How Do I Know If I Have Melanoma

Tools That Can Help You Find Melanoma On Your Skin

To help you find melanoma early, the American Academy of Dermatology developed the following:

Melanoma can look different on a childs skin. Taking this short quiz can help you hone your skills at finding childhood melanoma.

ImagesImages 1,3,4,5,6,7,8,10: Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2: Developed by the American Academy of Dermatology

Image 9: Used with permission of the Journal of the American Academy of Dermatology.

ReferencesBarnhill RL, Mihm MC, et al. Malignant melanoma. In: Nouri K, et al. Skin Cancer. McGraw Hill Medical, China, 2008: 140-167.

Gloster HM Jr, Neal K. Skin cancer in skin of color. J Am Acad Dermatol 2006 55:741-60.

National Comprehensive Cancer Network. NCCN guidelines for patients: Melanoma. 2018. Last accessed February 12, 2019.

What Are The Symptoms Of Skin Cancer Of The Head And Neck

Skin cancers usually present as an abnormal growth on the skin. The growth may have the appearance of a wart, crusty spot, ulcer, mole or sore. It may or may not bleed and can be painful. If you have a preexisting mole, any change in the characteristics of this spot – such as a raised or an irregular border, irregular shape, change in color, increase in size, itching or bleeding – are warning signs of melanoma. Sometimes the first sign of melanoma or squamous cell cancer is an enlarged lymph node.

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What Skin Cancer Looks Like

Skin cancer appears on the body in many different ways. It can look like a:

• Changing mole or mole that looks different from your others

• Dome-shaped growth

• Non-healing sore or sore that heals and returns

• Brown or black streak under a nail

It can also show up in other ways.

To find skin cancer on your body, you dont have to remember a long list. Dermatologists sum it up this way. Its time to see a dermatologist if you notice a spot on your skin that:

• Differs from the others

• Itches

• Bleeds

To make it easy for you to check your skin, the AAD created the Body Mole Map. Youll find everything you need to know on a single page. Illustrations show you how to examine your skin and what to look for. Theres even place to record what your spots look like. Youll find this page, which you can print, at Body Mole Map.

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Melanoma Can Be Tricky

Identifying a potential skin cancer is not easy, and not all melanomas follow the rules. Melanomas come in many forms and may display none of the typical warning signs.

Its also important to note that about 20 to 30 percent of melanomas develop in existing moles, while 70 to 80 percent arise on seemingly normal skin.

Amelanotic melanomas are missing the dark pigment melanin that gives most moles their color. Amelanotic melanomas may be pinkish, reddish, white, the color of your skin or even clear and colorless, making them difficult to recognize.

Acral lentiginous melanoma, the most common form of melanoma found in people of color, often appears in hard-to-spot places, including under the fingernails or toenails, on the palms of the hands or soles of the feet.

The takeaway: Be watchful for any new mole or freckle that arises on your skin, a sore or spot that does not heal, any existing mole that starts changing or any spot, mole or lesion that looks unusual.

Acral lentiginous melanoma is the most common melanoma found in people of color.

What If I Have Metastatic Melanoma Symptoms

Whether you have a suspicious mole or are experiencing some symptoms of advanced-stage melanoma, it is important to consult with a physician to receive an accurate diagnosis, as many other conditions can cause similar symptoms. At Moffitt Cancer Center, we provide a comprehensive range of screening, diagnostic, treatment and supportive care services for patients with melanoma and other types of cancer. Within our Cutaneous Oncology Program, our multispecialty team includes surgeons, dermatologists, medical oncologists and other experts who work together as a tumor board to ensure our patients receive the best possible treatment and care.

If you would like to schedule an appointment at Moffitt to discuss your metastatic melanoma symptoms, call or fill out a new patient registration form online. We do not require a referral to schedule an appointment.

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Skin Exam And Physical

If youve been diagnosed with melanoma, youve already had a skin biopsy. This biopsy was taken when you had part of the suspicious spot removed. After it was removed, a doctor looked at the spot under a microscope to find out if it contained cancer cells. This is currently the only way to tell if someone has skin cancer.

After getting the diagnosis, the next step is to get a complete skin exam and physical.

During the physical, your dermatologist will feel your lymph nodes. This is where melanoma usually goes when it begins to spread. It usually travels to the lymph nodes closest to the melanoma.

If there is a risk the cancer could have spread, your dermatologist may recommend that you have a lymph node biopsy. If a sentinel lymph node biopsy is recommended, it can be performed at the time of your surgery for melanoma.

After the skin exam and physical, your dermatologist may recommend testing, such as a CAT scan, MRI, or a blood test. These can also help detect spread.

Skin Warning Sign #: Changes In Your Skins Appearance

The most obvious skin cancer warning sign is that you should watch out for changes in the appearance of your skin, like moles or lesions.

