Melanoma - Symptoms, stages and causes

Melanoma - Symptoms, stages and causes

Dr. Beth Goldstein
7 minute read

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There is one type of skin cancer in particular that often carries a deeper level of fear and concern than some of the more common forms of skin cancer and that is Melanoma.

While all skin cancer is a concern and should be treated as such, melanoma is the scary older sibling of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) skin cancers. In the skin cancer family, this older sibling affects fewer people than its BCC and SCC kin, yet carries the most notoriety, with a shady reputation to boot. So what is melanoma, exactly, and what makes it more dangerous than BCC and SCC skin cancers? This question, and others, are covered in-depth below: 

As a primary care provider, nurse practitioner or PA, are you interested in learning more about how you can have skin concerns in your practice co-managed with an 'on-demand' dermatologist? Learn more here.

If you are a patient seeking a first or second opinion from a dermatologist on a spot mole or rash of concern, you can access a dermatologist via your local primary care provider or urgent care clinic. Find a list of partner primary care and urgent care clinics offering virtual dermatology here.

What is melanoma?

Melanoma is a skin cancer that occurs when melanocytes, meaning the cells (melanin) that give the skin its color, begin to mutate and grow out of control. This mutation is triggered by UV radiation (you’ve heard it from us before and you’ll hear it again: UV radiation is bad — and we mean bad — for your skin) that damages the skin and provokes the melanocytes to produce more melanin. When the melanin production is uncontrolled and abnormal, that is when it becomes a melanoma. 


What makes melanoma different from other skin cancers?

 Melanoma is different in that it develops from different cells than other types of skin cancer. While SCCs, BCCs, and Melanoma all develop out of the top cells that make up the top three layers of the skin, each one is named after the particular cell it develops from basal cells, squamous cells, and melanocytes. Basal cell carcinoma is the most common type of skin cancer in the United States, with more than 4 million diagnosed cases a year. Squamous cell carcinoma is similar to basal cell carcinoma in its commonality in the general population, as well as its treatability. Most BCC and SCC skin cancers pose no serious threat, though it is still important to detect early and focus on prevention. Squamous cell carcinomas can spread and cause serious consequences or death as well but fortunately that is quite rare. Melanoma, on the other hand, has a greater chance of spreading to other parts of the body, and when it does it becomes much less treatable and more serious — even life-threatening. This leads us to the next question...


So how dangerous is Melanoma skin cancer, really?


Melanoma skin cancer, when detected early, is highly treatable and highly curable when. Melanoma that has gone undetected, however, and has spread throughout the body, is much harder to treat and can even be deadly. That’s why melanoma is probably the skin cancer name you recognize - you probably haven’t heard of anyone dying from a basal cell carcinoma, but you may have heard of a celebrity, or even someone you know personally, battling a serious case of melanoma skin cancer. The singer and celebrity Bob Marley tragically passed away at just 36 from melanoma that wasn’t detected early, and while it’s nothing to live in fear of, it certainly has a scare factor. 


It’s always important to know the facts surrounding widespread cases, and not just the experience of someone you knew or heard about. There is good news – the five-year survival rate for patients in the United States whose melanoma is detected early is estimated to be around 99 percent. When early detection is combined with prevention and foundational knowledge of skin health and the risks of skin cancer, the outlook is even more positive. However, over 7,000 people will likely die of melanoma in the United States this year. Of that 7,000+, well over half will be men. It’s numbers like this one that became the impetus for The Daily by Modern Ritual, a sunscreen designed for men, and why it’s so important for men and women to understand what it takes to protect themselves and their skin. We don’t want anyone to become another statistic. 


Am I at risk of getting melanoma skin cancer?


All of this might lead you to wonder: Am I going to get melanoma? It’s certainly a good question to ask, and the data backs this up. New melanoma diagnoses are projected to increase by 5.8% in 2021, with deaths rising by 4.8%. In the past decade, the annual identification of invasive melanoma cases rose by 44%. That’s a lot of numbers, and they are all saying things that we wish they weren’t — despite increased awareness and information surrounding the seriousness of skin cancer and sun damage, cases are rising, not falling. It’s an important time to assess your own risk level and stay alert about your skin health:


  1. Have you often been exposed to UV radiation, either through extensive time in the sun or through tanning beds? Almost 90% of melanoma can be attributed to sun exposure. 

  2. Were you frequently sunburned as a child, or as an adult? 

  3. Do you have a lot of moles on the skin?

  4. Do you have fair skin, light hair, and freckle easily?

  5. Do you have a family history of melanoma, or skin cancer more generally?

  6. Are you older, or do you have a weakened immune system?

  7. Are you a male?


If you answered yes to any of the above, you have at least one of the risk factors that can be attributed to the development of melanoma. However, please be aware: none of these things mean you will for sure develop melanoma. Questions like these are just meant to give you a better look at where you stand when it comes to the commonalities among those diagnosed. Everybody is at risk, even those who have none of the above characteristics, and everyone should prioritize prevention and skin health, including wearing sunscreen every day. 

What does melanoma skin cancer look like and how do I check for it?


Melanoma can come in a myriad of shapes, sizes, and colors. There is no “one size fits all” when it comes to melanoma, but there are a few key ways to monitor your skin to ensure it is detected early. The “ABCDEs” of melanoma is a guide the Skin Cancer Foundation gives to help detection. Each letter is broken down by a characteristic of melanoma. A is for Asymmetry, as most melanoma skin spots are asymmetrical. B is for Borders, as melanoma spots are often uneven or scalloped, whereas normal moles should have an even border. C is for Color, as melanoma presents itself often as an unusually dark color, like a deep tan, brown, or black.  D is for diameter, as any melanoma spot that has reached the size of a pencil eraser is an immediate concern. E is evolving, as any mole or spot on your skin that is changing size, texture, color, or is bleeding or itching is a warning sign.


To check for melanoma, be sure to keep a watchful eye on your moles, both raised and flat ones, and overall skin patterns and textures, making sure to look for all of the warning signs we just listed. Of course, a dermatologist who specializes in skin cancer and can help you assess your risk level, discuss detection methods, and perform a skin check is another great way to take action and lower your risk level. 

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