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Melanoma is a type of skin cancer most often seen in adults. However, although rare, melanoma affects about 300-400 children and adolescents each year in the United States. Melanomas can develop on any part of the skin. They can also occur in the eye. If left untreated, melanoma can spread to other parts of the body.
In melanoma, cancer forms in skin cells called melanocytes. Melanocytes produce melanin which provides color (pigment) to the skin.
Melanin is a pigment produced by certain skin cells called melanocytes. Melanin helps protect the skin from ultraviolet (UV) radiation from the sun. People with darker skin color have more melanin and are less likely to develop melanoma.
Although usually thought of as an adult disease, melanoma accounts for about 1% of cancers in children under age 15 years. It occurs more often in older age groups, accounting for 7% of cancers in adolescents ages 15-19 years.
Symptoms of melanoma include unusual skin changes such as a mole that grows in size, changes color, bleeds, or itches. Melanomas can also appear as a pale or red colored bump.
Treatment for melanoma depends on the stage of disease. Usually melanoma patients are treated with surgery to remove the cancer. More severe disease may require additional treatment including targeted therapy, chemotherapy and/or immunotherapy.
When caught early, survival rates for melanoma are very good. However, melanoma can spread to lymph nodes and other parts of the body, which can make it hard to treat. For this reason, awareness and early detection of melanoma is very important.
Certain factors increase the risk for melanoma. These include having fair skin that burns easily, certain skin conditions, a family history of melanoma and/or unusual moles, and a history of sun exposure or sunburns. Melanoma is more common in adolescents.
Signs of melanoma include changes to the skin including:
A helpful way to think about signs of melanoma is to remember the ABC’s:
B: Border irregularity
C: Color variation
D: Diameter (> 5 millimeters)
E: Evolution or Evidence of change
Several types of procedures and tests are used to diagnose melanoma. These include:
If doctors are concerned that melanoma may have spread, additional tests may be needed. These include:
There are several subtypes of melanoma:
Spitzoid melanoma is the most common type of melanoma that is seen in younger patients.
Melanoma is classified as Stage I or II (melanoma in skin only), Stage III (melanoma has spread to lymph nodes), or Stage IV (metastatic melanoma).
Factors that determine melanoma stage include:
Melanoma in situ: Abnormal melanocytes are found in the outer layer of the skin only
Melanoma thickness 1 millimeter or less; no ulceration
Melanoma thickness >4 millimeters with ulceration
Melanoma has spread to other parts of the body including lung, liver, brain, bone, soft tissue, or distant sites on the skin
The chance of recovery from melanoma depends on a variety of factors such as:
Overall, the stage of disease is the most important factor for prognosis. Patients with localized melanoma that has not spread have an excellent prognosis with survival rates greater than 90%. However, patients with distant spread of disease are more difficult to treat.
Treatment for melanoma depends on the location of the melanoma, features of the tumor (gene changes and histology), and stage of disease.
Children may be offered treatment for melanoma as part of a clinical trial.
Survivors of melanoma are at higher risk for recurrence. Melanoma survivors should have regular exams by a dermatologist at least every 6 months. Survivors should check their skin regularly and see a doctor at any sign of change. Here are some simple ways to help prevent melanoma:
View the Kid’s Guide to Self-Screening from the Melanoma Research Foundation.
Do you know how to slip, slop, slap? Find out more about sun safety:
For general health and disease prevention, all cancer survivors should adopt healthy lifestyle and eating habits, as well as continue to have regular physical checkups and screenings by a primary physician at least yearly.
Childhood cancer survivors treated with chemotherapy or radiation should be monitored for acute and late effects of therapy.
Reviewed: June 2018