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How Firm Is Nodular Melanoma

Who Gets Nodular Melanoma

Skin Cancer Nodular Melanoma

Nodular melanoma accounts for about 15% of melanoma in Australia and New Zealand. Although more common in very fair skin , it may also occur in those who tan quite easily , and occasionally in brown or black skin .

Nodular melanoma is more common in males than in females. Most are over the age of 50 when it is diagnosed.

The main risk factors for nodular melanoma are:

  • Increasing age
  • Previous invasive melanoma or melanoma in situ
  • Many melanocyticnaevi
  • Multiple atypical naevi
  • Fair skin that burns easily

It is less strongly associated with sun exposure than superficial spreading and lentigo maligna types of melanoma.

The Abcdes Of Melanoma

To help people find a possible melanoma on their skin, dermatologists created the ABCDEs of melanoma:

A is for Asymmetry

If you find a spot on your skin that has any of the ABCDEs of melanoma, see a board-certified dermatologist for a skin exam.

The following pictures can help you see how the ABCDEs of melanoma can appear on the skin.

What Happens At Follow

The primary purpose of follow-up is to detect recurrences early, but it also offers an opportunity to diagnose a new primary melanoma at the first possible opportunity. A second invasive melanoma occurs in 5-10% patients an unrelated melanoma in situ affects in more than 20% of melanoma patients.

The Australian and New Zealand Guidelines for the Management of Melanoma make the following recommendations for follow-up for patients with invasive melanoma.

  • Self-skin examination
  • Routine skin checks by a patient’s preferred health professional
  • Follow-up intervals are preferably six-monthly for five years for patients with stage 1 disease, three-monthly or four-monthly for five years for patients with stage 2 or 3 disease, and yearly after that for all patients.
  • Individual patients needs should be considered before an appropriate follow-up is offered
  • Provide education and support to help the patient adjust to their illness

The follow-up appointments may be undertaken by the patient’s general practitioner or specialist, or they may be shared.

Follow-up appointments may include:

  • A check of the scar where the primary melanoma was removed
  • A feel for the regional lymph nodes
  • A general skin examination
  • A full physical examination
  • In those with many moles or atypical moles, baseline whole-body imaging and sequential macro and dermoscopic images of melanocytic lesions of concern

In those with more advanced primary disease, follow-up may include:

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Can You Have Melanoma For Years And Not Know

How long can you have melanoma and not know it? It depends on the type of melanoma. For example, nodular melanoma grows rapidly over a matter of weeks, while a radial melanoma can slowly spread over the span of a decade. Like a cavity, a melanoma may grow for years before producing any significant symptoms.

Facts About Nodular Melanoma

Nodular melanoma

Nodular melanoma is the second most common type of melanoma that is diagnosed today. It forms in the skin cells that create melanin for the skin the cells that give skin its color. That is why the nodule of skin cancer tends to be a different color than the rest of the skin. The nodules grow very quickly, so checking for the elevation and evolution of growths on the skin is an important part of early detection. New moles or freckles stop growing in a few weeks. The nodules that keep growing after a couple weeks could be this cancer.

Advanced stages of nodular melanoma are very difficult to treat. Thats why knowing the facts and statistics of this disease is extremely important.

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Is My Mole Really A Nodular Melanoma

If you have a mole or growth that concerns you, then press down on it with your finger. If it is limp, soft, or squishy, then what you have will typically be benign. Nodular melanomas are not soft. They are extremely firm to the touch and will not move or give when pressed down upon. If you feel a hard knot or pressure on the spot causes it to bleed, then set up an immediate appointment with your doctor.

Proactive prevention methods can also reduce your chances of developing nodular melanoma. Every time you go outside, use a sunscreen that is at least SPF 15. Make sure to re-apply that sunscreen every 2 hours you are outside. Protect your lips, nose, ears, and the back of the neck especially. If you can avoid sun exposure between 10am and 4pm, then do so. If not, wear long-sleeved shirts, pants, a hat, and sunglasses when outside.

How Common Is It

Overall, skin cancers are the most common cancers in the United States. But melanoma is less common than the other two major types, basal cell and squamous cell carcinoma.

Each year about 91,000 people in the U.S. are diagnosed with melanoma of the skin, according to the American Cancer Society. By comparison, about 3.3 million are diagnosed with one or more basal cell or squamous cell carcinomas.

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What Are The Risk Factors

Anyone can develop melanoma, however, the risk is higher in people who have:

  • Unprotected exposure to UV radiation
  • Lots of moles more than 10 moles above the elbow on the arms and more than 50 on the body
  • Moles with irregular shape and uneven colour
  • A previous melanoma or other type of skin cancer
  • A strong family history of melanoma
  • Pale, fair or freckled skin, especially if it burns easily and doesnt tan
  • Light coloured eyes , and fair or red hair
  • A weakened immune system from using immune suppression medicines for a long time.

Overexposure to UV radiation can permanently damage the skin. This damage adds up over time. Childhood exposure to UV radiation increases the risk of skin cancer later in life, although sun protection will help prevent melanoma at any age.

