Among the types of skin cancer, malignant melanoma is the most aggressive and serious. It is a type of cancer that arises from the uncontrolled proliferation of pigment cells called melanocytes in the skin. Melanocytes may produce the melanin pigment, which determines skin color. Symptoms appear in areas of the skin frequently exposed to sunlight, though it can rarely be seen around the nose, throat, and eyes.
What is Malignant Melanoma?
Malignant melanoma is a type of skin cancer that develops due to the uncontrolled proliferation of cells called melanocytes. Under normal conditions, these cells produce the melanin pigment, which protects the skin from the harmful ultraviolet (UV) rays of the sun. However, genetic predisposition, intense exposure to sunlight, or changes in moles can cause melanocytes to grow abnormally, leading to the development of a malignant tumor (melanoma).
Melanoma is the fastest-growing type of skin cancer and has a high potential for metastasis. It is also known that approximately 30% of melanomas originate from existing moles. Knowing and taking precautions against each symptom that appears on the body ensures success in the treatment of malignant melanoma.
What are the Risk Factors for Melanoma Skin Cancer?
The development of malignant melanoma can emerge from a combination of many genetic and environmental factors. While the likelihood varies from person to person, certain conditions significantly increase the risk of developing this disease.
- Excessive Sun Exposure (UV Rays)
Prolonged unprotected exposure to the sun’s ultraviolet (UV) rays is one of the most important causes of the development of malignant melanoma by damaging the DNA of skin cells. Severe sunburn during childhood can increase the risk of skin cancer in later years.
- Multiple and Atypical Moles (Nevi)
Having more than 50 moles on the body or the presence of dysplastic nevi, which are moles with irregular borders and different color tones, is a warning factor for melanoma development. These types of moles should be regularly checked under dermatological supervision.
- Family History of Skin Cancer
A family history of melanoma in first-degree relatives may indicate a genetic predisposition.
- Previous Occurrence of Skin Cancer
Individuals who have had basal cell or squamous cell skin cancer may have an increased likelihood of developing a second skin cancer. Therefore, regular dermatological follow-up is necessary.
- Tanning Bed Use
Tanning beds emit high-dose artificial UV rays. Frequent and prolonged use of a tanning bed, especially if started at a young age, can significantly increase the risk of developing melanoma.
- Weak Immune System
Situations such as organ transplantation, long-term use of cortisone, and immunosuppressive medication reduce the body’s capacity to fight cancer cells. In these individuals, the risk of melanoma is higher compared to normal.
What are the Symptoms of Malignant Melanoma?
Malignant melanoma may initially appear only as a change in a mole. However, as it progresses, it tends to spread to surrounding tissues. Common symptoms of skin cancer include:
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Change in color, shape, or size of an existing mole
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New dark, irregularly bordered spots
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Crusting, bleeding, and itching of the mole
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Asymmetry or irregular edges on the skin surface
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Presence of color variations (brown, black, blue tones)
Dermatologists use the ABCDE rule in evaluating suspicious lesions:
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A (Asymmetry)
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B (Border Irregularity)
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C (Color Variation)
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D (Diameter > 6 mm)
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E (Evolution)
What are the Symptoms of Skin Cancer on the Face?
New spots, crusting, or color changes around the nose, cheeks, forehead, or lips may be early warning signs of malignant melanoma. Any such changes should prompt a visit to a specialist without delay.
What are the Types of Malignant Melanoma?
Malignant melanoma is a type of skin cancer that does not progress in the same way in every patient and can present with different clinical types. The type of melanoma can directly affect the disease's course, spread rate, and treatment approach.
Superficial Spreading Melanoma
It is a common type, comprising approximately 70% of malignant melanoma cases.
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Typically develops on a previously existing mole.
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It progresses slowly on the skin surface but can spread rapidly once it reaches deeper layers.
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Appears as brown, black, or multicolored irregularly bordered spots.
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Occurs in sun-exposed areas such as the back, chest, and legs.
Nodular Melanoma
Among melanoma types, it is an aggressive type.
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Due to its rapid progression to deeper tissues, it is difficult to detect early.
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Generally appears as a dark and rapidly growing nodule (lump).
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Sometimes may be felt as a hard swelling on the skin without surface color change.
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Can develop on any part of the body but commonly occurs in the trunk, head, or neck area.
Lentigo Maligna Melanoma
This type of melanoma usually appears in older individuals and in sun-exposed facial areas.
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Develops as a result of UV damage caused by the sun over many years.
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Manifests as brown or dark irregular spots.
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Initially appears as a benign lentigo maligna but can transform into an invasive form over time.
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Found in areas exposed to the sun, such as the face, cheeks, ears, and nose.
Acral Lentiginous Melanoma
Unlike other types of melanoma, it can develop in areas not exposed to sunlight.