You can identify potential skin cancers in any part of your skin by using the ABCDE method:

• Asymmetry Look for any abnormalities including irregular shapes
• Border Check if the mole or spot has an irregular or poorly defined border
• Colour Any uneven colours of black, brown, pink, red, and white on your skin can be a sign
• Diameter Check for changes in the size and diameter of spots
• Evolving Any moles or spots that have grown or changed in any way over time

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What Age Spots Look Like

Age spots are very common and are usually harmless. When you hit 50 years old, youll probably start seeing age spots on your skin, especially if you have pale complexion. Theyre caused by years of exposure to UV rays from the sun. If youre out in the sun a lot, you may start getting age spots earlier than usual. Thats why its so important to take care of your skin while in the sun!

Youll usually find age spots on your hands, shoulders, arms, tops of your feet and upper back. These are the areas of your body that see the sun the most. Though age spots vary in size, youll usually see the following characteristics when identifying an age spot, according to Mayo Clinic:

• Flat and oval areas of skin discoloration
• Tan, black or brown in color
• Appear in areas that are commonly exposed to the sun

If you have age spots or any other type of cosmetic brown spot, we can help erase them. Learn more about our brown spot treatments here!

Symptoms If Cancer Has Spread To The Brain

You might have any of the following symptoms if your cancer has spread to your brain:

• headaches
• weakness of a part of the body
• fits
• personality changes or mood changes
• eyesight changes

• J Tobias and D HochhauserJohn Wiley and Sons Ltd

• TNM Staging ChartsLippincott Williams and Wilkins, 2009

• Improving supportive and palliative care for adults with cancerNational Institute for Clinical Excellence , 2004

• Oxford Textbook of Palliative MedicineEds D Doyle and othersOxford Universty Press, 3rd edition 2005

• Cancer and its Management J Tobias and D HochhauserWiley Blackwell, 2015

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What Kind Of Treatment Will I Need

There are many ways to treat melanoma. The main types of treatment are:

• Surgery

Most early stage melanomas can be treated with surgery alone. More advanced cancers need other treatments.

The treatment plan thats best for you will depend on:

• The stage of the cancer
• The results of lab tests on the cancer cells
• The chance that a type of treatment will cure the melanoma or help in some way
• Your age
• Other health problems you have
• Your feelings about the treatment and the side effects that come with it

What Is Metastatic Melanoma

Metastatic melanoma is melanoma that has spread beyond its original site in the skin to distant tissue sites. There are several types of metastatic melanoma. There may be spread through the lymphatic system to local lymph nodes. This may show up as swollen lymph glands or as a string of skin tumors along a lymphatic chain. Melanoma may also spread through the bloodstream , where it may appear in one or more distant sites, such as the lungs, liver, brain, remote skin locations, or any other body location.

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What Happens If They Find Melanoma In The Lymph Nodes

If the results of ultrasound scan, FNA or SNB are positive for melanoma, you may need further surgery to remove all the lymph nodes in the area. If no cancer cells are found, the melanoma is unlikely to have spread to other areas .

When melanoma has spread to your lymph nodes, the node usually forms a firm to hard lump. If this occurs between planned follow-up visits, you should let your doctor know immediately.

What Does Skin Cancer Look Like After Sunburn

Squamous cell carcinoma can appear as a firm, red nodule, or as a rough, scaly, flat lesion that may itch, bleed and become crusty. Both basal cell and squamous cell cancers mainly occur on areas of the skin frequently exposed to the sun, but can occur anywhere. Melanoma usually appears as a pigmented patch or bump.

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How Is Skin Cancer Of The Head And Neck Diagnosed

Diagnosis is made by clinical exam and a biopsy. Basal cell and squamous cell cancers are staged by size and extent of growth. Basal cell cancers rarely metastasize to lymph nodes, but they can grow quite large and invade local structures. Squamous cell cancers have a much higher incidence of lymph node involvement in the neck and parotid gland and can spread along nerves.

Melanoma is staged, based not on size but on how deeply it invades the skin layers. Therefore, a superficial or shave biopsy will not provide accurate staging information used to guide treatment. Melanomas can have a very unpredictable course and may spread to distant organs. Melanomas with intermediate thickness often require sentinel node biopsy, a surgical procedure performed by a head and neck surgeon, to determine if microscopic spreading to lymph nodes has occurred.

Symptoms If Cancer Has Spread To The Lymph Nodes

Lymph nodes are part of a system of tubes and glands in the body that filters body fluids and fights infection.

The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen. Swollen lymph nodes in the neck area can make it hard to swallow.

Cancer cells can also stop lymph fluid from draining away. This might lead to swelling in the neck or face due to fluid buildup in that area. The swelling is called lymphoedema.

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How Do I Know If I Have Skin Cancer

All potentially cancerous skin growths must be biopsied to confirm a cancer diagnosis. Depending on the suspected type of skin cancer, the biopsy techniques vary slightly but crucially.

