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Skin cancer (malignant)

Malignant Melanoma

What is melanoma? — Melanoma is a serious form of skin cancer. It happens when normal cells in the skin change into abnormal cells and grow out of control.
Melanoma can occur anywhere on the skin, including the back and other hard-to-see areas. It can also occur on the skin lining the mouth, nose, and genitals. When it is not treated, melanoma can spread to organs inside the body. Melanoma can run in families.
What are the symptoms of melanoma? — Melanoma often looks like a brown or black mole or birthmark. But melanoma has features that make it different from normal moles and birthmarks. People can remember the abnormal features of melanoma by thinking of the letters A, B, C, D, and E (picture 1):
Asymmetry – One half can look different than the other half.
Border – It can have a jagged or uneven edge.
Color – It can have different colors.
Diameter – It is larger than the eraser on the end of a pencil.
Evolution – Its size, color, or shape can change over time.
Skin affected by melanoma can also bleed or become swollen, red, or crusty.
Many moles and birthmarks are normal and are not melanoma. But if you have a mole or birthmark that you think might be abnormal, show it to your doctor or nurse.
Is there a test for melanoma? — Yes. Your doctor or nurse will do an exam and check the skin all over your body. If he or she suspects you have melanoma, you will have a follow-up test called a biopsy. During a biopsy, a doctor will usually remove the whole abnormal area. In some cases, the doctor might instead take a small sample of skin from the abnormal area. Either way, another doctor will look at the skin that is removed under a microscope to see if the cells are melanoma.
What is melanoma staging? — Staging is a way in which doctors find out how deep in the skin and how far inside the body the melanoma has spread.
The right treatment for you will depend a lot on the stage of your melanoma. Your treatment will also depend on your age and other medical problems.
How is melanoma treated? — Most people with melanoma have 1 or more of the following treatments depending on the stage:
Surgery – Melanoma is usually treated with surgery to remove the cancer. That's usually true even if the biopsy appeared to have removed the whole abnormal area. During surgery, the doctor might also check nearby lymph nodes to see if the melanoma has spread inside the body. Lymph nodes are bean-shaped organs under the skin that store infection-fighting cells.
Immunotherapy – Immunotherapy is the term doctors use to describe medicines that work with the body's infection-fighting system to stop cancer growth.
Targeted therapy – Targeted therapy is the term doctors use to describe a group of medicines that work only on cancers with certain characteristics. These medicines usually work by blocking a specific protein or molecule.
Radiation therapy – Radiation kills cancer cells.
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
What happens after treatment? — After treatment, you will need to be checked every so often to see if the melanoma comes back or if new melanomas appear. Your doctor will do an exam and check your skin all over. He or she might also order follow up imaging tests. Imaging tests create pictures of the inside of your body and can show abnormal growths.
Most doctors also recommend that you check your skin every month to look for any changes. It might also help to have a partner, friend, or relative help you. They can check parts of your body that are hard for you to see, like your back. Tell your doctor or nurse if you find any new moles or birthmarks, or if the ones you have look different.
What happens if the melanoma comes back or if a new melanoma appears? — If the melanoma comes back or if you develop a new melanoma, you might have more surgery, radiation therapy, chemotherapy, or immunotherapy.
Can melanoma be prevented? — You can help prevent melanoma by protecting your skin from the sun's rays. Sun exposure and sunburn are a big cause of melanoma. To reduce the chance of getting melanoma, you can:
Stay out of the sun in the middle of the day (from 10 AM to 4 PM).
Wear sunscreen and reapply it often.
Wear a wide-brimmed hat, long-sleeved shirt, or long pants.
Not use tanning beds. They increase your risk of getting melanoma.
Some people are at higher risk for melanoma than others. You might be at higher risk if you have family members who have had melanoma or if you have had certain abnormal moles in the past. In this case, your doctor might recommend checking your skin every month, plus getting an exam once a year.
What else should I do? — It is important to follow all your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15499 Version 13.0
Release: 28.2.2 - C28.105
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