Gainesville Dermatology & Skin Surgery offers personalized treatments for a wide range of skin conditions, including melanoma, among other types of skin cancer. Our Gainesville dermatologists provide the highest level of care to each patient for effective, innovative treatments for their skin conditions. Melanoma is the most dangerous form of skin cancer — early detection is critical and can vastly increase the probability of a successful outcome following treatment.
What Is Melanoma?
The leading cause of death from skin disease, melanoma — or malignant melanoma — is the most dangerous type of skin cancer. Melanoma is far more dangerous than other, more prevalent forms of skin cancer, such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), due to its ability to spread to other organs more rapidly if not treated at an early stage. Melanoma can form in the eyes and, rarely, within internal organs, such as the intestines, but it is commonly found on the trunk — the area of skin from the shoulder to the hips as well as the head, neck, arms, and legs. According to the Skin Cancer Foundation, only 20-30 percent of melanomas are found in existing moles, while 70-80 percent of melanomas arise on normal-looking skin. Melanoma begins in cells known as melanocytes — skin cells found in the upper layer of skin that produce skin pigment (melanin).
The two types of melanin are eumelanin and pheomelanin. When the skin is exposed to ultraviolet (UV) radiation, whether from the sun or tanning beds, it causes skin damage that triggers melanocytes to produce additional melanin, but only the eumelanin pigment tries to protect the skin by tanning or darkening the skin’s pigment. Melanoma happens when DNA damage from burning or tanning due to UV radiation triggers mutations, or changes, in the melanocytes, which results in uncontrolled cellular growths. Individuals with naturally darker skin have a greater amount of eumelanin, while those with fair skin have more pheomelanin. Unlike eumelanin, pheomelanin does not have the ability to protect the skin from sun damage, or photodamage. People with darker skin are at lower risk for developing melanoma than fair-skinned individuals, who are more susceptible to photodamage, burning, and skin cancer.
Melanoma is among the fastest-growing cancers worldwide, especially in people under the age of 30. The exact causes of melanoma are unclear. However, exposure to UV radiation from natural sunlight or tanning beds and lamps increases the risk of developing melanoma. The sun’s rays that nourish and energize the human body are unfortunately also a main culprit behind melanoma. As such, limiting exposure to these risk factors may help reduce the risk of melanoma In addition to exposure to sunlight, other causes of melanoma may include unusual moles and a genetic predisposition to skin cancer.
Other risk factors include, but are not limited to, the following.
- Precancerous skin conditions
- A fair complexion with skin that freckles and burns easily, does not tan, or tans poorly
- Exposure to certain environmental factors, including radiation and solvents
- A history of many blistering sunburns, especially during youth
- Several large or many small moles
- A family history of atypical moles (atypical nevus)
- A weakened immune system
Types Of Skin Melanoma
There are many types of skin cancer, but the four main types of melanoma skin cancer are superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. For more information about various different skin cancer types or to schedule regular skin cancer screenings, contact our dermatologist office.
Superficial Spreading Melanoma
Superficial spreading melanoma is the most common type of melanoma. It is usually flat and irregular in shape and color with multiple different shades of black and brown. This type of melanoma primarily affects Caucasians. It can arise in an existing mole or appear as a new lesion. Signs of superficial spreading melanoma may appear anywhere on the body.
Lentigo maligna typically occurs in older people. When this type of cancer becomes invasive or spreads beyond the original site, the disease is known as lentigo maligna melanoma. It may appear flat or slightly raised with blotchy patches and uneven borders. This type of melanoma grows close to the skin’s surface, and the tumor typically arises on sun-damaged skin.
Acral Lentiginous Melanoma
Acral lentiginous melanoma is the least common form of melanoma. It usually occurs in hard-to-spot places on the body, such as the palms of the hands, soles of the feet, or under the fingernails and toenails. It may appear as a black or brown lesion. This type of melanoma is more common in those with non-Caucasian skin.
The most aggressive type of melanoma, nodular melanoma grows deeper into the skin and develops more rapidly than other melanoma types. It occurs most frequently on the torso, legs, arms, and scalp. It usually starts as a raised area of the skin that is dark, black and blue, or blue and red in tone and color. Some nodular melanomas have no color (amelanotic melanoma).
Key to successfully treating melanoma is recognizing symptoms early. Early stage melanoma detection can vastly increase your chances for cure. Patients may not notice a small spot if they do not inspect the skin carefully. As such, it is recommended that patients have regular skin examinations by our dermatologists in Gainesville, FL, and conduct self-examinations once per month — use a hand mirror to check hard-to-see places. Look for anything new, changing, or unusual on both sun-exposed and sun-protected areas of the face and body. Melanomas typically appear on sun-exposed areas of skin, but keep in mind, though, that they can likewise arise anywhere on the skin — even in areas where the sun doesn’t shine.
With regard to skin cancer symptoms and, more specifically, melanoma symptoms, a mole, sore, lump, or growth on the skin can be a sign of melanoma or another form of skin cancer. A sore or growth that bleeds or changes in color can likewise be a sign of skin cancer. If a lesion does not appear or feel similar to any other spots on the body, it might be a melanoma. The ABCDE rule can help patients remember possible signs of melanoma:
- Asymmetrical Shape. Look for moles with unusual shapes, such as jagged edges on one side and smoothness on the other.
- Irregular Border. Irregular, notched, or scalloped borders are a common characteristic of melanomas.
- Changes In Color. A mole shouldn’t have multiple colors or an uneven color distribution, such as a gradient appearance.
