Skin Cancer

(Melanoma)
Definitions:
Melanoma, also known as malignant melanoma, is a type of
cancer that develops from the pigment-containing cells known as
melanocytes. Melanomas typically occur in the skin but may rarely occur
in the mouth, intestines, or eye. In women they most commonly occur on
the legs, while in men they are most common on the back. Sometimes
they develop from a mole with concerning changes including an increase
in size, irregular edges, change in color, itchiness, or skin breakdown.

Illustration:

Frequency:
One person dies of melanoma every hour (every 52 minutes).
An estimated 76,380 new cases of invasive melanoma will be
diagnosed in the U.S. in 2016.

 An estimated 10,130 people will die of melanoma in 2016.

Melanoma accounts for less than one percent of skin cancer
cases, but the vast majority of skin cancer deaths.
The vast majority of melanomas are caused by the sun. In
fact, one UK study found that about 86 percent of melanomas
can be attributed to exposure to ultraviolet (UV) radiation
from the sun.
Melanoma is one of only three cancers with an increasing
mortality rate for men, along with liver cancer and
esophageal cancer.
The estimated 5-year survival rate for patients whose
melanoma is detected early is about 98 percent in the U.S.
The survival rate falls to 63 percent when the disease reaches
the lymph nodes, and 17 percent when the disease
metastasizes to distant organs.
On average, a persons risk for melanoma doubles if he or
she has had more than five sunburns.
Regular daily use of an SPF 15 or higher sunscreen reduces
the risk of developing squamous cell carcinoma by about 40
percent16 and the risk of developing melanoma by 50
percent.

MEN/WOMEN
From ages 15-39, men are 55 percent more likely to die of
melanoma than women in the same age group.
An estimated 46,870 new cases of invasive melanoma in men
and 29,510 in women will be diagnosed in the U.S. in 2016.
An estimated 6,750 men and 3,380 women in the U.S. will die
from melanoma in 2016.
Women aged 49 and under have a higher probability of
developing melanoma than any other cancer except breast and
thyroid cancers.

 Up until age 49, significantly morewhite women develop

melanoma than white men (1 in 206 women vs. 1 in 297 men).
From age 50 on, significantly more men develop melanoma than
women. Overall, one in 33 white men and one in 52 white women
will develop melanoma in their lifetimes.
The majority of people diagnosed with melanoma are white men
over age 55.
ETHNICITY
The estimated 5-year melanoma survival rate for blacks is only
70 percent, versus 93 percent for whites.
Skin cancer represents approximately two to four percent of all
cancers in Asians.
Skin cancer comprises one to two percent of all cancers in blacks
and Asian Indians.
Melanomas in blacks, Asians, Filipinos, Indonesians, and native
Hawaiians most often occur on non-exposed skin with less
pigment, with up to 60-75 percent of tumors arising on the
palms, soles, mucous membranes and nail regions.
Basal cell carcinoma is the most common cancer in Caucasians,
Hispanics, Chinese Asians and the Japanese.
Squamous cell carcinoma is the most common skin cancer
among blacks and Asian Indians.
Squamous cell carcinomas in blacks tend to be more aggressive
and are associated with a 20-40 percent risk of metastasis
(spreading).
Late-stage melanoma diagnoses are more prevalent among
minority patients than Caucasian patients; 52 percent of nonHispanic black patients and 26 percent of Hispanic patients
receive an initial diagnosis of advanced stage melanoma, versus
16 percent of non-Hispanic white patients.

Diagnosis and Treatment:

Ask your doctor whether you should consider periodic

screening for skin cancer. You and your doctor may consider
screening options such as:
Skin exams by a trained professional. During a skin exam,
your doctor conducts a head-to-toe inspection of your skin.
Skin exams you do at home. A self-exam may help you learn
the moles, freckles and other skin marks that are normal for you
so that you can notice any changes. It's best to do this standing
in front of a full-length mirror while using a hand-held mirror to
inspect hard-to-see areas. Be sure to check the fronts, backs and
sides of your arms and legs. In addition, check your groin, scalp,
fingernails, soles of your feet and spaces between your toes

Diagnosing melanoma:
Sometimes cancer can be detected simply by looking at
your skin, but the only way to accurately diagnose melanoma is with
a biopsy. In this procedure, all or part of the suspicious mole or
growth is removed, and a pathologist analyzes the sample.
Biopsy procedures used to diagnose melanoma include:
Punch biopsy. During a punch biopsy, your doctor uses a tool with a
circular blade. The blade is pressed into the skin around a suspicious
mole, and a round piece of skin is removed.
Excisional biopsy. In this procedure, the entire mole or growth is
removed along with a small border of normal-appearing skin.
Incisional biopsy. With an incisional biopsy, only the most irregular
part of a mole or growth is taken for laboratory analysis.

