Malignant melanoma (or simply melanoma) is the third most common type of skin cancer, representing approximately 1% of new skin cancer diagnoses. However, malignant melanoma is the most dangerous of the three most common types of skin cancer. Melanomas are particularly dangerous because they tend to metastasize (i.e. spread to other tissues) if not treated early in their development. Once they metastasize, curability drops significantly.
Malignant melanoma can be thought of as a cancerous skin mole. Regular skin moles are benign.
Moles are common, typically small, round, tan/brown skin spots caused by clusters of melanin (skin pigment) cells called melanocytes. However, moles come in a wide variety of sizes, shapes and colors.
Moles are most common in Caucasians, but occur in all peoples. Moles can develop on any skin location. Starting in childhood, most people will develop between 10 and 45 moles, but will stop acquiring new ones by their 30’s or 40’s. Moles may grow larger or darker with age or hormone changes associated with puberty of pregnancy. Sometimes, moles go away on their own over time.
Most moles are not dangerous. However, they can sometimes change and become melanoma cancer. Unfortunately, melanoma cancer is one of the most deadly types of cancers, and needs to be caught early to be cured.
The ABCDE guide to identifying melanoma cancer is list of features that indicate that a mole may be changing into melanoma cancer or is melanoma cancer already:
- A is for asymmetry. One half of the mole is different appearing then the other half.
- B is for irregular border (shape). A mole that is not round or circular.
- C is for color. Multiple colors or a very dark (black) color.
- D is for diameter. Greater than 6 mm in diameter (about the size of a pencil eraser).
- E is for evolving. Evolving means changing – growing or becoming itchy or painful
Diagnosis of malignant melanoma is confirmed by removal with pathologic examination.
Melanoma treatment requires complete surgical removal including some surrounding normal appearing skin and subcutaneous tissues. Melanoma skin cancers tend to spread readily to lymph nodes and or distant tissues (referred to as metastases) if not detected and treated early. Overall, melanoma has a significantly higher risk of metastasis (i.e. spread to other tissues) than basal cell or squamous cell skin cancers. Thus, early detection and complete removal is the best way to minimize metastatic risk.
Excision and sometimes Mohs Surgery are the preferred treatments for local removal.
Adjunct imaging, lymph node sampling or removal and systemic treatments may be recommended.
To prevent or catch skin cancer early, minimize sun exposure, do skin self-exams monthly and get professionally examined by a dermatology provider for any suspicious skin growths and also, on a regular periodic basis, if recommended.
With over 25 years experience, board-certified dermatologist and fellow-trained Mohs skin cancer surgeon Dr. Robert Strimling, MD is a board-certified specializes in the diagnosis, prevention and treatment, including Mohs surgery and reconstruction, of squamous cell carcinoma and other skin cancers.
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