your disease and check any information you gain with a specialist. Get a second opinion about the proposed treatment. Ask these questions: click ask your doctor.