Treatments for melanoma include:

Surgery. The entire melanoma is cut out, along with a border
(margin) of normal-appearing skin.

Chemotherapy, which uses medicines to stop or slow the growth of

cancer cells.
Immunotherapy, which uses medicines to help your body's immune
system fight the cancer.
Targeted therapy with inhibitors. These are medicines that
inhibit, or prevent, cancer cells from growing by blocking signals in
the cell. Inhibitors are only given if a gene test shows that a person
has the BRAF gene change, or mutation.

Metastatic and recurrent melanoma

Melanoma can spread (metastasize) to other parts of the
body, where it can cause tumors. When melanoma has spread and
appears as a tumor in another part of the body, it sometimes can be
successfully treated with surgery. But metastatic melanoma usually
needs other treatments, too, such as chemotherapy, interferon,
immunotherapy, or radiation therapy.
Metastatic melanoma and melanoma that can't be removed
with surgery may be treated with inhibitors.
Melanoma can come back after treatment. This is called
recurrent melanoma. All of the treatments mentioned above may be
used for recurrent melanoma as well as:
Hyper thermic isolated limb perfusion. If the melanoma is on
your arm or leg, chemotherapy medicine may be added to a
warm solution and injected into the bloodstream of that arm or
leg. The flow of blood to and from that limb is stopped for a short
time so the medicine can go right to the tumor.
Medicines injected directly into the tumor.
Lasers to destroy the tumor.

Prognosis:
For very early-stage melanoma that is only located near
where it started, 5-year survival is over 98%. Survival for melanoma

that has spread to the nearby lymph nodes is 63%. If melanoma has
spread to other parts of the body, survival is 17%. However, survival
varies depending on a number of factors.

Prevention:
List of skin cancer prevention tips.
Seek the shade, especially between 10 AM and 4 PM.
Do not burn.
Avoid tanning and never use UV tanning beds.
Cover up with clothing, including a broad-brimmed hat and
UV-blocking sunglasses.
Use a broad spectrum (UVA/UVB) sunscreen with an SPF
of 15 or higher every day. For extended outdoor activity, use a
water-resistant, broad spectrum (UVA/UVB) sunscreen with an
SPF of 30 or higher.
Apply 1 ounce (2 tablespoons) of sunscreen to your entire
body 30 minutes before going outside. Reapply every two
hours or immediately after swimming or excessive sweating.
Keep newborns out of the sun. Sunscreens should be used
on babies over the age of six months.
Examine your skin head-to-toe every month.
See your physician every year for a professional skin exam.

Reducing the risk of melanoma and other type of

cancer:
Avoid the sun during the middle of the day. For many
people in North America, the sun's rays are strongest between
about 10 a.m. and 4 p.m. Schedule outdoor activities for other
times of the day, even in winter or when the sky is cloudy. You
absorb UV radiation year-round, and clouds offer little protection
from damaging rays. Avoiding the sun at its strongest helps you
avoid the sunburns and suntans that cause skin damage and

increase your risk of developing skin cancer. Sun exposure

accumulated over time also may cause skin cancer.
Wear sunscreen year-round. Sunscreens don't filter out all
harmful UV radiation, especially the radiation that can lead to
melanoma. But they play a major role in an overall sun
protection program. Use a broad-spectrum sunscreen with an SPF
of at least 15. Apply sunscreen generously, and reapply every
two hours or more often if you're swimming or perspiring. The
American Academy of Dermatology recommends using a broadspectrum, water-resistant sunscreen with an SPF of at least 30.
Wear protective clothing. Sunscreens don't provide complete
protection from UV rays. So cover your skin with dark, tightly
woven clothing that covers your arms and legs and a broadbrimmed hat, which provides more protection than a baseball
cap or visor does. Some companies also sell photo protective
clothing. A dermatologist can recommend an appropriate brand.
Don't forget sunglasses. Look for those that block both types of
UV radiation UVA and UVB rays.
Avoid tanning lamps and beds. Tanning lamps and beds emit
UV rays and can increase your risk of skin cancer.
Become familiar with your skin so that you'll notice
changes. Examine your skin regularly for new skin growths or
changes in existing moles, freckles, bumps and birthmarks.