Melanoma

Skin cancers can be separated into two different categories: melanoma and non-melanoma. Melanoma, also known as malignant melanoma and cutaneous melanoma, is a much less common cancer of the skin, but is considered to be the most dangerous. Melanoma’s chance of spreading to other body parts is significantly high, and it can be fatal if it isn’t treated in its earliest stages.

This skin disease begins in the melanocytes, which are cells that give your skin its pigment by producing melanin to protect the deeper layers against damage from ultraviolet (UV) radiation in sunlight. Previously healthy melanocytes can begin to mutate and grow uncontrollably as a result of DNA damage. UV radiation is believed to be what usually causes such damage, but genetic or other environmental factors may also play a role. These abnormal cells eventually form cancerous tumors.

There are several known risk factors that may make it more likely for patients to develop melanoma. These include exposure to UV radiation from sunlight or artificial sources, such as indoor tanning; having many moles or atypical moles; having fair skin, blond or red hair, and blue eyes; a family history of the disease; inherited genetic conditions; age; a weakened or suppressed immune system; and a history of severe sunburns.

The first sign of melanoma might be a skin irregularity that seems to be changing in appearance and doesn’t go away over time. Sometimes a new spot may appear on the skin, or an existing mole may look and feel different from the others around it. The “ABCDEs” and the “Ugly Ducking” sign can help you know what to look for when you’re examining your skin:

• A is for Asymmetry: If you were to draw a line down the center of a normal, healthy mole, the two sides would match. Cancerous lesions are typically more irregularly shaped.
• B is for Border: Instead of an even border, the outer edge might be scalloped, notched, or indistinct.
• C is for Color: Although melanomas can look black, brown, and tan, unusual colors like red, white, and blue may be present.
• D is for Diameter: Watch out for any mole that is larger than the size of a pencil eraser.
• E is for Evolving: If you are noticing new symptoms such as bleeding, oozing, itching, or crusting, or changes to the texture or color of the mole, this could indicate the presence of cancer.

Most moles on your skin will look similar to each other. The “Ugly Duckling” strategy involves checking for any moles that look radically different or are isolated from the rest.

Although you can’t completely remove your chances of developing melanoma, there are steps that can be taken to significantly decrease the risk. Reduce the amount of time you expose yourself to UV radiation from sunlight during the daytime hours when the sun is strongest, wear broad-spectrum SPF 30+ sunscreen, use sun-protective clothing, and don’t use artificial, indoor tanning devices.

You don’t have to stay out of the sun to be safe. Just remember to:

• Slip on protective clothing.
• Slop on sunscreen with SPF 30+.
• Slap on a hat with a wide brim to shade the head, face, ears, and neck.
• Seek shade or shelter, especially during midday hours (10 a.m.-4 p.m.).
• Slide on wrap-around sunglasses.
• Swallow Heliocare Ultra.

There are various treatment options available, which are based upon how advanced the melanoma is, the patient’s overall health, and potential side effects from therapy. Melanoma is often treated with surgical techniques, such as Mohs surgery (only for specific types and locations) and excision. We may also refer you to an oncologist for further evaluation and management.

The Bryn Mawr Skin & Cancer team also diagnoses and treats nonmelanoma cancers, like basal cell carcinoma and squamous cell carcinoma.