Care At Our London Clinic

Nodular Melanoma Development

We appreciate that nodular melanoma can spread, to lymph nodes and organs within the body. A range of treatment may still help, chemotherapy, radiotherapy, targeted genetic therapy.

Because of the dangers, our objective is to diagnose and treat the condition at the earliest possible stage. Although fairer skin, multiple moles, age and sun exposure play a part, nobody is immune.

Any patient contacting us about the possibility of nodular malignant melanoma will see a skin cancer specialist as soon as possible and where needed, will be treated quickly.

The greatest care will be offered during treatment and afterwards. From assisting with restorative surgery if needed, to follow up appointments and regular skin checks.

Skin cancer treatment leads our work. For individual support, you are welcome to get in touch with our friendly team at any time.

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Melanomas That Could Be Mistaken For A Common Skin Problem

Melanoma that looks like a bruise

Melanoma can develop anywhere on the skin, including the bottom of the foot, where it can look like a bruise as shown here.

Melanoma that looks like a cyst

This reddish nodule looks a lot like a cyst, but testing proved that it was a melanoma.

Dark spot

In people of African descent, melanoma tends to develop on the palm, bottom of the foot, or under or around a nail.

Did you spot the asymmetry, uneven border, varied color, and diameter larger than that of a pencil eraser?

Dark line beneath a nail

Melanoma can develop under a fingernail or toenail, looking like a brown line as shown here.

While this line is thin, some are much thicker. The lines can also be much darker.

How Is Melanoma Diagnosed

Physical examination if you notice any changes to your skin, your doctor will examine you, looking carefully at any spots you have identified as changed or suspicious. The doctor will ask if you or your family have a history of melanoma.

Removing the mole If the doctor suspects that a spot on your skin may be melanoma, the whole spot is removed for examination by a tissue specialist . This is generally a simple procedure done in your doctors office. Your GP may do it, or you may be referred to a dermatologist or surgeon.

Checking the lymph nodes The lymph nodes are part of your bodys lymphatic system, which helps to protect the body against disease and infection. The lymphatic system is a network of vessels, tissues and organs. There are large groups of lymph nodes in your neck, armpits and groin. Sometimes melanoma can travel through the lymphatic system.

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Preventionslip Slop Slap Seek Slide

One of the most successful health education initiatives ever conducted in Australia was called Slip, Slop, SlapSlip on a shirt, Slop on sunscreen, and Slap on a broad-brimmed hat. The original slogan has now been expanded to Slip, Slop, Slap, Seek, and Slide, and exported to countries like the United States. Seek means to find some shade. Slide is a bit of a grammatical stretch, but good advice: Slide on a pair of wrap-around sunglasses.

What Is The Cause Of Nodular Melanoma

Nodular melanoma

Nodular melanoma is due to the development of malignant pigment cells along with the basal layer of the epidermis. These cells may occasionally arise from an existing melanocytic naevus but commonly occur within another type of melanoma or in previously normal-appearing skin. What triggers the melanocytes to become malignant is unknown, but it is likely to be a series of changes to the DNA. NRAS mutations are often found in patients with nodular melanomas.

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Treatment For Nodular Melanoma

Nodular melanoma is highly curable when diagnosed early. However, because nodular melanoma grows so quickly, it is often found at a more advanced stage. The goals for treatment of nodular melanoma are to:

  • cure the cancer
  • preserve the appearance of your skin
  • prevent the cancer from coming back

The extent and depth of the melanoma guides your care plan. Treatment often involves surgery to remove the melanoma. If the melanoma is more advanced and has spread to other parts of the body, such as the lymph nodes or internal organs, then immunotherapy, targeted therapy, chemotherapy, radiation, surgery, or a combination of therapies may be used to shrink the tumor.

Diagnostic Excision Of A Lesion Suspicious Of Nodular Melanoma

If the skin lesion is suspected to be a nodular melanoma, it should be urgently cut out . A small biopsy is best avoided, except in unusually large lesions. An incisional or punch biopsy could be misleading.

The pathological diagnosis of melanoma can be challenging. Nodular melanomas have little or no spread of malignant cells within the epidermis the melanoma cells are found within the dermis or subcutaneous fat. Extra tests using immunohistochemical stains may be necessary.

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Act Quickly With Nodular Melanoma

Nodular melanomas do spread more quickly than other types of melanoma and therefore should not be ignored. The thing your doctor will do if they suspect it may be a nodular melanoma is to cut it out and send off for analysis. At this stage, it could be cured, or further treatment may be required if it has spread further. There may be more surgery or radiation treatment. The treatment all depends on the stage at which the nodular melanoma was found.

Knowing what is nodular melanoma is hugely important when it comes to recovery and treatment so dont ignore any growths. Watch them using our app and if they continue to grow, head to the doctor for a checkup.

