Frequently Asked Questions about Melanoma
Here are answers to some frequently asked questions about melanoma.
Q: What is the skin?
A: The skin is the body’s biggest organ. It keeps water and other fluids in the body. And it keeps out germs and other foreign substances. The skin has these 3 layers.
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Epidermis is the top layer. It is very thin and protects the body from things such as germs that could get inside and cause harm. Melanoma forms in skin cells, called melanocytes, which are in this layer.
Q: What is melanoma?
A: Melanoma is a type of skin cancer that starts in skin cells called melanocytes. It is thought to start when normal melanocytes become cancerous, called malignant. Melanoma can spread quickly to the liver, lungs, bones, and brain. It has the potential to spread anywhere in the body.
Q: What is the biggest risk factor for melanoma?
A: About 90% of all melanomas are attributed to excess exposure to sunlight. The more time people spend in the sun, especially during youth, the higher their chance of getting this type of cancer. People who have had a severe blistering sunburn – especially as a child – have a higher risk of getting melanoma. People with fair skin get skin cancer more often. There also seems to be a hereditary form of melanoma. It is not very common, though. The current thinking is that sunlight exposure and changes in genes may work together to cause melanoma.
Q: Where on the body do people usually get melanoma?
A: Melanoma can occur anywhere on the skin. When it’s on the skin, it’s called cutaneous melanoma. Men usually get it on the front and back part of the body between the shoulders and the hips, called the trunk. They may also get it on their head or neck. Women usually get it on their arms and lower legs. Sometimes, melanoma may occur on areas of the skin that never are exposed to sunlight, such as the soles of the feet, mouth, or sinuses. Another unusual place for melanoma is under the nail beds of fingers and toes.
Q: Is melanoma preventable?
A: The best way to prevent melanoma is to avoid getting a lot of sun. When going outside, everyone should use these tips to protect themselves.
Q: What are atypical moles or dysplastic nevi?
A: Some moles do not look the same as normal or typical moles and are more likely to become a melanoma. These abnormal moles are sometimes called dysplastic nevi. The cells in these moles are abnormal but are not yet cancerous. People may have just a few atypical moles or they may have many.
Q: Can melanoma be found early?
A: Everyone should check their skin often for any strange or changing moles or other lesions. People who have more than 50 moles or who have been told they have atypical or dysplastic moles should see a dermatologist regularly to have their skin checked.
About 10% of people with melanoma have family members with it. A person whose close relatives have had melanoma has a higher chance of getting it. People with a family history of melanoma need to have their skin checked by a doctor more often. They also need to take extra care to avoid the sun.
Q: What are the signs of a melanoma?
A: The first sign of melanoma may be a mole that changes in size, shape, or color. The ABCD traits that may suggest a melanoma are asymmetry, border, color, and diameter.
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The color of a melanoma is sometimes uneven. The color of a melanoma may be different shades of black, brown, red, or blue.
Melanomas can look very different from each other. Some might have all of the ABCD changes and some may only have one. It is important to talk to a doctor right away if you notice any changes in moles.
Q: What should a person do when they find a strange-looking mole?
A: Any strange-looking moles should be shown to a doctor as soon as possible. The doctor might make a referral to a dermatologist. This doctor specializes in skin problems, including skin cancers. If the doctor suspects cancer, he or she may remove the mole in a biopsy. The doctor sends the removed mole to a specialist called a pathologist, who checks it under the microscope for cancer cells.
Q: Should everyone get a second opinion for a diagnosis of melanoma?
A: Many people with cancer get a second opinion from another doctor. There are many reasons to get one. Here are some of those reasons.
Many people have a hard time deciding which melanoma treatment to have. It may help to have a second doctor review the diagnosis and treatment options before starting treatment. It is important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer seek a second opinion. Many other companies will pay for a second opinion if asked.
Q: How can someone get a second opinion?
A: There are many ways to get a second opinion.
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Ask a primary care doctor. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.
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Consult The Official ABMS Directory of Board Certified Medical Specialists. This book from the American Board of Medical Specialties lists doctors by state. It gives their specialty, background, and training. It is available at most public libraries. It is also online at www.abms.org.
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Seek other options. Check with a local medical society, a nearby hospital or medical school, or a support group to get names of doctors who can give a second opinion. Or ask other people who’ve had cancer for their recommendations.
Q: How is melanoma treated?
A: Surgery is the most common treatment. If it’s done in the early stages, meaning before the cancer has spread, there is a high chance that it can lead to a cure. During surgery, the doctor removes the cancer and normal cells around it. This is called an excision. Chemotherapy or immunotherapy may also be used if it has spread to other parts of the body. Radiation is generally only used to treat symptoms when a person can’t have surgery or chemotherapy.
Q: What is a skin graft?
A: Skin from another part of the body is used to replace skin that was removed during surgery. The skin is usually taken from the back or thigh. The surgeon stitches it to the area where the melanoma was removed.
Q: How often should a person who’s had melanoma see his or her doctor?
A: People who have had melanoma should see their doctor regularly for the rest of their lives. Their risk of getting it again is about 900 times higher than those who haven’t had it.
People with this type of cancer should see their doctor every 3 to 4 months for the first few years after the diagnosis. If there is no evidence that the melanoma has come back after a few years, then they can see the doctor once a year.
Q: Is it safe for someone with a history of melanoma to become pregnant or to take estrogen?
A: This has not been determined. And it is a source of great controversy. Researchers do not have good evidence that taking oral contraceptives or postmenopausal hormone replacement therapy is harmful. A woman with melanoma should talk with her doctor if she is thinking about any of these things.
Q: What are clinical trials?
A: Clinical trials are studies of new kinds of cancer treatments. Doctors use clinical trials to learn how well new treatments work and what their side effects are. Promising treatments are ones that work better or have fewer side effects than the current treatments. People who participate in these studies get to use treatments before the U.S. Food and Drug Administration (FDA) approves them for the public. People who join trials also help researchers learn more about cancer and help future cancer patients.