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Occurs on the palms, soles, or under the nails.
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Begins as dark streaks and spots.
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Diagnosis is often delayed as it can be overlooked.
Desmoplastic Melanoma
A rare type of melanoma, but it has a high tendency to infiltrate deep tissues.
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May appear as a hard, pale, or skin-colored mass.
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Typically emerges on the head, neck, and back areas.
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Because there is no significant color change, it can sometimes be confused with a benign mass.
Amelanotic Melanoma
In this type of skin lesion there is little or no pigment (color).
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May appear as a pink, red, or flesh-colored nodule.
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Because there is no change in color, it is quite difficult to diagnose.
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Can progress rapidly, thus early diagnosis is crucial.
How Quickly Does Skin Cancer Spread?
Melanoma tends to spread faster compared to other types of skin cancer. However, the duration of spread can vary according to factors like tumor depth, its stage, and the patient's immune status.
Early-stage melanomas are limited to the skin and can be completely cured when surgically removed. But melanoma diagnosed at a late stage can metastasize to lymph nodes and internal organs, making treatment difficult. Therefore, recognizing changes in moles early is important, focusing not on how quickly the skin cancer spreads but on how early it is diagnosed.
How is Malignant Melanoma Diagnosed?
Malignant melanoma, which arises from melanocyte cells, can manifest with various subtypes exhibiting different histological characteristics and clinical behaviors.
- Dermatological Examination
The first step in the diagnosis is a detailed skin examination conducted by a specialist. The specialist evaluates moles, spots, and color changes on the body, examining for changes in shape, color, border, and size.
At this stage, the ABCDE rule is generally used:
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A (Asymmetry): If the two halves of a mole do not resemble each other,
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B (Border): If the borders are irregular or blurred,
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C (Color): If there are color variations,
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D (Diameter): If the diameter is larger than 6 mm,
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E (Evolving): If growing, crusting, or bleeding over time, this situation is considered a warning sign for malignant melanoma.
- Dermatoscopy Examination
After the dermatological examination, the doctor examines suspicious areas in detail using a special magnifying device called a dermatoscope. This method enables the differentiation of early-stage melanoma lesions from simple skin spots.
- Biopsy
If a suspicious lesion is identified following dermatoscopy, a biopsy is performed for diagnosis. A biopsy involves taking a small sample of the suspicious skin tissue and examining it under a microscope.
- Imaging Tests for Staging
After a melanoma diagnosis, staging tests can be carried out to determine the degree of spread of the disease. Imaging tests provide information about the tumor's depth and whether it has spread to lymph nodes or other organs.
- Sentinel Lymph Node Biopsy
If the melanoma is thick or if there is suspicion of lymph node involvement, a sentinel lymph node biopsy can be performed. This procedure allows for the determination of the first lymph node that cancer cells reach and its examination under a microscope.
What are the Treatment Methods for Malignant Melanoma?
The treatment of malignant melanoma can be planned according to the stage and spread of the disease. The goal of treatment is to completely eliminate the cancerous tissue and stop the progression of the disease.
- Surgical Treatment
It is the most effective method in early-stage melanomas. The tumor is surgically removed along with the surrounding healthy tissue. Reconstructive surgery may be applied for aesthetic purposes when necessary.
- Lymph Node Biopsy and Dissection
If the melanoma has deepened, sentinel lymph node biopsy is used to investigate if the cancer cells have spread to the lymph nodes. If there is involvement, regional lymph nodes may be removed.
- Immunotherapy
Aims to strengthen the immune system to fight cancer cells. It can be used in advanced-stage melanomas.
What are the Methods for Preventing Malignant Melanoma (Skin Cancer)?
Simple daily measures can reduce the risk of malignant melanoma:
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Broad-spectrum creams with at least SPF 30 should be preferred.
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Hats, sunglasses, and long-sleeved thin clothing can reduce UV exposure.
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Artificial UV rays can increase the risk of melanoma.
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A specialist should be consulted if there are new moles or changes in shape, color, or border.
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Sunburns during childhood can increase the risk of melanoma in later years.
Frequently Asked Questions
What are the common symptoms of malignant melanoma?
Changes in color, shape, and size of existing moles; irregular borders; bleeding; crusting and itching are among common symptoms.
Can malignant melanoma be treated?
Yes. It can be completely cured when surgically removed at an early stage. In advanced stages, it can be controlled with immunotherapy and targeted drug treatments.
Is malignant melanoma genetic?
A family history of skin cancer increases the risk, but it can also develop in individuals without genetic predisposition due to intense UV exposure.
How often should moles be checked?
Individuals with a high number of moles or those in the risk group are advised to undergo a dermatological examination at least once a year.
