How Dangerous Is Melanoma Its All A Matter Of Timing
Skin cancer holds the unfortunate distinction of being the worlds most common cancer. Though its prevalence around the globe is disturbing, there is some good news: When caught early, skin cancers are almost always curable.
You might already know that catching a cancer early means a more favorable prognosis. But it can be difficult to comprehend just how big a difference early detection makes with melanoma, the most dangerous form of skin cancer. Melanoma should never be underestimated, but treating a tumor early rather than after it is allowed to progress could be lifesaving.
Leland Fay, 46, understands better than most the seriousness of this distinction. When the Monument, Colorado native was diagnosed with melanoma in 2012, he was given a bleak prognosis due to the advanced stage of the tumor it had already reached stage IV.
Leland hadnt thought much of the little black mole on his head a few months earlier, when a dermatologist froze it off during a routine exam. But the mole resurfaced, bigger than it had been originally. After a biopsy and imaging tests, doctors told Leland it was melanoma, and that it had already spread. He could have as few as six weeks to live.
To fully comprehend the significance of timing, it can be helpful to understand exactly what happens to a melanoma when it advances to a later stage, and what it means when a melanoma spreads beyond the original tumor site.
Melanoma On The Chest Back Or Abdomen
Chest ~ Abdomen ~ Upper middle back ~ Left breast ~ Back ~ My husbands back, my shoulder ~ His back ~ My stomach and that never sees the sun. ~ Mole on my back ~ Two places on my abdomen.
Many of our community members have been diagnosed with melanoma on their chest, back, or abdomen. For some people, these melanoma presented as abnormal moles , whereas some patients notice a firm, dome-shaped bump or large tan patch . Melanomas on the back can be more difficult to see and find on your own, so be sure to schedule regular full-body skin exams with your healthcare provider.
Who Is At Risk For Developing Melanoma
Everyone is at some risk for melanoma, but increased risk depends on several factors. These are sun exposure, number of moles on the skin, skin type and family history .
Also Check: How Many People Die From Skin Cancer
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.
I’ve Been Diagnosed With Melanomawhat Happens Next
Doctors use the TNM system developed by the American Joint Committee on Cancer to begin the staging process. Its a classification based on three key factors:
T stands for the extent of the original tumor, its thickness or how deep it has grown and whether it has ulcerated.
What Is Breslow depth?
Breslow depth is a measurement from the surface of the skin to the deepest component of the melanoma.
Tumor thickness: Known as Breslow thickness or Breslow depth, this is a significant factor in predicting how far a melanoma has advanced. In general, a thinner Breslow depth indicates a smaller chance that the tumor has spread and a better outlook for treatment success. The thicker the melanoma measures, the greater its chance of spreading.
Tumor ulceration: Ulceration is a breakdown of the skin on top of the melanoma. Melanomas with ulceration are more serious because they have a greater risk of spreading, so they are staged higher than tumors without ulceration.
N indicates whether or not the cancer has already spread to nearby lymph nodes. The N category also includes in-transit tumors that have spread beyond the primary tumor toward the local lymph nodes but have not yet reached the lymph nodes.
M represents spread or metastasis to distant lymph nodes or skin sites and organs such as the lungs or brain.
After TNM categories are identified, the overall stage number is assigned. A lower stage number means less progression of the disease.
Read Also: Does Aflac Cancer Policy Cover Skin Cancer
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.
Looking For More Of An Introduction
If you would like more of an introduction, explore this related item. Please note that these links will take you to other sections on Cancer.Net:
ASCO Answers Fact Sheet: Read a 1-page fact sheet that offers an introduction to melanoma. This free fact sheet is available as a PDF, so it is easy to print.
Cancer.Net Patient Education Video: View a short video led by an ASCO expert in melanoma that provides basic information and areas of research.
Recommended Reading: Can You Get Skin Cancer On Your Scalp
When Melanoma Can’t Be Cured
If your cancer has spread and it is not possible to cure it by surgery, your doctor may still recommend treatment. In this case, treatment may help to relieve symptoms, might make you feel better and may allow you to live longer.Whether or not you choose to have anti-cancer treatment, symptoms can still be controlled. For example, if you have pain, there are effective treatments for this. General practitioners, specialists and palliative care teams in hospitals all play important roles in helping people with cancer.
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.
Read Also: How Many Types Of Skin Cancer Exist
Symptoms Of Metastatic Melanoma Other Than A Mole
Other symptoms of this type of cancer may not appear until a later stage, when the melanoma has metastasized to another area of the body. Metastatic melanoma most often spreads to the lymph nodes, brain, bones, liver or lungs, and the additional symptoms experienced at this late stage will depend on where the melanoma has spread. For example:
- Lungs A persistent cough or shortness of breath
- Brain Headaches or seizures
- Lymph nodes Swelling of the lymph nodes
- Liver Loss of appetite or unexplained weight loss
- Bone Bone pain or unusual fractures
Treatments For Advanced Melanoma
In most cases, treatment can’t cure advanced melanoma. But some can help you live longer and feel better. The goal of any therapy you get will be to shrink or remove your tumor, keep the cancer from spreading further, and ease your symptoms.
Surgery. This is the main way to remove melanoma from the skin and lymph nodes. You might also have an operation on organs where the cancer has spread. Thereâs no guarantee your surgeon will get all of it. Some melanoma is too small to see, even with high-tech scans.
Radiation. Your doctor might recommend radiation to kill any cancer cells that have been left behind after surgery or if melanoma spreads to your brain or bones. It can also relieve pain from the disease or treat melanoma that comes back over and over.
