Malignant melanoma, often referred to as black skin cancer, is one of the most aggressive forms of skin cancer. Unlike basal cell carcinoma or squamous cell carcinoma, which typically grow more slowly, melanoma develops from pigment-producing skin cells called melanocytes and has a high potential to spread to other organs if not detected early. Although it accounts for a smaller percentage of skin cancers overall, it is responsible for the majority of skin cancer-related deaths worldwide.
How Malignant Melanoma Develops
Melanocytes are responsible for producing melanin, the pigment that gives skin its color and helps protect it from harmful ultraviolet (UV) radiation. When these cells undergo genetic changes, they can begin to grow uncontrollably and form malignant tumors. Overexposure to sunlight and artificial UV sources such as tanning beds increases the risk of these mutations.
Risk Factors
Several factors contribute to the development of melanoma:
- Excessive UV exposure: Sunburns, particularly during childhood, increase lifetime risk.
- Fair skin and light eyes: Less natural pigment means lower UV protection.
- Family history: Genetic predisposition plays a significant role.
- Large numbers of moles or atypical moles: People with more than 50 moles or irregularly shaped moles have higher risk.
- Weakened immune system: Chronic illness or immune-suppressing treatments may contribute.
- Older age: Risk increases with age, though melanoma can also occur in young adults.
Symptoms and Warning Signs
Early detection is critical, as melanoma is highly treatable in its initial stages. Common signs include:
- Dark spots or moles that change in size, shape, or color
- Asymmetry in the shape of a mole
- Uneven or blurred borders
- Varied colors within one spot, ranging from black, brown, and red to blue or white
- Diameter larger than 6 mm
- Evolving changes over time, including itching, bleeding, or crusting
Doctors often use the ABCDE rule (Asymmetry, Border, Color, Diameter, Evolving) to help identify suspicious skin changes.
Types of Melanoma
Melanoma can present in different forms:
- Superficial spreading melanoma: The most common type, often growing outward before penetrating deeper layers.
- Nodular melanoma: Grows quickly and penetrates deeply from the start, making it particularly aggressive.
- Lentigo maligna melanoma: Develops slowly in sun-exposed areas, often in older adults.
- Acral lentiginous melanoma: Occurs on the palms, soles, or under nails, more common in darker skin types.
Diagnosis
Diagnosis begins with a thorough skin examination by a dermatologist. If a suspicious lesion is found, a biopsy is performed to confirm malignancy. Additional tests such as ultrasound, CT scans, or MRI may be required to determine if the melanoma has spread to lymph nodes or other organs.
Treatment Options
Treatment depends on the stage and spread of the melanoma:
- Surgical removal: The primary treatment, where the tumor and some surrounding tissue are excised.
- Sentinel lymph node biopsy: Performed to check if cancer has spread to nearby lymph nodes.
- Immunotherapy: Medications that stimulate the immune system to attack cancer cells.
- Targeted therapy: Used when tumors carry specific genetic mutations, such as BRAF mutations.
- Radiation and chemotherapy: Applied in advanced or metastatic cases when other therapies are less effective.
Prevention
Prevention remains the most effective strategy against melanoma:
- Avoid excessive sun exposure, particularly midday UV radiation.
- Use broad-spectrum sunscreen with sufficient SPF protection.
- Wear protective clothing, hats, and sunglasses.
- Avoid tanning beds.
- Perform regular self-examinations and attend routine dermatological check-ups.
With more than 37 years of experience, Erdem Hospital provides expert diagnostics, advanced treatments, and preventive care for malignant melanoma, ensuring patients receive comprehensive support from early detection to recovery.
Frequently Asked Questions
- Is melanoma always life-threatening?
Not always. If detected and treated early, melanoma has a high survival rate. However, delayed diagnosis increases the risk of metastasis. - How fast does melanoma spread?
It varies. Some forms, like nodular melanoma, can spread within weeks, while others progress more slowly. Regular monitoring of skin changes is essential. - Can people with dark skin develop melanoma?
Yes. Although less common, melanoma can occur in darker skin tones, often in less sun-exposed areas such as palms, soles, or under nails. - How often should skin checks be done?
Individuals at higher risk should see a dermatologist annually or more frequently if advised. Monthly self-examinations are recommended for everyone. - Is melanoma preventable?
While genetic risk cannot be eliminated, lifestyle changes such as sun protection and avoiding tanning beds significantly reduce the risk.
