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More than moles

Identifying and treating melanoma


Your skin has a big job to do, protecting you against heat and sunlight, guarding against injury and infection, regulating temperature and so much more. That’s why skin cancer, the most common type of cancer, presents such a threat to your health.

In 2016, nearly 76,000 people in the United States will be diagnosed with melanoma, the most aggressive type of skin cancer, and about 10,000 people will die from the disease.

Types of skin cancer

The different types of skin cancer affect the different cell types composing the outer layer of your skin: basal and squamous cells and melanocytes. Basal and squamous cell skin cancers, commonly called “nonmelanoma” cancers, tend to respond well to treatment and rarely spread. Melanoma, on the other hand, is more likely to spread to other parts of the body if not diagnosed and treated early.

Are you at risk?

Traditionally, those who are most likely to develop melanoma have the following risk factors:

  • Ultraviolet light exposure
  • Moles
  • Fair skin, freckles and light hair
  • A family history of melanoma
  • A personal history of melanoma or other skin cancers
  • A weakened immune system
  • Older age
  • Male gender

New research has found that 66 percent of people with melanoma had 20 or fewer moles, meaning you can’t gauge risk on moles alone. In the study, those younger than 60 who had more than 50 moles had a less severe form of cancer than those who had 20 or fewer moles.

“A lot of people we see with melanoma haven’t had previously concerning moles,” said Dr. Jennifer Dallas with Novant Health Cancer Specialists in Charlotte, North Carolina. “They don’t have the typical melanoma skin type, so anecdotally, this study’s findings are reasonable.”

Genetics may raise risk

There is a gene mutation in melanoma cells that has been linked to about half of all melanomas.

“There are some mutations that exist in melanoma, specifically the BRAF gene mutation,” Dallas said. “New medications have been developed that target the BRAF mutation, so patients receive a more effective therapy. Our hope is to provide better treatment with fewer side effects.”

Another study recently claimed that, even without sun exposure, some people were at risk because of a genetic mutation in the MC1R gene. Individuals with red hair are at the highest risk.

Signs of melanoma

There are several indicators of melanoma, the first sign usually being a change in the shape, color, size or feel of an existing mole.

Most physicians recommend following the “ABCDE” rule to determine if a mole has changed:

  • Asymmetry – half of a mole’s shape does not match the other half.
  • Border is irregular – the edges of the mole are often ragged, notched or blurred in outline. The pigment may spread to the surrounding skin.
  • Color is uneven – shades of black, brown and tan may be present. Areas of white, gray, red, pink or blue also may be seen.
  • Diameter – there is a change in size, usually an increase. Melanomas can be tiny, but most are larger than 6 millimeters wide.
  • Evolving – the mole has changed over the past few weeks or months.

Therapies to treat melanoma

The initial treatment for melanoma is to remove it surgically. However, if the melanoma has advanced, additional therapy may be necessary.

Dallas said, traditionally, chemotherapies have not been very effective when it comes to treating melanoma. She mentioned that several new drugs have recently emerged to treat melanoma.

“There are new immunotherapy drugs that effectively boost the immune system to kill tumor cells,” Dallas said. “The treatments are given through IVs and have shown to be very effective. In a field where we traditionally haven’t had a lot to offer patients, it’s exciting to have newer medications as an option.”

With any cancer, it’s important to know about your family history and discuss that with your physician, Dallas said. If you have a strong family history of cancer, it may be worthwhile to consider meeting with a genetic counselor.

Preventing melanoma

Skin cancer usually forms in skin that has been exposed to damaging sunlight, but it can form anywhere. The National Cancer Institute provides tips to protect your skin from sunlight, which include:

  • Using sunscreen products with an SPF of at least 15. Apply to skin 30 minutes before going outside. Reapply every two hours or after swimming or sweating.
  • Wearing a hat with a wide brim. It should shade your face, neck and ears.
  • Wearing sunglasses that block UV radiation.
  • Wearing long sleeves and long pants.




Published: 6/29/2016