Skin Cancer: What’s Your Melanoma Risk?

Skin cancer is, by far, the most common form of cancer. While skin cancer on its own is generally easy to manage once caught because the condition grows slowly, there are more aggressive skin cancer types that can be more deadly if not detected early enough.(1)

Melanoma accounts for just 1% of all skin cancer cases but is responsible for a large majority of deaths from skin cancer. According to the American Cancer Society, there are more than 100,000 new melanoma diagnoses each year, while nearly 7,000 people die from the disease annually.(1)

Melanoma cases are generally on the rise. Despite this and somber melanoma-related statistics, the condition is highly treatable if caught early. Learn more about prevention tips and other important considerations to help protect yourself against melanoma.

What is Melanoma?

Melanoma, the most aggressive form of skin cancer, occurs in the cells (melanocytes) that produce melanin – or the pigment that gives your skin color. Melanocyte cells with DNA damage may begin to grow at out-of-control rates and eventually form cancerous masses.2 Melanoma is more dangerous than other skin cancers because malignant melanoma cells are more likely to spread to other parts of the body.3

Melanoma growths are usually identifiable. Most melanoma cells still produce melanin, so melanoma tumors tend to be brown or black in appearance. Melanoma tumors can also be pink, tan or even white if the melanoma cells involved are not producing melanin.3

Importantly, not all growths in the melanocyte cells turn out to be melanoma. Benign tumors may look similar to melanoma, but they are not dangerous. A mole, also called a nevus, is a benign tumor that develops from melanocytes. Just about everyone has moles are most are harmless. A Spitz nevus is a specific type of mole that can closely resemble melanoma – but it is benign. Moles are sometimes removed just out of an abundance of caution.3

Causes and Risk Factors for Melanoma

While the exact cause for melanoma is unknown, certain risk factors are associated with a higher likelihood of developing the condition. These risk factors – a combination of environmental and genetic factors – can include:2

• Family history. Having a close relative with melanoma generally means your risk for melanoma is higher.
• Weakened immune system. A weak immune system can increase your risk for developing melanoma and other skin cancers.
• Excessive exposure to UV (ultraviolet) light. Spending too much time in the sun without adequate sun protection or using tanning beds and lights can increase your risk for melanoma through excessive exposure to UV radiation.
• Having fair skin. Less melanin in the skin means less protection against UV damage, which increases the risk for melanoma. Of note, melanoma does also occur in people with darker skin.
• A history of bad sunburns. A history of severe, blistering sunburn has been associated with an increased risk for melanoma.
• Having many or unusual moles. People with many moles tend to face a higher risk of melanoma. Overall, the lifetime risk for melanoma is about 2.6% (1 in 38) for whites, 0.1% (1 in 1,000) for Blacks, and 0.6% (1 in 167) for Hispanics.1

Early Warning Signs of Melanoma

Catching melanoma in its earliest stages can make a significant difference in outcomes. When caught early, the five-year survival rate is 99%. The rate of survival drops off to 65% if cancer spreads to the lymph nodes and 25% if it reaches distant organs.4

The best way to achieve early detection is to keep a close eye on your skin. Watch for anything new, unusual, or changing on all areas of your body – both exposed and non-exposed areas. Melanoma can develop anywhere, but some areas are more prone than others. For women, melanoma most commonly appears on the legs, while men are more likely to see melanomas develop on the body’s trunk.4

The “A, B, C, D, E”s of Detecting Melanoma

According to the Skin Care Foundation, identifying melanoma early can be as easy as A, B, C, D, E. Beyond anything new, unusual, or changing, keep an eye out for the following signs:

• Asymmetry. Most melanomas are asymmetrical – meaning if you drew a line through the middle of a lesion, the two halves would not match. Melanoma lesions are not round or oval like a normal mole.
• Border. The borders of a melanoma lesion are typically uneven edges. Normal moles have smooth, even borders.
• Color. Lesions that show more than one color are something to be concerned about. Regular, non-cancerous moles tend to be just a single shade of brown – while melanoma lesions can be multiple shades of tan, brown or black.
• Diameter or Dark. Lesions that grow in diameter are cause for concern, as well as lesions that are darker than others.
• Evolving. Changes in size, shape, elevation or color of a spot, as well as bleeding, itching or crusting, can indicate presence of melanoma.

Annual Skin Checks for Melanoma

Beyond keeping an eye on your own skin, your doctor should perform a skin check each year as part of routine preventive care. Your primary care doctor can perform a skin check and refer you to a dermatologist if anything seems suspicious or you may go directly to a dermatologist. Dermatologists use special techniques to look at spots on the skin more carefully.

Annual skin checks are especially crucial for people at high risk of melanoma. The dermatologist may take full-body pictures to track your moles over time and identify new ones more clearly. He or she can recommend more frequent checks if your medical history and profile calls for it.3

How is Melanoma Diagnosed?

Melanomas have a distinct look, but ultimately a biopsy is the surest way to confirm a cancer diagnosis. A biopsy procedure involves a doctor removing the entire growth using a blade and sending it to a lab to further examine the cells.

If melanoma is diagnosed, the next step is to “stage” – or determine the extent – of cancer. To do this, the doctor will:2

• Determine the thickness. In general, the thicker the tumor, the more serious the disease. Knowing the thickness helps inform a treatment plan.
• Check the lymph nodes. An additional biopsy is performed to see if cancer has spread to the lymph nodes, which would indicate more advanced disease.
• Check other areas for cancer. In advanced melanoma, doctors will likely recommend imaging tests to see where else in the body cancer has reached. This is not needed for smaller melanoma growths with little risk of spread.

Melanoma is staged using the Roman numerals 0 through IV. At stage 0 and stage I, a melanoma tumor is small and has a high treatment success rate. The higher the numeral, the lower the chances of full recovery even with treatment. By stage IV, cancer has spread beyond the skin to other body organs, such as the lungs or kidneys.

What Treatments Are Available for Melanoma?

Once the diagnosis and stage of melanoma have been confirmed, the doctor will go over all available options. Smaller melanomas that have not spread may only require removal, while advanced melanomas may require more aggressive forms of treatment.

Your doctor will review your specific case to see what options are most appropriate for you. The available treatments are:2

• Surgery. Surgery is used to remove small melanomas. People with early-stage melanomas may only require this treatment and nothing beyond. If cancer has spread to nearby lymph nodes, surgery can be done to remove those as well.
• Immunotherapy. Drug treatments to help the immune system fight cancer.
• Targeted therapy. Targeted drugs are used to fight specific weaknesses in the cancer cells to kill them off. The doctor will test your cancer cells to see if targeted therapy could be appropriate in your case.
• Radiation therapy. Treatment that uses high-powered energy beams to kill the cancer cells.
• Chemotherapy. Medication used to kill cancer cells. Chemotherapy can be taken in IV or pill form.

Now that you're up to speed on critial Melanoma information, stay healthy and stay up to speed on the ever-evolving findings.