Myth or Medicine
Second Opinion 5
Melanoma is the most dangerous form of skin cancer, these cancerous growths develop when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations (genetic defects) that lead the skin cells to multiply rapidly and form malignant tumors. These tumors originate in the pigment-producing melanocytes in the basal layer of the epidermis.
Melanomas often resemble moles; some develop from moles. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white. Melanoma is caused mainly by intense, occasional UV exposure (frequently leading to sunburn), especially in those who are genetically predisposed to the disease. Melanoma kills an estimated 8,790 people in the US annually.
If melanoma is recognized and treated early, it is almost always curable, but if it is not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. While it is not the most common of the skin cancers, it causes the most deaths. The American Cancer Society estimates that at present, about 120,000 new cases of melanoma in the US are diagnosed in a year. In 2010, about 68,130 of these were invasive melanomas, with about 38,870 in males and 29,260 in women.
Even if you have carefully practiced sun safety all summer, it's important to continue being vigilant about your skin in fall, winter, and beyond. Throughout the year, you should examine your skin head-to-toe once a month, looking for any suspicious lesions. Self-exams can help you identify potential skin cancers early, when they can almost always be completely cured.
First, for a successful self-exam, you obviously need to know what you're looking for. As a general rule, to spot either melanomas or non-melanoma skin cancers (such as basal cell carcinoma and squamous cell carcinoma), take note of any new moles or growths, and any existing growths that begin to grow or change significantly in any other way. Lesions that change, itch, bleed, or don't heal are also alarm signals.
It is so vital to catch melanoma, the deadliest form of skin cancer, early that physicians have developed two specific strategies for early recognition of the disease: the ABCDEs and the Ugly Duckling sign.
A=Asymetry (If you draw a line through this mole, the two halves will not match.)
B=Borders (The borders of an early melanoma tend to be uneven. The edges may be scalloped or notched.)
C=Color (Having a variety of colors is another warning signal. A number of different shades of brown, tan or black could appear. A melanoma may also become red, blue or some other color.)
D=Diameter (Melanomas usually are larger in diameter than the size of the eraser on your pencil (1/4 inch or 6 mm), but they may sometimes be smaller when first detected.)
E=Evolving (Any change — in size, shape, color, elevation, or another trait, or any new symptom such as bleeding, itching or crusting — points to danger.)
The Ugly Duckling Sign=This method is based on the concept that these melanomas look different — they are "ugly ducklings" — compared to surrounding moles. The premise is that the patient’s “normal” moles resemble each other, like siblings, while the potential melanoma is an “outlier,” a lesion that, at a given moment in time, looks or feels different than the patient’s other moles, or that over time, changes differently than the patient’s other moles.
The Four Basic Types Melanomas fall into four basic categories. Three of them begin in situ — meaning they occupy only the top layers of the skin — and sometimes become invasive; the fourth is invasive from the start. Invasive melanomas are more serious, as they have penetrated deeper into the skin and may have spread to other areas of the body.
Superficial spreading melanoma is by far the most common type, accounting for about 70 percent of all cases. This is the one most often seen in young people. As the name suggests, this melanoma grows along the top layer of the skin for a fairly long time before penetrating more deeply.
The first sign is the appearance of a flat or slightly raised discolored patch that has irregular borders and is somewhat asymmetrical in form. The color varies, and you may see areas of tan, brown, black, red, blue or white. This type of melanoma can occur in a previously benign mole. The melanoma can be found almost anywhere on the body, but is most likely to occur on the trunk in men, the legs in women, and the upper back in both.
Lentigo maligna is similar to the superficial spreading type, as it also remains close to the skin surface for quite a while, and usually appears as a flat or mildly elevated mottled tan, brown or dark brown discoloration. This type of in situ melanoma is found most often in the elderly, arising on chronically sun-exposed, damaged skin on the face, ears, arms and upper trunk. Lentigo maligna is the most common form of melanoma in Hawaii. When this cancer becomes invasive, it is referred to as lentigo maligna melanoma.
Acral lentiginous melanoma also spreads superficially before penetrating more deeply. It is quite different from the others, though, as it usually appears as a black or brown discoloration under the nails or on the soles of the feet or palms of the hands. This type of melanoma is sometimes found on dark-skinned people, and can often advance more quickly than superficial spreading melanoma and lentigo maligna. It is the most common melanoma in African-Americans and Asians, and the least common among Caucasians.
Nodular melanoma is usually invasive at the time it is first diagnosed. The malignancy is recognized when it becomes a bump. It is usually black, but occasionally is blue, gray, white, brown, tan, red or skin tone.
The most frequent locations are the trunk, legs, and arms, mainly of elderly people, as well as the scalp in men. This is the most aggressive of the melanomas, and is found in 10 to 15 percent of cases.
Source: Skin Cancer Foundation
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