Melanoma is one of the most dangerous forms of skin cancer; it originates in the melanocytes, the cells responsible for producing the pigment that gives our skin its color. This pigment, known as melanin, is a term familiar to many of us, as it provides color to our skin, hair, and eyes.
The Mayo Clinic states that melanoma typically starts on the skin when exposed to the sun. The common areas where melanoma may be found include the following:
- Arms.
- Back.
- Face.
- Legs.
In some cases, melanoma can develop in the eyes, and although it is rare, it can form inside the body and affect areas such as the nose or throat.
MedicalNewsToday reports that the most common form of melanoma in our community is acral lentiginous melanoma, which has a prevalence of 35-60%. This type of melanoma develops on the soles of the feet and under the nails.
It tends to occur in less visible areas, combined with its ability to blend in with our complexions, exacerbates the rate of late diagnoses and introduces more risk to our community.
What Causes Melanoma?
The exact cause of all melanomas is not determined, although many cases can be linked to ultraviolet (UV) radiation exposure. One of the most common sources of UV radiation is natural sunlight. As we enjoy outdoor activities, we must also prioritize safeguarding our skin with sunscreen and taking precautions against sun exposure.
Healthline reports that DNA damage within melanocytes can trigger the uncontrolled growth of new skin cells. As these cells build up, they can eventually develop into a tumor.
So much remains unsaid regarding the exact causes of melanomas and DNA damage. Many specialists attribute them to genetic and environmental factors.
How to Identify Melanoma on Your Skin
Recognizing the signs of melanoma can be challenging, especially on darker skin. Melanomas may be less noticeable due to their ability to camouflage themselves. These skin cancers can start as new growths or manifest as existing moles or freckles change. Understanding the Centers for Disease Control and Prevention’s (CDC) ABCDE guidelines for melanoma detection can help you achieve an early diagnosis. Be mindful of any changes in your skin, as this is the most common sign of skin cancer. Whether it is a new growth, a sore that won’t heal, or a change in a mole, don’t hesitate to bring it up to your doctor.
For melanoma specifically, try to remember this list of warning signs:
A. Asymmetrical: Does the mole or spot have an irregular shape with two parts that look very different?
B. Border: Is the border irregular or jagged?
C. Color: Is the color uneven?
D. Diameter: Is the mole or spot more significant than the size of a pea?
E. Evolving: Has the mole or spot changed during the past few weeks or months?
If you answered “yes” to any of the questions above, consider visiting your healthcare provider to be safe.
The Stages & Diagnosis
Healthline points out that melanomas consist of the following stages:
- Stage 0 (Melanoma in situ): The melanoma is only in the epidermis, the top layer of skin.
- Stage I: Low-risk primary melanoma with no evidence of spread. This stage is curable with surgery.
- Stage II: Features indicate a higher risk of recurrence, but there is no evidence that cancer has spread to other organs.
- Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
- Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.
The first step toward diagnosing melanoma is a physical examination of the skin. Your doctor will carefully check for markings or moles on your skin that may suggest the presence of cancerous cells. In addition to examining the common areas associated with melanoma, they may also assess other regions such as the:
- Palms.
- Scalp.
- Feet, including your soles and between toes.
- Genitals.
- Buttocks.
- Eyes.
- Mouth.
To reach a diagnosis, your doctor may also use several tests, such as the following:
Computed tomography (CT): CT scans use potent X-rays to get detailed images of where cancer may have spread.
Magnetic resonance imaging (MRI): MRIs use magnets, radio waves, and an injected substance called gadolinium to get highly detailed, cross-sectional images of your body to find where cancerous cells have spread.
Positron emission tomography (PET): PET Scans involve injecting radioactive glucose that is tracked by a scanner. This helps doctors detect areas of high chemical activity in your body where diseased or cancerous tissue might be present. When doctors suspect that a mole might be cancerous, they may recommend a biopsy. During this procedure, a skin sample is removed and sent to a laboratory for testing to detect the presence of melanoma cells. If the doctor believes that melanoma has spread, they might suggest a lymph node biopsy. This involves taking a tissue sample from nearby lymph nodes, often with an injection of dye near the tumor site. These procedures can be vital for diagnosing and staging melanoma.
Treatment
If you have been diagnosed with melanoma, you will most likely be working with dermatologists as well as surgical and medical oncologists. Your treatment depends on the stage of your cancer and your unique health needs. It can be helpful to know the treatment options out there. According to the Skin Cancer Foundation, some of the most common forms of treatment include:
- The surgical removal of the melanoma.
- Immunotherapy: it boosts the body’s ability to fight melanoma and other cancers by using synthetic versions of natural immune system proteins or by enabling the release of cells that attack tumors.
- Targeted therapy: uses drugs and other agents to attack melanoma by inhibiting the action of defective genes and molecules.
- Chemotherapy: a systemic approach to stopping tumor growth using certain medicines that kill or stop cancer cells from multiplying.
- Radiation: a localized treatment that directs high-energy X-ray beams to penetrate and destroy the tumors or keep them from growing.
Ask Questions
Although Black Americans don’t lead in melanoma diagnoses, we have a 26% higher risk of death from melanoma than white Americans, as reported by Northwell Health. Given the rarity of melanoma in our community, both healthcare professionals and the broader medical community may overlook the possibility of skin cancer or lack experience in identifying melanoma on our skin. Therefore, we need to monitor our skin and proactively engage with our doctors by asking questions such as:
- How far has the melanoma spread within or beneath the skin?
- Has the melanoma spread to other parts of my body?
- What kinds of tests will I need before we can decide on treatment?
- Will I need to see any other types of doctors?
- What type or subtype of melanoma do I have?
- If I’m concerned about the costs and insurance coverage for my diagnosis and treatment, who can help me?
The best type of diagnosis is an early one. We highly recommend prioritizing regular skin checks, communicating with your doctors, and practicing sun safety.
