What If I Have Melanoma

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.

Skin Exam And Physical

You may have had a complete skin exam during your last dermatology appointment. Dermatologists often perform this exam when a patient has a suspicious spot on their skin that could be skin cancer.

During a complete skin exam, your dermatologist examines you head to toe. This exam includes a look at all of your skin, including the skin on your scalp, face, genitals, and the bottoms of your feet. Your dermatologist will also examine your nails and look inside your mouth.

If you did not have a complete skin exam before being diagnosed with melanoma, youll have one at your next appointment.

During a complete skin exam, your dermatologist may use a device called a dermatoscope

This device provides a closer look at the spots on your skin.

At your next appointment, youll receive a physical. During your physical, your dermatologist will ask how youre feeling and about your health, illnesses, and injuries. Your dermatologist will also want to know what diseases run in your family and the medications you take.

During your physical, your dermatologist will check your lymph nodes to find out if any feel swollen. There are many reasons for swollen lymph nodes. For example, if you have an infection or recently received a vaccination, lymph nodes can feel swollen. When you have melanoma, the swelling might be a sign that the cancer has spread.

If youre unsure what diseases your close blood relatives have had, try to find out

Where Else Does Melanoma Spread To

When melanoma advances to stage 3, it means the tumor has spread to the lymph nodes or the skin around the primary tumor and lymph nodes. In stage 4, the cancer has moved to other areas far beyond the lymph nodes, like your internal organs. The most common places melanoma spreads to are the:

• lungs
• brain
• stomach, or abdomen

These growths will cause different symptoms, depending on which areas it has spread to. For example, you may feel breathless or constantly cough if the cancer has spread to your lungs. Or you may have a long-term headache that wont go away if it has spread to your brain. Sometimes the symptoms for stage 4 melanoma may not appear for many years after the original tumor was removed.

Talk to your doctor if youre feeling new pains and aches or symptoms. Theyll be able to help diagnose the cause and recommend treatment options.

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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.

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.

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Types Of Skin Malignancies:

• Melanoma the least common form of skin cancer, but responsible for more deaths per year than squamous cell and basal cell skin cancers combined. Melanoma is also more likely to spread and may be harder to control.
• Nonmelanoma malignancies:
• Squamous cell cancer the second-most common skin cancer. It’s more aggressive and may require extensive surgery, depending on location and nerve involvement.
• Basal cell cancer the most common form of skin cancer. It is rarely fatal but can be locally aggressive.

These skin malignancies are typically caused by ultraviolet radiation from exposure to the sun and tanning beds.

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

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Melanoma Can Be Colorless

While its true that many melanomas are dark brown to black in color, some melanomas have no color and appear as pink spots or bumps. Beware of isolated pink spots, especially if the spot looks different than the other marks on the skin, says Dr. Marghoob. Pay attention to any spot or mark that has an uneven texture, shape, border, or distribution of colors. In addition, any spot that has changed in some way should prompt a visit to your local doctor.

The Risks The Causes What You Can Do

Skin cancers like melanoma have damaged DNA in skin cells that lead to uncontrolled growth of these cells. Ultraviolet rays from the sun or tanning beds damage DNA in your skin cells. Your immune system repairs some of this damage but not all. Over time, the remaining DNA damage can lead to mutations that cause skin cancer. Many other factors also play a role in increasing the risk for melanoma, including genetics , skin type or color, hair color, freckling and number of moles on the body.

Understanding what causes melanoma and whether youre at high risk of developing the disease can help you prevent it or detect it early when it is easiest to treat and cure.

These factors increase your melanoma risk:

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Melanoma Symptoms And Signs

Melanoma is a type of skin cancer that forms in pigment-forming cells . Melanoma is the most serious type of skin cancer. Rarely, melanomas can be found in other areas of the body that contain pigment-forming cells, including the eye, the tissues around the brain and spinal cord, or the digestive tract. Melanomas of the skin produce changes in the appearance of the skin, but these changes can sometimes be seen with other skin conditions. The characteristic symptoms include a change in an existing mole or new mole with asymmetric borders, uneven coloring, increasing size, scaling, or itching. Melanomas are typically not painful. It is always important to seek medical advice when you develop a new pigmented spot on the skin or have a mole that is growing or changing.

The 4 Stages Of Melanoma

Two main things determine the stage of melanoma: The thickness or depth of the tumor and how far it has spread when its diagnosed, explains David Polsky, M.D., dermatologist at NYU Langone Medical Center in New York City. In stages 0, 1, and 2, the melanoma is limited to the skin. In stage 3, its spread to the lymph nodes, small structures throughout your body that help filter fluids and fight infection. In the most advanced stage, stage 4, melanoma cells have broken away from the original tumor, traveled through the body and formed a new tumor somewhere else.

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What Does A Melanoma Mole Look Like

Melanomas are usually brown or black, but some can appear pink, tan, or even white. Some melanomas have areas with different colors, and they might not be round like normal moles. They often appear as tan, brown, or black raised spots with a waxy texture or rough surface.

Herein, what does early signs of melanoma look like?

Early warning signs of melanomaBorder: The edge is not smooth, but irregular or notched. Color: The mole has uneven shading or dark spots. Diameter: The spot is larger than the size of a pencil eraser. Evolving or Elevation: The spot is changing in size, shape or texture.