What Is The Treatment For Nodular Melanoma Symptoms

Red melanoma being overlooked: expert

In most cases, the nodule and the surrounding tissue is removed as a surgical procedure. This tissue is then checked to ensure that all of the cancer had been removed. Further surgery or treatment may be required if it is found that the cancer has spread. This may include the removal of lymph nodes. The prognosis is dependent on the depth and the size of the nodular melanoma symptoms and those with thicker nodules will need more invasive treatment and have lower rates of survival.

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What Are The Symptoms

Melanoma looks can vary greatly. In you have lots of moles, a melanoma usually stands out and looks different from the other moles. The first sign is often a new spot or a change in an existing mole.

  • Size The spot may appear or grow larger.
  • Colour The mole may become increasingly blotchy with different depth and shades of colour .
  • Shape or border The spot may increase in height, become scaly, have an irregular edge or lack symmetry .
  • Itching or bleeding The mole may itch or bleed at times.
  • Elevation the spot may start as a raised nodule or develop a raised area, which is often reddish or reddish brown.

New moles can appear during childhood and through to the 30s and 40s, as well as during pregnancy. However adults of any age can have new and changing spots. It is important to get to know your skin and check it regularly. In a room with good light, fully undress and use a full-length mirror to check your whole body. For areas that are hard to see, use a handheld mirror or ask someone to help.

See you doctor if you notice a freckle, mole or lump that is NEW or CHANGING in size, shape or colour, or a sore that does not heal over 4-6 weeks.

What Do I Do To Prevent Nodular Melanoma

The most obvious way to prevent any type of melanoma is to stay out of the sun and to always use sun protection when you are out. But checking your skin is also essential especially where these fast-growing nodular moles are concerned.

Look for any new skin growths and keep a close watch on them. If they seem to be growing or they are changing in any way it is essential they are check by your doctor. You may also wish to see your doctor with any new growths, even if they are still small. The earlier you catch nodular melanoma the better.

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Can You Have Melanoma For 3 Years And Not Know

How long can you have melanoma and not know it? It depends on the type of melanoma for example, a nodular melanoma can spread quickly in a matter of weeks, whereas a radial melanoma can spread slowly over a decade. Melanoma can grow for years before causing any noticeable symptoms, similar to a cavity.

What Causes Nodular Melanoma

Nodular melanoma

Nodular melanoma happens when melanocyte cells in your skin mutate and become cancerous. Melanocytes are the cells in your skin that make melanin. This is the pigment that gives your skin its color.

Sometimes, these cells can mutate after exposure to ultraviolet radiation. The sun is by far the most significant source of UV radiation, but it can also come from other sources, such as lasers and tanning beds.

If you get too much exposure to UV radiation, it can damage the DNA of your skin cells. This can lead to mutations in the DNA, causing the cells to grow out of control.

These mutations can lead to all types of skin cancer, including nodular melanoma. More research needs to be done to determine what causes specific types of skin cancer to form.

Exposure to UV light can cause mutations in skin cells and lead to multiple types of skin cancer. Scientists dont know exactly why DNA mutations to the melanocyte cells sometimes cause nodular melanoma and not other melanomas.

However, there are some risk factors that may increase the risk of nodular melanoma:

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A Dangerous Skin Cancer

Melanoma is a serious form of skin cancer that begins in cells known as melanocytes. While it is less common than basal cell carcinoma and squamous cell carcinoma , melanoma is more dangerous because of its ability to spread to other organs more rapidly if it is not treated at an early stage.

Learn more about melanoma types, risk factors, causes, warning signs and treatment.

Melanoma Fact

Only 20-30% of melanomas are found in existing moles.

While 70-80% arise on normal-looking skin.

A Crucial Discovery From The Land Down Under

Australia and New Zealand have the worlds highest incidence of melanoma their citizens are 5 times more likely to develop melanoma than U.S. citizens. This gives their medical scientists significant motivation to continually try and find new breakthroughs in the fight against skin cancer.

In 2003, the head of the Victorian Melanoma Service published a summary of the research done by noted dermatologist Dr. John W. Kelly. It focused on the inadequacy of the ABCD warning signs, and advocated for the addition of EFG signs of nodular melanoma.

This quote from the cited source article illustrates just how vital the results of Dr. Kellys research is in helping both doctors and patients identify nodular melanoma:

Nodular melanomas were mostly symmet-rical , with a regular border and of single colour , the majority being amelanotic. They were also more likely to be elevated , weeping, crusted or tender in comparison to SSM.* Nodular melanoma are mostly red or pink in colour and if present, pigmenta-tion is usually evenly distributed throughout the lesion. They are raised from the outset and grow progressively as a round nodule.

Additionally, some nodular melanoma can actually be pale in color. Together, all of this means that people who apply only the ABCDE principles to skin lesions may very well mistake a deadly cancer for a common, benign skin blemish. That type of error can have fatal consequences.

Please help us spread the word.

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How Dangerous Is Melanoma

Melanoma is usually curable when detected and treated early. Once melanoma has spread deeper into the skin or other parts of the body, it becomes more difficult to treat and can be deadly.

  • The estimated five-year survival rate for U.S. patients whose melanoma is detected early is about 99 percent.
  • An estimated 7,180 people will die of melanoma in the U.S. in 2021.


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