Frequently Asked Questions
What is melanoma?
Melanoma is the most serious type of skin cancer. Although it represents only 4% of all skin cancers it accounts for 79% of all skin cancer deaths.
How many people are affected?
More than 70,000 people learn they have melanoma each year, and the number continues to rise.
How does melanoma develop?
Melanoma develops from cells in the skin called melanocytes. Melanocytes are located in the bottom of the epidermis (the top of the skin).
What are melanocytes?
They are the pigment-producing cells in your body, primarily found in the skin.
What are the main types of skin cancer?
They are squamous-cell carcinoma, basal-cell cacinoma, and melanoma.
Are all skin cancers life threatening?
Basal-cell cancers very rarely kill people. Typically, only If ignored for decades, can they become life threatening. In contrast, melanomas have the potential to become life threatening much more quickly and it is much more important that people do not wait to have them examined and treated.
What does malignant melanoma mean?
It means that the cells that make up the melanoma have acquired the ability to invade into deeper tissues. A malignant melanoma eventually will leave the skin and start new tumors in other organs by traveling through the lymph system and bloodstream.
What is the difference between benign and malignant tumors?
Benign tumors do not spread into other tissues of the body and almost never convert into an invasive cancer. They usually can be easily removed through surgery. They usually do not grow back.
Malignant tumors behave more aggressively. They invade into other tissues, can spread through the body, and when removed surgically have a chance of recurring. A malignant tumor is much more serious than a benign tumor and can be life threatening.
Where in the body can melanoma start?
Melanoma can start anywhere there are pigment cells (melanocytes). Most commonly, it starts in the skin—called cutaneous melanoma. Because melanocytes are also located in the eye, spinal cord, and brain, melanomas can also develop in these areas. Melanomas that do not start in the skin are rare.
What is metastatic melanoma?
Metastasis is a process where a cancer gains the ability to send pieces (cells) out to other areas in the body, and, instead of dying (as our cells appropriately do when they are in the wrong part of the body), the cancer cells survive and start new tumors. Metastasis can end up almost anywhere in the body. Melanomas tend to spread to the liver, lungs, or brain.
Who is at risk for developing melanoma?
People with fair skin that burns and freckles easily and people with red or blond hair and light eyes are at highest risk.
People with many ordinary moles are at an increased risk.
People who have atypical moles also called dysplastic nevi. These atypical moles are more likely to become cancerous than ordinary moles. The more atypical moles a person has, the higher their risk of developing melanoma.
Family history of melanoma. Having 2 or more close relatives who have had melanoma increases the risk.
People who have had at least one severe sunburn as a child or teenager.
People with weakened immune systems from things such as treatments for other cancers, medications given after transplantation, or HIV.
People who spend a great deal of time in the sun. UV radiation from the sun can cause premature aging of the skin and skin damage which can lead to melanoma. Artificial sources of UV radiation, such as tanning booths and sunlamps, can also cause skin damage and increase the risk of melanoma.
If I have melanoma, should my family also be checked by a doctor ?
Yes. Having even one person in a family with melanoma increases the likelihood that anyone related to that person by blood will develop a melanoma.
How can I protect myself or my family from developing melanoma?
Because frequent sun exposure (and especially sunburns) increases the rate of developing melanoma, you can decrease your chances by being smart about being in the sun!
Avoid sun exposure between 10 am and 4 pm whenever possible.
Always use sunscreen when outside.
Wear long sleeves, pants, and hats when outside.
Wear sunglasses that have UV-absorbing lenses.
What are the signs/symptoms of melanoma?
Asymmetry: The shape of one half does not match the other.
Border: The edges of the mole are irregular, notched, or blurred.
Color: The color is uneven. Black, brown, and tan may be mixed with areas of white, grey, red, pink, or blue.
Diameter: The mole is usually increased in size, often larger than 5 mm or the size of a pencil eraser.
Evolution: The most important sign is a change in an existing mole or the development of a new mole.
If I suspect that I or someone in my family has melanoma, what should we do?
Contact your dermatologist . He may decide to do a biopsy. A skin biopsy is the only way to confirm the diagnosis of a melanoma. A biopsy is the process where a physician removes part or all of a mole or other skin lesion so that it can be examined microscopically by a pathologist.
Is a biopsy done in the office?
Yes. A biopsy is done in the dermatologist’s office. It is a quick procedure that usually only takes a few minutes. The skin is cleaned and numbed with a quick shot of anesthetic. Then, the piece of skin is taken, and if necessary a stitch is used to close the site.
What are the stages of melanoma?
Stage 0- The tumor is limited to the top layer of the skin and it has not spread to surrounding tissues, lymph nodes or distant sites. There is a very low risk of recurrence.
Stage I – The tumor has not spread to nearby lymph nodes or distant sites. There is a low risk for recurrence or distant metastasis.
Stage II – The tumor has not spread to nearby lymph nodes or distant sites. There is an intermediate risk for recurrence or distant metastasis.
Stage III – The tumor have spread to regional lymph nodes. There is no evidence of distant metastasis. There is an intermediate to high risk for recurrence or distant metastasis.
Stage IV – The melanoma has spread beyond the regional lymph nodes to other organs, lymphs nodes, or skin areas away from the original tumor.
What does recurrence mean?
It means that the cancer has come back after it has been treated.
Does recurrence happen at the original site?
Recurrence can happen at the original site or at another part of the body.
What types of treatment are available?
Surgery – to fully excise the original tumor and possibly nearby lymph nodes
Chemotherapy – systemic treatments given to help attack all cancer cells in the body
Biological therapy – systemic treatment given after surgery to prevent the recurrence of microscopic cancer cells
Radiation therapy – multiple treatments of radiation beams aimed at specific areas causing problems
Once I have a skin biopsy, will I need further surgery?
It depends on the stage of the tumor.
If the doctor has removed the entire tumor and it is an early stage (usually Stage 0, or Stage I), you may not need any further surgery.
If the melanoma was not completely removed, the doctor may need to take out the remaining tumor. He/she will look for normal tissue around the tumor to ensure that he/she removed the whole tumor. This is called a wide local excision.
Also depending upon your stage (usually some Stage I and all Stage II) he/she may decide to do a sentinel lymph node biopsy. The results of this biopsy will determine the need for further surgery
What is sentinel lymph node biopsy?
A technique used to identify the lymph node that the melanoma is most likely to spread to first. After the original biopsy is done, the surgeon will inject a radioactive substance near the melanoma. The surgeon follows the movement of this dye on a computer screen. The first lymph node to take up this dye is called the sentinel lymph node. The surgeon will remove this lymph node(s) in order to determine if the cancer has spread.