About Malignant Melanomas
by Peggy Deland
Malignant melanoma is the most dangerous type of skin cancer--even small lesions are often life-threatening. This cancer develops in cells that produce melanin, a pigment that colors skin. Melanin-producing cells are located in other parts of the body as well, and can also develop malignant melanoma. However, melanoma in locations other than the skin is extremely rare.
Malignant melanoma often develops on an existing mole, which changes in size, shape and color. Sometimes the cancer is found in new, mole-like growths on the skin. The American Academy of Dermatology has developed a guide to assist in finding suspicious moles or growths. This guide uses an A-B-C-D-E format--each letter represents a suspicious change in the mole. The letters stand for asymmetry, border (irregular), changes in color, diameter (greater than 1/4 inch) and evolving (changing over time). Any moles that exhibit these symptoms, or are scaly, itchy, change in texture, ooze or bleed should be shown to your doctor right away.
Malignant melanoma may be suspected based on the appearance of a mole or growth, but a biopsy is required to accurately diagnose the condition. Depending on the size of the mole, the doctor may remove the entire growth or only a portion. Although it was once believed that removing part of the mole could cause remaining cancer cells to spread, this is not the case. Melanoma in locations other than the skin can be difficult to detect; these are most often noticed during dental, gynecological and optical exams. Biopsy is also performed to diagnose lesions that are not on the skin.
There are several treatments for malignant melanoma; depending on whether the cancer has metastasized (spread), one or more treatments may be necessary. All melanoma lesions must be surgically removed. This helps prevent the cancer from spreading and, if it has already spread, can provide relief from associated symptoms and improve the chance of survival. Chemotherapy, radiation therapy, and biological therapy may also be used. Although it is very difficult to cure malignant melanoma that has spread beyond the skin, these treatments can provide both relief from symptoms and increase the chance of long-term survival.
Some people are at much higher risk of developing malignant melanoma than others are. The highest risk is among those who are fair skinned, have many moles, and are frequently exposed to the sun. The more easily you get sunburned, the more important it is to use a high-SPF sun block to reduce your chance of developing this deadly cancer. Some people have unusual moles called dysplastic nevi; these are large, flat moles that usually have mixed colors and irregular borders. Dysplastic nevi are much more likely to become cancerous than other moles.
Where you live can have a strong influence on your risk of developing malignant melanoma. People who live in climates with a high UV index are at significantly higher risk of developing this cancer than those who do not. The riskiest areas to live in the United States are areas with a subtropical climate--south Florida and south Texas--and the desert areas of New Mexico and Arizona. The problem is not the climate but the amount of UV radiation from the sun that reaches the earth in these areas. Similarly, UV radiation from tanning beds and lamps greatly increases the risk of developing this form of cancer.