Melanoma is a less common but dangerous type of skin cancer that can spread to other parts of the body very quickly. It most frequently develops in melanocytes, the cells that create the pigment melanin, which gives skin its color. Because of this, melanomas are often brown or black in color, though they can also be red, pink or white.
While late-stage melanoma can be quite dangerous, this type of cancer is highly treatable if caught early. The five-year survival rate is 99% in patients whose melanoma was detected and treated early before spreading to lymph nodes or other areas. Therefore, knowing the early signs of melanoma is a crucial step in monitoring skin health.
What Does Melanoma Look Like?
It is imperative that you perform self skin exams at home in between visits with your dermatologist to look for early signs of melanoma or other types of skin cancer. While it is important to check for both changes to existing moles and new lesions on your skin, around 70% to 80% of melanomas form on normal-looking skin.
When performing self exams of existing and new moles, check for the “ABCDEs” of melanoma and what are sometimes referred to as “ugly duckling” characteristics to spot potentially problematic moles:
- Asymmetry, where each half of the mole or lesion looks different in shape, size or color from the other.
- Borders that are rough or irregularly shaped.
- Color that varies in shades or tones or that changes over time.
- Diameters larger than the size of a pencil eraser.
- Evolution or change in any of the above characteristics or the addition of itching or bleeding.
Additionally, note any mole or lesion that stands out or is different from others in the same area, called the”ugly duckling” warning sign.
Types of Melanoma
There are four distinct types of melanoma. Knowing what each one looks like can help you to spot warning signs early.
- Superficial spreading melanoma. This is the most common type of melanoma and is characterized by its slow, horizontal growth across the skin’s surface before penetrating to deeper layers of skin in later stages. Superficial spreading melanoma often presents as a flat or raised mole with irregular borders and color variations.
- Nodular melanoma. Known for its aggressive vertical growth, nodular melanoma can quickly penetrate into the deeper layers of the skin. It typically appears as a raised, dome-shaped nodule and can lack the typical features of other melanomas.
- Lentigo maligna melanoma. This type of melanoma is often found on sun-damaged skin, particularly in older individuals. It tends to spread slowly and often appears as a mole with irregular borders and color variations.
- Acral lentiginous melanoma. This is the most common type of skin cancer found in people of color and was the type of melanoma that Bob Marley had, beginning under a toenail. Acral lentiginous melanoma is most frequently found on the palms, soles, or under the nails and often appears as a black or brown spot on the skin.
What Are the Risk Factors of Melanoma?
While anyone can develop melanoma, certain factors can increase your risk. These include:
- A history of prolonged UV exposure, including indoor tanning beds
- Fair skin and light hair and eyes
- Older age
- Living in a sunny climate or a high-elevation location
- Many moles, especially atypical moles
- A family or personal history of skin cancer
- A weakened immune system
- Genetic factors such as mutations within CDKN2A and CDK4 genes
How Is Melanoma Treated?
Detecting melanoma early greatly improves treatment outcomes. Excision, or removal of the tumor via surgery, is the main treatment option for melanoma and may be the only treatment necessary for early-stage melanoma. While Mohs surgery is sometimes used to treat melanoma, it can only treat early-stage melanoma and certain types of melanoma that remain on the surface of the skin. When used to treat melanoma, a specific type of Mohs surgery called slow Mohs is used.
Immune checkpoint inhibitor drugs like pembrolizumab (Keytruda®) can be used to treat high-risk melanomas that cannot be removed via surgery or have spread to other parts of the body. While these medications can be successful, a novel mRNA vaccine called mRNA-4157/V940 has shown promising evidence of increased survival rate and decreased recurrence rate by 44% in high-risk melanoma patients when combined with drugs like pembrolizumab.
This vaccine is designed to help the body’s immune system generate a specific T-cell response based on the molecular makeup of the tumor cells. It works by teaching T-cells to recognize specific proteins called neoantigens that are produced by cancer cells. This, in combination with immune checkpoint inhibitors, helps the immune system recognize and fight cancer cells more effectively.
While not available yet, the melanoma vaccine has been granted a breakthrough therapy designation by the FDA and clinical trials are ongoing.
Melanoma Prevention
While there is no proven way to prevent all melanomas, you can reduce your risk of developing all types of skin cancer by practicing sun-safety habits like:
- Wearing daily sunscreen and reapplying throughout the day.
- Wearing sun-protective clothing when outdoors for prolonged periods of time.
- Eating an antioxidant-rich diet.
- Performing regular at-home skin checks.
- Seeing your dermatologist at least once or twice per year for a professional skin cancer screening.
Bottom Line
While melanoma is a serious type of skin cancer, it is also highly treatable if caught early. Practice good sun-safety habits and maintain regular appointments with your dermatologist to stay on top of your skin’s health.
The skin cancer experts at Feinstein Dermatology are dedicated to providing the latest and most effective skin cancer treatment options and detection methods, as well as helping patients reduce their skin cancer risk as much as possible. Whether you suspect an early warning sign of skin cancer or simply want to stay on top of regular skin cancer screenings, our experts are happy to help you maintain excellent skin health.
Easily request an appointment with us online or call our Delray Beach office at (561) 498-4407. We look forward to hearing from you!
