Malignant Melanoma

Melanoma is a cancer of the pigment-producing cells in the skin, known as melanocytes. Normal melanocytes reside in the outer layer of the skin and produce a brown pigment called melanin, which is responsible for skin color. Melanoma occurs when melanocytes become cancerous, grow, and invade other tissues.

Melanoma begins on the surface of the skin where it is easy to see and treat. If given time to grow, melanoma can grow down into the skin, ultimately reaching the blood and lymphatic vessels, and spread around the body (metastasize), causing life-threatening illness. If treated early, melanoma is curable; however, it can be fatal if allowed to grow and spread.

While it is not certain how all cases of melanoma develop, it is clear that excessive sun exposure, especially severe blistering sunburns early in life, can promote melanoma development. There is also evidence that UV radiation from indoor tanning beds may cause melanoma.

Anyone can get melanoma, but fair-skinned sun-sensitive people are at a higher risk. Due to UV radiation being the primary culprit, people who tan poorly, or burn easily are at the greatest risk.

In addition to excessive sun exposure throughout life, people with many moles are at an increased risk to develop melanoma. People with more than 50 moles are at a greater risk. Some people have moles that are unusual and irregular looking. These moles are known as dysplastic or atypical moles. People with atypical moles are at increased risk of developing melanoma. Melanoma also runs in families.

Periodic skin examinations by the physicians at Cleaver Dermatology can truly be life-saving.                        

Melanoma can occur anywhere on the skin or the nails, even in places not directly exposed to the sun like the eyes, mucous membranes (mouth and genitals), or internal organs. Melanoma is usually brown or black in color, but sometimes, may be red, skin-colored, or white.

When looking at a spot on the skin it is helpful to apply the ABCD rules:

Asymmetry - Draw an imaginary line through the middle of the spot. Are the two sides the same size and shape? Melanomas are typically asymmetric.

Border Irregularity - The edge, or border, of melanomas are usually ragged, notched, or blurred.

Color - Benign moles can be any color, but a single mole will be only one color. Melanoma often has a variety of hues and colors within the same lesion.

Diameter - Melanomas continue to grow, while moles remain small. Is the lesion larger than a pencil eraser (6mm)?

A quick look from Dr. Cleaver can confirm whether a lesion is suspicious for melanoma. If so, he will perform a biopsy. If a melanoma is detected, Dr. Cleaver will consider all treatments and choose the best for your situation.               

Treatment begins with the surgical removal of the melanoma and some normal-looking skin around the growth. Removal of the normal-looking skin is done to verify there is no melanoma left behind.

Since excessive exposure to UV radiation is a major contributing factor to melanoma, use sun protection. The sun is the strongest between 10 AM through 4 PM. Wear a broad-spectrum sunscreen, one that blocks both types of ultraviolet light (UVA and UVB), and reapply as directed on the bottle. Wear a wide-brimmed hat and sunglasses to help block ultraviolet light. Avoid indoor tanning.

Early detection remains the best treatment. Self examinations performed montly will help you keep an eye on any changing spots. Remember to use the ABCD rules, and to see Dr. Cleaver and his staff periodically for a complete skin examination. If a mole is changing, schedule an appointment immediately for screening.