What is melanoma?

Melanoma is a form of skin cancer in which abnormal skin cells grow out of control. It helps to learn about this condition and what can be done about it.

It is very important for you to take good care of your skin so that you don't get melanoma. If you've had melanoma, protect your skin from the sun to lower your risk of getting it again. And if you've had treatment for melanoma, you will need regular checkups with your doctor to make sure it hasn't come back.

Melanoma shows up mostly on skin that is not regularly covered up. But it can show up anywhere on the body. It is most often found early, when it can be cured. The most common treatment is surgery to remove it. Sometimes lymph nodes near the cancer also are removed. Other treatments for melanoma may include medicines that target cancer cells (targeted therapy) and medicines that help your immune system fight cancer (immunotherapy). In some cases, radiation therapy or chemotherapy may be used.

You may not have any symptoms in the early stages of melanoma. Or a melanoma may be sore, or it may itch or bleed. Most melanomas start as a new skin growth. But any change in the shape, size, or color of a mole may be a sign of melanoma.

Treatment for melanoma is based on the stage of the cancer and other things, such as your overall health. The main treatment is surgery to remove the cancer. Other treatment options may include immunotherapy and targeted therapy.

If melanoma has spread beyond the skin (metastatic cancer), you may have surgery. You'll probably need other treatments too. These may include immunotherapy or targeted therapy. In some cases, radiation therapy or chemotherapy may be used.

Your doctor will talk with you about your options and then make a treatment plan.

Surgery

The doctor removes the cancer and a border of normal skin (margin) around it. If you have early-stage cancer, the doctor may be able to remove all of it. You may not need more treatment.

If a large melanoma is removed, you may need a skin graft or other repair surgery.

In some cases, one or more lymph nodes may be removed.

• The doctor may remove the first lymph node that the cancer may have spread to. This is called a sentinel lymph node biopsy. If no cancer cells are found, you may not need to have more lymph nodes removed.
• If cancer is found in the sentinel lymph node, nearby lymph nodes may be removed and checked for cancer cells.

After surgery, you may have only regular checkups. Or you may also have other treatments to help prevent a return (recurrence) of the cancer.

Medicines

Medicines used to treat melanoma include:

• Immunotherapy. This treatment helps your immune system fight cancer. The medicine may be spread on the melanoma or injected into it. Or it may be injected into a vein or under the skin.
• Targeted therapy. These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading. Some of these medicines target a specific gene in the cancer cells. If you have a gene that can be targeted, you may be given one or more of these medicines. They are usually given as pills.

Treatment for metastatic or recurrent cancer

Melanoma that has spread to other parts of the body (metastatic cancer) may cause tumors. These can sometimes be removed with surgery. But metastatic melanoma often needs other treatments too. Examples include immunotherapy, targeted therapy, and chemotherapy. These treatments and others may also be used for melanoma that has come back after treatment (recurrent cancer).

Radiation therapy may help relieve symptoms caused by melanoma that has spread to the bones or other organs. Radiation therapy uses high-dose X-rays to destroy cancer cells and shrink tumors.

Clinical trials are research studies that test new treatments to find out how well they work. Your medical team can tell you if there's a clinical trial that might be right for you.

The best way to lower your risk for melanoma is to protect your skin whenever you are out in the sun. For example, stay out of the sun during midday hours. Wear sun-protective clothes. Use sunscreen with an SPF of at least 30 every day. Avoid sunbathing and tanning salons.

Your doctor will check your skin for melanoma. If your doctor suspects melanoma, a sample of tissue (biopsy) will be removed and tested. If your biopsy shows melanoma, you may have more tests to find out if it has spread to your lymph nodes or other places.

• Learn the most important warning signs for melanoma—a change in the size, shape, or color of a mole or other skin growth, such as a birthmark.
• Check all the skin on your body once a month for skin growths or other changes, such as changes in color and feel of the skin.
  • Stand in front of a full-length mirror. Look carefully at the front and back of your body. Then look at your right and left sides with your arms raised.
  • Bend your elbows and look carefully at your forearms, the back of your upper arms, and your palms.
  • Look at your feet, the bottoms of your feet, and the spaces between your toes.
  • Use a hand mirror to look at the back of your legs, the back of your neck, and your back, rear end (buttocks), and genital area. Part the hair on your head to look at your scalp.
• If you see a change in a skin growth, contact your doctor. Look for:
  • A mole that bleeds.
  • A fast-growing mole.
  • A scaly or crusted growth on the skin.
  • A sore that will not heal.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• If you have pain, follow your doctor's instructions to relieve it. Pain from cancer can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Do not smoke. Smoking can slow healing. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.

Protect your skin

• Always wear sunscreen on exposed skin. Make sure to use a broad-spectrum sunscreen that has a sun protection factor (SPF) of 30 or higher. Use it every day, even when it is cloudy. While you are outdoors, apply more sunscreen every 2 to 3 hours or anytime your skin gets wet.
• Wear a wide-brimmed hat, a long-sleeved shirt, and pants if you are going to be outdoors for very long.
• Stay out of the sun during the midday hours (10 a.m. to 4 p.m.), when UV rays are strongest.
• Avoid sunlamps and tanning salons.

What exactly causes melanoma isn't known. But some things, like too much UV radiation from sun exposure, can damage DNA. This can cause normal skin cells to become abnormal. These abnormal cells can quickly grow out of control.

Any of these things can put you at higher risk for this disease:

• Getting sunburns, especially during childhood.
• Spending too much time in the sun.
• Using tanning beds or sunlamps.
• Having lighter skin. But people with any skin color can get melanoma.
• Having a family history of melanoma.
• Having many abnormal, or atypical, moles. These moles may fade into the skin and have a flat part that is level with the skin. They may be smooth or slightly scaly. Or they may look rough and "pebbly."

Melanoma is the most serious kind of skin cancer because it can quickly spread to other parts of the body. Most melanomas show up as a new spot or skin growth. But they can also form in an existing mole. Less often, melanoma begins in other places, such as the eye or the intestines.