Early Warning Signs Of Melanoma
The key to detecting melanoma early is to know what to look for and where to look for it. This isnt always easy, as melanoma can be a master of disguise. It may look like an age spot, a bruise, a sore, a cyst, a scar or a dark line beneath your nail. You may not feel a melanoma, but there are times that it may itch, hurt or bleed.
The ABCDE method may help you determine whether an abnormal skin growth may be melanoma:
- A is for asymmetry: Does the mark look different on each half?
- B is for border: Are the edges jagged or irregular?
- C is for color: Is your lesion uneven in color with specks of black, brown and tan?
- D is for diameter: Is your lesion getting larger?
- E is for evolving or elevation: Has your lesion changed in size, shape or texture over the past few weeks or months?
If the answer to any of these questions is yes, or even maybe, see a dermatologist for a proper evaluation. The only way to be sure whether a mole is melanoma is to visit a doctor.
Other melanoma warning signs may include:
- Sores that dont heal
- Pigment, redness or swelling that spreads outside the border of a spot to the surrounding skin
- Itchiness, tenderness or pain
What Are The Symptoms Of Melanoma That Has Spread
Melanoma that has spread from the skin to other areas of the body is known as metastatic melanoma. However, since melanoma often first presents itself as an abnormal mole, many people with this malignancy can receive a diagnosis before the cancer has spread. This mole may be asymmetrical, have an uneven border, have an inconsistent color, be large or change over time. A melanoma may also appear as a sore or itchy bump, a tender nodule or a patch of skin that is scaly or bleeding. In some cases, early signs of melanoma are not present. For example, if the cancer starts in a mucous membrane rather than on the skin, a mole may not be present.
Red Flag #: Chest Pain And Trouble Breathing
Melanoma is also known to spread to the lungs, though Dr. Zaba notes that most people dont experience noticeable symptoms in the lungs until a tumor has gotten pretty large. A cough that just wont quit or recurring chest infections can signal that the cancer has traveled to the lungs, Dr. Polsky says. Shortness of breath or trouble breathing can also be a red flag.
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E: Evolving And/or Elevated
“E” stands for two different features of melanoma:
- Elevation: Moles are often elevated above the skin, often unevenly so with some parts raised and others flat.
- Evolving: A mole that is evolving is also concerning and, in retrospect, many people with melanomas note that a mole had been changing in terms of size, shape, color, or general appearance before they were diagnosed.
When a melanoma develops in an existing mole, the texture may change and become hard, lumpy, or scaly. Although the skin may feel different and itch, ooze, or bleed, a melanoma does not usually cause pain.
Signs And Symptoms Of Melanoma Skin Cancer
How melanoma skin cancer looks can vary. Melanoma skin cancer often starts as an abnormal mole anywhere on the skin. A mole is a common non-cancerous growth. It is normally a small, round or oval spot that is usually brown, tan or pink. It may be raised or flat. Most people have a few moles.
A change in the colour, size or shape of a mole is usually the first sign of melanoma skin cancer. These changes can happen in a mole or spot that is already on your skin, or changes can appear as a new mole. Other health conditions can also look like melanoma skin cancer.
The ABCDE rule below can help you look for the common signs and symptoms of melanoma skin cancer. See your doctor if you have any of these changes on your skin:
A is for asymmetry One-half of a mole does not have the same shape as the other half.
B is for border The edge of a mole is uneven . It can look jagged, notched or blurry. The colour may spread into the area around the mole.
C is for colour The colour of a mole is not the same throughout. It could have shades of tan, brown and black. Sometimes areas of blue, grey, red, pink or white are also seen.
D is for diameter The size of a mole is larger than 6 mm across, which is about the size of a pencil eraser.
E is for evolving There is a change in the colour, size, shape or feel of the mole. The mole may become itchy or you may have a burning or tingling feeling.
Other signs and symptoms of melanoma skin cancer include:
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Red Flag #: Bone Pain Or Fractures
The bones are considered a late-stage site of melanoma metastasestypically, it doesnt spread to the bones until its already spread to another area of the body first. Melanoma can cause pain in the bones where its spread, and some peoplethose with very little body fat covering their bonesmay be able to feel a lump or mass. Metastatic melanoma can also weaken the bones, making them fracture or break very easily. This is most common in the arms, legs, and spine. If you feel any sharp, sudden, or new pains that wont go away, talk to your doctor.
