Second opinion: Melanoma - a deadly skin cancer

Lauren Langford, MD

Melanoma, the most serious and potentially deadly form of skin cancer, develops in the cells (melanocytes) that produce melanin - the pigment that gives your skin, hair and eyes color.
Melanoma can also form in your eyes and internal organs, such as your intestines. Of the skin cancers, melanoma is by far the most serious type because it can rapidly spread to other parts of the body including liver, lungs bone and brain. Melanoma can develop from a mole, but most moles do not become melanoma.
Although everyone is at risk for melanoma, increased risk depends on several factors - sun exposure, number of moles on the skin, skin type and family history (genetics). The exact cause of all melanomas is not clear, but exposure to ultraviolet radiation from sunlight or tanning lamps and beds increases your risk of developing melanoma.
The longer you are out in the sun, the more UV radiation you receive. A blistering sunburn at an early age can double a person's chance of developing melanoma later in life. Exposure to tanning beds before age 30 increases a person's risk of developing melanoma by 75 percent. Younger people who regularly use tanning beds are eight times more likely to develop melanoma than people who have never used them. Even occasional use of tanning beds by people under 30 triples the chances of developing melanoma.
There is a strong correlation between childhood protection from the sun, and low incidence of melanoma later in adulthood, as well as during childhood. Next time you're tempted to encourage your pasty-faced child to "get more sun," think of "get some color in your skin" as synonymous with "get some melanoma in your skin."
Genetics, or heredity, also play a major role in melanoma. About one in every 10 patients diagnosed with melanoma has a family member with a history of melanoma. If your mother, father, siblings or children have had melanoma, you are in a melanoma-prone family. Each person with a first-degree relative diagnoses with melanoma has a 50 percent greater chance of developing the disease than people who do not have a family history of the disease.
Accurate diagnosis of melanoma requires biopsy of the lesion and analysis of the sample by a pathologist. Some doctors use a clinical technique called epiluminescence microscopy, or dermatoscopy, to diagnose skin cancers; however, the gold standard for a solid diagnosis is a skin biopsy. Tissue biopsies sample or remove the suspicious mole or growth for microscopic analysis.
If melanoma is diagnosed, the next step is to determine the extent or stage of the cancer. To assign a stage to your melanoma, the pathologist will determine the thickness of the cancer by carefully examining the lesion under a microscope and measuring it. Thickness helps the doctor to decide on a treatment plan. Usually thicker tumors mean more serious disease.
To see if the cancer has spread to nearby lymph nodes, a surgeon will use a procedure known as a sentinel node biopsy. Even if the sentinel node test is free of cancer, there is still a risk that the melanoma might have spread. For this reason, melanoma is a very serious disease.
Unfortunately, kids do get melanoma and the incidence has been rising, just as it has been rising in adults. The number of kids getting diagnosed with melanoma is not large, but there are too many cases to simply dismiss a mole that appears unusual. You should notify your child's doctor if you notice any unusual skin lesions or if a mole is quickly changing in size or color; if the outline becomes notched; if the surface becomes rough, scaly or ulcerated; if it itches, tingles, bleeds, weeps; or looks different from other moles on the body.
By understanding your risk factors for malignant melanoma and taking preventative measures, you can reduce your risk of ever encountering this increasingly common malignancy.
For more information about melanoma, visit http://www.cancer.org/cancer/skincancer-melanoma/index.