Immunotherapy or biologic therapy. These drugs help your immune system find and attack cancer cells. Depending on the ones you take, you might have to go in for treatment every 2, 3, or 4 weeks.
Your doctor might want you to take more than one drug. Some studies show that people who do have fewer side effects.
The flip side of immunotherapy is that sometimes these drugs cause your immune system to attack healthy organs. Then youâd need to stop melanoma treatment and take drugs to stop the attack.
Chemo can shrink the cancer, but chances are it will start growing again after a few months and youâll need more treatment. Immunotherapy and targeted therapy usually work better.
Other side effects include:
Also Check: Does Sunburn Cause Skin Cancer
Diagnosis Of Metastatic Melanoma
Your care team may use several tests to diagnose metastatic melanoma.
If theres evidence of a primary tumor, a biopsy may be taken. For this, a small section of suspected cancerous skin is removed with a razor, scalpel or small punch tool. The removed tissue is examined under a microscope to determine whether its melanoma.
Additional tests are needed to determine whether the cancer is metastatic melanoma, or if theres no visible primary tumor. To test for metastatic melanoma, or melanoma that has spread to lymph nodes or distant parts of the body, your care team may perform the following tests.
- Lymph node mapping and sentinel lymph node biopsy : Your doctor may perform a physical exam of your lymph nodes and check for swelling or physical masses. If no tumors are found , an SLNB may be done. For an SLNB, a radioactive dye is injected to locate the primary tumor. Then, the doctor will remove the lymph nodes that the dye traveled to and check them for melanoma.
- Computed tomography scan, positron emission tomography scan, magnetic resonance imaging scan or ultrasound exam: Each of these scans is a noninvasive way to look inside your body and check for tumors.
- Blood chemistry studies: Cancer may cause elevated or abnormal levels of certain substances in your blood. A laboratory test can identify if your blood chemistry shows signs of a cancerous tumor.
What Does A Common Mole Look Like
A common mole is usually smaller than about 5 millimeters wide . It is round or oval, has a smooth surface with a distinct edge, and is often dome-shaped. A common mole usually has an even color of pink, tan, or brown. People who have dark skin or hair tend to have darker moles than people with fair skin or blonde hair. Several photos of common moles are shown here, and more photos are available on the What Does a Mole Look Like? page.
Common Mole Photos
This common mole is 1 millimeter in diameter .
This common mole is 2 millimeters in diameter .
This common mole is about 5 millimeters in diameter .
This common mole is about 5 millimeters in diameter .
This common mole is about 5 millimeters in diameter .
You May Like: How To Detect Melanoma Early
What Will Happen After Treatment
Youll be glad when treatment is over. For years after treatment, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back.
At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed. After 5 years, they may be done once a year.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as good as you can.
When A Mole Becomes Melanoma
A mole is merely a cluster of melanocytes and surrounding skin tissue. They may be raised or flat, and may appear pink, brown, tan or similar to normal skin color. Common moles tend to be smaller than a pencil eraser. Melanoma can develop either from an existing mole or appear as a new mole, when the melanocytes become malignant. Melanoma can develop anywhere melanocytes are found, including the eye , digestive tract and lymph nodes, although these sites are less common.
Melanoma is less common than squamous cell and basal cell skin cancers, and accounts for only 5 percent of all skin cancers. But it is the most serious skin cancer type and causes the majority of skin cancer deaths. Melanoma is more likely to spread to lymph nodes and other parts of the body, and form new tumors. It occurs most commonly in the trunk, between the shoulders and hips, on the head, neck, and in women, on the lower legs. Although rare in black people or others with dark skin, when melanoma does develop in people with darker skin types, it tends to occur on the palms and soles.
The number of melanoma cases has increased for the past 30 years, especially among young adults. During these decades, melanoma rates have increased 64 percent among white men and 153 percent among white women. Melanoma is now the most common cancer among people age 25 to 29. Indoor tanning is an important risk factor.
Also Check: What Does Skin Carcinoma Look Like
How Do Doctors Determine The Staging And Prognosis Of A Melanoma
The most useful criterion for determining prognosis is tumor thickness. Tumor thickness is measured in fractions of millimeters and is called the Breslow’s depth. The thinner the melanoma, the better the prognosis. Any spread to lymph nodes or other body locations dramatically worsens the prognosis. Thin melanomas, those measuring less than 0.75 millimeters when examined microscopically, have excellent cure rates, generally with local surgery alone. For thicker melanomas, the prognosis is guarded.
Melanoma is staged according to thickness, ulceration, lymph node involvement, and the presence of distant metastasis. The staging of a cancer refers to the extent to which it has spread at the time of diagnosis, and staging is used to determine the appropriate treatment. Stages 1 and 2 are confined to the skin only and are treated with surgical removal with the size of margins of normal skin to be removed determined by the thickness of the melanoma. Stage 3 refers to a melanoma that has spread locally or through the usual lymphatic drainage. Stage 4 refers to distant metastases to other organs, generally by spread through the bloodstream.
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.
Only 20-30% of melanomas are found in existing moles.
While 70-80% arise on normal-looking skin.
Don’t Miss: How Long Can You Live With Melanoma
Should People Have A Doctor Remove A Dysplastic Nevus Or A Common Mole To Prevent It From Changing Into Melanoma
No. Normally, people do not need to have a dysplastic nevus or common mole removed. One reason is that very few dysplastic nevi or common moles turn into melanoma . Another reason is that even removing all of the moles on the skin would not prevent the development of melanoma because melanoma can develop as a new colored area on the skin . That is why doctors usually remove only a mole that changes or a new colored area on the skin.