Similarly, can I see pictures of melanoma? Our overview of melanoma pictures includes pictures of moles and other skin lesions, that you can use as a first comparison to any moles you might feel uncomfortable with. The melanoma pictures give you an idea of what melanoma skin cancer can look like. Signs of melanoma can differ in form, color or borders.

Simply so, what is a cancerous mole look like?

“Normal” moles can appear flat or raised or may begin flat and become raised over time. The surface is typically smooth. Moles that may have changed into skin cancer are often irregularly shaped, contain many colors, and are larger than the size of a pencil eraser.

Is melanoma flat or raised?

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There Are Different Types Of Cancer That Start In The Skin

There are two main forms of skin cancer: melanoma and nonmelanoma.

Melanoma is a rare form of skin cancer. It is more likely to invade nearby tissues and spread to other parts of the body than other types of skin cancer. When melanoma starts in the skin, it is called cutaneous melanoma. Melanoma may also occur in mucous membranes . This PDQ summary is about cutaneous melanoma and melanoma that affects the mucous membranes.

The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. They are nonmelanoma skin cancers. Nonmelanoma skin cancers rarely spread to other parts of the body.

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What Are The Signs Of Symptoms Of Metastatic Melanoma

Signs and symptoms depend upon the site of metastasis and the amount of tumor there. Metastases to the brain may first appear as headaches, unusual numbness in the arms and legs, or seizures. Spread to the liver may be first identified by abnormal blood tests of liver function long before the patient has jaundice, a swollen liver, or any other signs of liver failure. Spread to the kidneys may cause pain and blood in the urine. Spread to the lungs may cause shortness of breath, other trouble breathing, chest pain, and continued cough. Spread to bones may cause bone pain or broken bones called pathologic fractures. A very high tumor burden may lead to fatigue, weight loss, weakness and, in rare cases, the release of so much melanin into the circulation that the patient may develop brown or black urine and have their skin turn a diffuse slate-gray color. The appearance of multiple blue-gray nodules in the skin of a melanoma patient may indicate widespread melanoma metastases to remote skin sites.

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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Advanced Stages Of Melanoma

• Your lymph nodes may be hard or swollen
• Hard lumps may appear in your skin
• You may lose your breath, have chest pain or noisy breathing or have a cough that wont go away
• You may feel pain in your liver
• Your bones may feel achy
• Headaches that wont go away
• Bowel issues or constipation
• You may feel extremely tired and fatigued

Skin Cancer Of The Head And Neck Treatment

Many early-stage small basal cell cancers or squamous cell cancers can be removed by Mohs surgery, a technique that spares normal tissue through repeated intraoperative margin testing, removing only the cancer and leaving adjacent normal tissue. Tumors with nerve involvement, lymph node involvement or of a large size are not suitable for Mohs surgery. They require a multimodality approach to treatment, with formal surgical resection and adjuvant radiation or chemotherapy.

Melanoma is more likely to spread, and aggressive surgical resection with wide margins is required, in addition to radiation and/or chemotherapy.

Johns Hopkins Head and Neck Cancer Surgery

Johns Hopkins Head and Neck Cancer Surgery provides comprehensive surgical care and treatment for head and neck cancers. Our surgeons are at the leading edge of head and neck cancer treatment. You will benefit from the skilled care of head and neck surgeons, guiding clinical advancements in the field of head and neck cancer care.

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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.

Biological Therapies And Melanoma

Biological therapies are treatments using substances made naturally by the body. Some of these treatments are called immunotherapy because they help the immune system fight the cancer, or they occur naturally as part of the immune system.

There are many biological therapies being researched and trialled, which in the future may help treat people with melanoma. They include monoclonal antibodies and vaccine therapy.

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How Is Metastasis Detected

If your healthcare provider suspects that your melanoma may have spread, there are several tools available to verify the diagnosis. These include a blood test for lactate dehydrogenase , which increases when melanoma metastasizes, and imaging studies, such as chest X-ray, computed tomography , magnetic resonance imaging , positron emission tomography and ultrasound.

The practitioner may also need to take a sample of your lymph nodes, using a procedure called “sentinel lymph node mapping.” If confirmed, there are many treatments available, including chemotherapy, immunotherapy, radiation therapy and surgery.

Questions To Ask About Choosing A Treatment And Managing Side Effects

• What are my treatment options?

• What clinical trials are available for me? Where are they located, and how do I find out more about them?

• What treatment plan do you recommend? Why?

• What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

• What are the possible side effects of each treatment option, both in the short term and the long term? Is there anything we can do to prevent them?

• Who will be part of my health care team, and what does each member do?

• Who will be leading my overall treatment?

• How will each treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

• Could this treatment affect my sex life? If so, how and for how long?

• Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

• If Im worried about managing the costs of cancer care, who can help me?

• What support services are available to me? To my family?

• If I have questions or problems, who should I call?

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Skin Cancer Diagnosis Always Requires A Skin Biopsy

When you see a dermatologist because youve found a spot that might be skin cancer, your dermatologist will examine the spot.

If the spot looks like it could be a skin cancer, your dermatologist will remove it all or part of it. This can easily be done during your appointment. The procedure that your dermatologist uses to remove the spot is called a skin biopsy.

Having a skin biopsy is essential. Its the only way to know whether you have skin cancer. Theres no other way to know for sure.

What your dermatologist removes will be looked at under a microscope. The doctor who examines the removed skin will look for cancer cells. If cancer cells are found, your biopsy report will tell you what type of skin cancer cells were found. When cancer cells arent found, your biopsy report will explain what was seen under the microscope.