What To Look For
Any new spots that appear on the skin could potentially be skin cancer, considering that one in five people will develop at least one skin cancer in their lifetime. Definitively distinguishing the different types of skin cancer requires a biopsy and microscopic evaluation, but the general appearance of these tumors also differs to some degree.
- Basal cell carcinomas are often shiny and have been described as “pearlescent.” They may be flat, raised, or dome-shaped, and are often pink, pale, or flesh-colored. On careful inspection, tiny blood vessels may be visible when compared with the surrounding skin. Basal cell cancer characteristically is very often ulcerated and has been called a rodent ulcer because it looks like a mouse has gnawed it.
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- Squamous cell carcinomas are often raised and feel crusty to touch. They can appear scaly and may be ulceratedthat is, have a central depression that is lighter and flatter than the surrounding area. These cancers sometimes bleed, ooze, or form scabs.
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How Does Melanoma Make You Feel
At first, melanoma can cause few symptoms. Some people may have melanoma without any pain or discomfort. In these cases, the only symptoms may be a new or unusual mole or mark.
Sometimes, however, marks or patches on the skin become tender, itchy, or painful. There may also be inflammation surrounding them.
People undergoing treatment for melanoma may experience additional symptoms. For example, chemotherapy and radiation therapy can cause fatigue and nausea.
What Are The Symptoms Of Skin Cancer
Talk to your doctor if you notice changes in your skin such as a new growth, a sore that doesnt heal, a change in an old growth, or any of the A-B-C-D-Es of melanoma.
A change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesnt heal, or a change in a mole.external icon Not all skin cancers look the same.
For melanoma specifically, a simple way to remember the warning signs is to remember the A-B-C-D-Es of melanoma
- A stands for asymmetrical. Does the mole or spot have an irregular shape with two parts that look very different?
- B stands for border. Is the border irregular or jagged?
- C is for color. Is the color uneven?
- D is for diameter. Is the mole or spot larger than the size of a pea?
- E is for evolving. Has the mole or spot changed during the past few weeks or months?
Talk to your doctor if you notice changes in your skin such as a new growth, a sore that doesnt heal, a change in an old growth, or any of the A-B-C-D-Es of melanoma.
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What Is Melanoma Of The Head And Neck
Melanoma is a cancer that arises from melanocytes, the cells that give skin its pigment or color. Melanoma most commonly occurs in skin cells, but can rarely also occur in mucous membranes of the respiratory, gastrointestinal, genital or urinary organs. Melanoma arising in skin cells is caused by ultraviolet radiation from exposure to the sun and tanning beds.
Melanoma is the least common form of skin cancer, but it is responsible for more deaths per year than all other skin cancers combined. Melanoma is also more likely than other skin cancers to spread, and may be harder to control. However, approximately 75% of melanomas are found before they have spread, and can be cured with treatment. Mucosal melanomas make up 1% of all melanomas, and are more likely to spread to other sites
What Is Melanoma Cancer
Melanoma is a serious type of skin cancer. Most melanoma is treated surgically, and in many cases this surgery is curative. Through numerous clinical trials, the surgery that is required to treat melanoma has become less invasive. A number of these less radical procedures were pioneered at the Saint Johns Cancer Institute Melanoma Program.
100,350people in the U.S. will be diagnosed with melanoma in 2020 and the American Cancer Society estimates that number will continue to increase year after year.
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Red Flag #: Unexplained Weight Loss And Loss Of Appetite
Unintentional weight loss is a common side effect of any cancer. When it comes to melanoma, extreme weight loss usually only happens after the cancer has spread from the skin to other parts of the body. Dr. Zaba says she can sometimes tell if a patients melanoma has metastasized because it looks like they have cachexia, a syndrome marked by drastic loss of fat and muscle and increased weakness. Cachexia can also cause loss of appetite, which further contributes to the problem.
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How Is Melanoma Diagnosed
If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.
After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.
Melanomas are grouped into the following stages:
- Stage 0 : The melanoma is only in the top layer of skin .
- Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.
- Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.
- Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
- Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.
Flat Red Patches And Rashes
One type of cancer that affects the skin, T-cell lymphoma, often begins with very itchy, flat, red patches and plaques that are easily mistaken for eczema or psoriasis.
One type of T-cell lymphoma, mycosis fungoids, transitions from these patches to dome-shaped nodules, and then to extensive reddened areas on multiple areas of the body. It may spread to lymph nodes and other regions of the body such as the lungs, liver, and bones. T-cell lymphomas most often begin on the buttocks, groin, hips, armpits, and chest.