- Diameter. Most moles are smaller than 1/4 inch in diameter.
- Evolving. A mole that, over time, grows in size, changes color and/or starts to itch or bleed should be evaluated by a Gainesville dermatologist.
How Is Melanoma Diagnosed?
During a dermatologist appointment, our skin specialists use a dermoscope — a tool commonly used by dermatologists which may allow for early melanoma detection — to inspect patients’ skin, paying close attention to the size, shape, color, and texture of any suspicious areas. If the dermatologist suspects a patient has skin cancer, a skin biopsy (removal of skin from the growth) may be required. Following a skin biopsy, a sample is sent to the lab for examination under a microscope. In certain cases, a sentinel lymph node (SLN) biopsy may be performed in order to see whether or not the cancer has spread to nearby lymph nodes. If melanoma is diagnosed, X-rays or CT scans may be required in order to see if the cancer has spread.
After melanoma is diagnosed during a skin check and the type of melanoma is identified, the next step is for your dermatologist to identify the stage of the disease, which may require additional tests including imaging such as PET scans, blood tests, and MRIs. The melanoma stage is determined by several factors, including how much the skin cancer has grown, whether or not the disease has metastasized (spread), and other considerations. Melanoma staging is a complex, yet crucial process. Knowing the stage of a specific case helps doctors decide how to best treat the disease and predict your chances of remission and recovery.
The outlook for melanoma treatment — or the melanoma prognosis — largely depends upon a wide range of factors, including how quickly the cancer was diagnosed and how far it has spread within the body. If caught at an early stage, melanomas can typically be cured. Melanomas that are invasive or have spread to the lymph nodes are more likely to return following treatment. If a melanoma is deep within the skin or has spread to nearby lymph nodes, the cancer is more likely to have spread to other tissues and organs. If you have previously had melanoma and have since recovered, it is crucial that you perform monthly self-checks and attend regular dermatologist appointments in order to examine the body for any unusual changes and to prevent melanoma recurrence. The risk of developing melanoma increases in patients that have had this cancer, and it may return years after initial treatment.
Skin cancer treatment and melanoma treatment almost always requires surgery, during which the skin cancer and a portion of the surrounding skin will be removed. The amount of skin and tissue removed largely depends upon the degree to which the melanoma has grown and spread. If the cancer has spread to nearby lymph nodes, the lymph nodes may require removal. Depending on the risk of skin cancer recurrence following surgery, patients may receive chemotherapy or immunotherapy. Treatment is more difficult for cases in which cancer spreads to other organs. Treatment for melanoma involves shrinking the skin cancer and, if required, treating the cancer in other areas of the body. Melanoma treatment may include the following.
Mohs micrographic surgery, or skin cancer surgery, may be performed to remove cancer that has spread to other parts of the body. Mohs dermatology procedures are performed in order to relieve pain or discomfort commonly associated with growing cancers.
Chemotherapy uses drugs to destroy cancer cells. It may be given intravenously, in a pill form, or both depending upon the treatment. Chemotherapy may also be given in a vein in the arm or leg during a procedure called isolated limb perfusion.
Immunotherapy, or biological therapy, uses drugs such as interferon and boosts the immune system in order to help the body fight cancer. These treatments are made of substances naturally produced by the body, or similar substances produced in a laboratory.
Radiation treatment uses high-powered energy beams, such as X-rays, to kill cancer cells in the body. This therapy may be recommended after surgery to remove lymph nodes. It is sometimes used to help relieve pain and melanoma symptoms that spread to other areas of the body.
Targeted therapy uses medications designed to target specific vulnerabilities in cancer cells. Targeted therapy drugs are used to treat advanced cases of melanoma. These drugs are only effective in cases where the patient’s cancer cells have a certain genetic mutation.
When To Contact A Dermatologist
It is recommended that all individuals receive dermatologist skin exams at least once per year in order to ensure there are no abnormalities on the skin. Please contact our dermatologist if you notice a new growth or any other changes to your skin, as well as if an existing spot, lesion, or mole becomes painful, swollen, inflamed, or begins to bleed or itch. Our dermatologists approach each skin condition with comprehensive knowledge and the utmost compassion — schedule a dermatologist appointment for targeted skin treatments and specialized exams.
There is no sure way to prevent melanoma. Certain risk factors, such as age, race, and family history cannot be controlled. The following, however, may assist with melanoma prevention, sun damage prevention, and reducing your risk of developing melanoma and other types of skin cancers. Certain individuals — including those with a family history of melanoma, severely sun-damage skin, and a significant number of skin moles — should see their dermatologist for regular skin exams.
- Apply high-quality sunscreen with a sun protection factor (SPF) rating of 35 or higher, even if you are outdoors only for a short period of time.
- Apply a large amount of sunscreen to all exposed areas of skin, including ears and feet, and reapply sun protection often, especially after perspiring or swimming.
- Choose sunscreens that block both ultraviolet A (UVA) and ultraviolet B (UVB) light — look for a label that reads “broad spectrum.”
- Use caution in higher altitudes, where skin burns faster than at lower altitudes
- Avoid sun lamps, tanning beds, and unprotected exposure to sunlight.
- Perform a self-check on your entire body once per month to inspect the skin for irregularities and use a hand-held mirror to inspect hard-to-spot places.
- Schedule regular skin examinations with your Gainesville dermatologist.
- Regularly inspect your skin for signs of any new or irregular moles and promptly report any findings to your dermatologist.
- Avoid weakening your immune system as a weakened immune system is at increased risk of developing melanoma and other forms of skin cancer.