Any potential melanoma requires a surgical biopsy, in which the entire growth is removed with a scalpel if possible. A pathologist then studies the sample under a microscope to determine whether cancer cells are present.

If melanoma is diagnosed, other tests may be ordered to assess the degree of cancer spread . They include:

• Imaging. Your doctor will order one or more tests to look for metastasis. They include CT scan, MRI, PET scan, bone scan, and chest X-ray.
• Other biopsies. Using a variety of techniques, your doctor may want to get tissue samples from lymph nodes.

Skin growths that are most likely basal cell carcinoma, squamous cell carcinoma, or other forms of non-melanoma can be biopsied in various ways. Part or all of the growth can be taken with a scalpel for examination under a microscope.

What Are The Survival Rates For Metastatic Melanoma

Survival rates for melanoma, especially for metastatic melanoma, vary widely according to many factors, including the patient’s age, overall health, location of the tumor, particular findings on the examination of the biopsy, and of course the depth and stage of the tumor. Survival statistics are generally based on 5-year survival rates rather than raw cure rates. Much of the success reported for the targeted therapies focuses on disease-free time because in many cases the actual 5-year survival is not affected. It is hoped that combination therapy discussed above will change that.

• For stage 1 , 5-year survival is ⥠90%.
• For stage 2 , 5-year survival is 80%-90%.
• For stage 3 , 5-year survival is around 50%.
• For stage 4 , 5-year survival is 10%-25% depending upon sex and other demographic factors.

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Blog: Learn More About Melanoma

• Atypical mole and melanoma syndrome
• If you have AMS, you and your family members should be screened regularly

Not everyone with risk factors gets melanoma. Individuals are encouraged to visit with their primary care doctor or a dermatologist if there is any concern or suspicion about melanoma. Early detection is vital to treating and surviving cancer.

Fair complexion: People with blond or red hair, light skin, blue eyes and a tendency to sunburn are at increased risk.

What Does A Normal Vs An Abnormal Mole Look Like

Normal moles are usually round or oval and smaller than a pencil eraser. They are one consistent color , with a clear border. Most people have less than 50 moles. You can be born with moles, develop them with age or even have some disappear.

Cancerous, or malignant, moles may vary greatly in appearance. To help identify moles that might indicate melanoma, think of the letters A-B-C-D-E:

• A | Asymmetry: Mole is an irregular shape, such as if one side looks different than the other
• B | Border: Mole has irregular, ragged, notched or scalloped borders
• C | Color: Mole has more than one color or uneven shading
• D | Diameter: Mole is bigger than a pencil eraser
• E | Evolution: Mole changes in some way

Talk to your doctor, if you notice any skin changes that seem unusual.

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Look Out For An Ugly Duckling

The Ugly Duckling is another warning sign of melanoma. This recognition strategy is based on the concept that most normal moles on your body resemble one another, while melanomas stand out like ugly ducklings in comparison. This highlights the importance of not just checking for irregularities, but also comparing any suspicious spot to surrounding moles to determine whether it looks different from its neighbors. These ugly duckling lesions or outlier lesions can be larger, smaller, lighter or darker, compared to surrounding moles. Also, isolated lesions without any surrounding moles for comparison are considered ugly ducklings.

What Is Recurrent Melanoma

Recurrent melanoma refers to a recurrence of tumor at the site of removal of a previous tumor, such as in, around, or under the surgical scar. It may also refer to the appearance of metastatic melanoma in other body sites such as skin, lymph nodes, brain, or liver after the initial tumor has already been treated. Recurrence is most likely to occur within the first five years, but new tumors felt to be recurrences may show up decades later. Sometimes it is difficult to distinguish recurrences from new primary tumors.

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How Is Melanoma Treated

Your melanoma treatment will depend on the stage of the melanoma and your general health.

Surgery is usually the main treatment for melanoma. The procedure involves cutting out the cancer and some of the normal skin surrounding it. The amount of healthy skin removed will depend on the size and location of the skin cancer. Typically, surgical excision of melanoma can be performed under local anesthesia in the dermatologist’s office. More advanced cases may require other types of treatment in addition to or instead of surgery.

Treatments for melanoma:

• Melanoma Surgery: In the early stages, surgery has a high probability of being able to cure your melanoma. Usually performed in an office, a dermatologist numbs the skin with a local anesthetic and removes the melanoma and margins .
• Lymphadenectomy: In cases where melanoma has spread, removal of the lymph nodes near the primary diagnosis site may be required. This can prevent the spread to other areas of your body.
• Metastasectomy: Metastasectomy is used to remove small melanoma bits from organs.
• Targeted cancer therapy: In this treatment option, drugs are used to attack specific cancer cells. This targeted approach goes after cancer cells, leaving healthy cells untouched.
• Radiation Therapy: Radiation therapy includes treatments with high-energy rays to attack cancer cells and shrink tumors.
• Immunotherapy: immunotherapy stimulates your own immune system to help fight the cancer.