Other cancers, such as breast cancer, may spread to the skin and initially be mistaken for a benign rash. Inflammatory breast cancer is a type of breast cancer that originates in the skin and appears, at first, to be an eczematous type of rash.
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What Is Metastatic Melanoma
Melanoma is a type of skin cancer. When it spreads to other places in your body, it’s called metastatic, or advanced. You may also hear your doctor refer to it as stage IV melanoma.
Melanoma often spreads to:
Although in many cases metastatic melanoma canât be cured, treatments and support can help you live longer and better. Doctors have therapies that have greatly increased survival rates. And researchers are working to find new medications that can do even more.
Remember: You still have control over the decisions you make about your treatment and your life. It’s important to have people you can talk to about your plans, your fears, and your feelings. So find support and learn about your treatment options. That will help you make the most of your life.
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.
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Red Flag #: Headaches Or Visual Changes
Just like the liver, not everyone will notice symptoms of melanoma spreading to the brain. But when symptoms do show up, its usually in the form of headaches, problems with eyesight, paralysis on one side of the body, or seizures. If someone simply has a headache, that doesnt mean they have advanced stage melanoma, Dr. Yushak says. But if its a headache thats not going away after a week, and you never have headaches, then thats something that definitely needs to be checked out.
Red Flag #: Swollen Lymph Nodes
If melanoma spreads, it often goes to the lymph nodes first, says Melinda L. Yushak, M.D., assistant professor of hematology and medical oncology at Emory University School of Medicine in Atlanta. The cancer cells will first travel to the nodes closest to the original tumor, she says. Lymph nodes are located throughout your entire body, but large clusters are found in the neck, underarms, chest, abdomen, and groin. If the cancer has made its way to the lymph nodes, it usually wont be painful, but theyll feel swollen or even hard to the touch, Dr. Zaba says.
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When Should I Call My Doctor
You should have a skin examination by a doctor if you have any of the following:
- A personal history of skin cancer or atypical moles .
- A family history of skin cancer.
- A history of intense sun exposure as a young person and painful or blistering sunburns.
- New or numerous large moles.
- A mole that changes in size, color or shape.
- Any mole that itches, bleeds or is tender.
A note from Cleveland Clinic
Receiving a diagnosis of melanoma can be scary. Watch your skin and moles for any changes and seeing your doctor regularly for skin examinations, especially if youre fair-skinned, will give you the best chances for catching melanoma early when its most treatable.
Last reviewed by a Cleveland Clinic medical professional on 06/21/2021.
References
Taking Care Of Yourself
Hearing that your cancer has spread is scary, but a lot of research is underway to find new treatments. And there are treatments available to try to stop the disease from spreading, so you can live longer.
It’s important to have support and to talk about your fears and feelings, too. Your doctor can help you find a cancer support group.
These tips may help you feel better during melanoma treatment:
- If you lose your appetite, eat small amounts of food every 2 to 3 hours instead of bigger meals. A dietitian can give you other tips on nutrition and eating during your cancer treatment. Ask your doctor for a referral.
- Exercise can help you feel better overall and fight fatigue. But listen to your body, and balance rest and activity.
- Get the kind of emotional support that’s right for you. It could be from family, friends, your cancer support group, or a religious group.
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What Tests Are Used To Stage Melanoma
There are several tests your doctor can use to stage your melanoma. Your doctor may use these tests:
- Sentinel Lymph Node Biopsy: Patients with melanomas deeper than 0.8 mm, those who have ulceration under the microscope in tumors of any size or other less common concerning features under the microscope, may need a biopsy of sentinel lymph nodes to determine if the melanoma has spread. Patients diagnosed via a sentinel lymph node biopsy have higher survival rates than those diagnosed with melanoma in lymph nodes via physical exam.
- Computed Tomography scan: A CT scan can show if melanoma is in your internal organs.
- Magnetic Resonance Imaging scan: An MRI scan is used to check for melanoma tumors in the brain or spinal cord.
- Positron Emission Tomography scan: A PET scan can check for melanoma in lymph nodes and other parts of your body distant from the original melanoma skin spot.
- Blood work: Blood tests may be used to measure lactate dehydrogenase before treatment. Other tests include blood chemistry levels and blood cell counts.