Malignant Melanoma

Melanoma is a cancerous tumor that grows out of melanocyte cells. These cells make the pigment melanin which colors the skin, hair, and eyes. Melanoma most often develops in the skin (cutaneous), but it can also occur in the eye (ocular), and in other areas of the body where melanocytes are found. Melanoma is a serious cancer that can spread rapidly throughout the body.

Who gets it?

Melanoma affects people of all ages, and is one of the most common cancers in young adults. It is rare in black people and others with dark skin. The risk of developing melanoma increases with age. It also runs in families.

Among Western countries, the number of people who develop melanoma has been increasing over the years. In the United States, the number of new cases of this cancer has more than doubled in the past 20 years.

What are the symptoms?

The first sign of melanoma is often a change in the size, shape, color, or feel of a mole on the skin. These changes can be remembered as "ABCD":

- Asymmetry - an odd shape, or one half is shaped differently from the other

- Border - ragged, notched, blurred, or irregular outline - Color - different shades of black, brown, and tan in the same mole; there may also be patches of white, gray, red, pink, or blue in it - Diameter - the mole grows larger; melanomas are usually larger than ¼ inch across

Other mole changes to watch for are itching, oozing, or bleeding, or the mole becomes hard or lumpy. Melanoma usually does not cause pain.

How is it diagnosed?

A skin examination by a physician, nurse specialist, or nurse practitioner can uncover suspicious moles. A suspect mole is entirely or partially removed (biopsy) and the tissue examined under a microscope. This is the only way to make a definite diagnosis.

Four basic types

- Superficial spreading melanoma - 70% of cases, most likely to occur on the trunk in men, the legs in women, and the upper back in both. - Lentigo maligna melanoma - found most often in the elderly, in chronically sun-exposed or -damaged skin on the face, ears, arms, and upper trunk. - Acral lentiginous melanoma - appears as a black or brown discoloration under the nails or on the soles of the feet or palms of hands; most common melanoma in African-Americans and Asians, least common among whites. - Nodular melanoma - 10-15% of cases, spreads quickly, looks like a black bump but may be other colors, found on the trunk, legs, and arms of elderly or scalp in men.

How is it treated?

The treatment plan takes into account the type of melanoma, its location, whether it has begun to spread, and the person's age and health. The standard treatments are:

- Surgery - remove the melanoma and a ring of tissue around it (to make sure no cancer cells were missed) - Chemotherapy - to kill cancer cells that have spread throughout the body - Immunotherapy - interferon-alfa and interleukin-2 may be given to help the body's immune system prevent a recurrence of the melanoma - Radiation therapy - to kill cancer cells that may have spread beyond the tumor.

The good news!

If melanoma is diagnosed early and removed before it begins to spread it is almost 100% curable. You can also reduce your risk by:

1- avoiding suntans, tanning booths, and sunburns - all damage the skin and increase melanoma risk 2- having your skin examined during your regular physical checkups 3- checking your own skin and reporting any changes to your doctor immediately

Clinical trials are research studies that involve people. They are the final step in a long process that begins with research in a lab and animal testing. Many treatments used today are the result of past clinical trials.

In cancer research, clinical trials are designed to answer questions about new ways to:

- Treat cancer - Find and diagnose cancer - Prevent cancer

- Manage symptoms of cancer or its treatment.

The guidelines that clinical trials follow clearly state who will be able to join the study and the treatment plan. Every trial has a person in charge, usually a doctor, who is called the principal investigator. The principal investigator prepares a plan for the study, called a protocol, which is like a recipe for conducting a clinical trial.

The protocol explains what the trial will do, how the study will be carried out, and why each part of the study is necessary. It includes information on:

- The reason for doing the study - Who can join the study - How many people are needed for the study - Any drugs they will take, the dose, and how often - What medical tests they will have and how often - What information will be gathered about them.

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Questions to Ask

If you are thinking about taking part in a clinical trial, here are some questions that can help you decide.

About this trial

- Why is this trial being done? - Why do the doctors who designed the trial believe that the treatment being studied may be better than the one being used now? Why may it not be better? - How long will I be in the trial? - What kinds of tests and treatments are involved? - What are the possible side effects or risks of the new treatment? - What are the possible benefits? - How will the doctor know if the treatment is working?


- Will I have to pay for any of the treatments or tests? - What costs will my health insurance cover?

Daily life

- How could the trial affect my daily life? - How often will I have to come to the hospital or clinic? - Will I have to travel long distances?

Comparing choices

- What are my other treatment choices, including standard treatments? - How does the treatment I would receive in this trial compare with the other treatment choices?

How to Find Clinical Trials

The National Cancer Institute, drug companies, medical institutions, and other organizations sponsor clinical trials. Clinical trials take place in many settings, such as cancer centers, large medical centers, small hospitals, and doctors' offices.

The National Cancer Institute maintains the most complete database of cancer clinical trials in the country. This database is called PDQ®. The following resources from the National Cancer Institute can help you search PDQ® and see if there is a trial for your type and stage of cancer.

National Cancer InstituteCancer Information ServiceToll-free: 1-800-4-CANCER (1-800-422-6237)TTY: 1-800-332-8615Answers questions about cancer clinical trials and cancer-related services and helps users find information on the NCI Web site. Provides NCI printed materials.Online: online:

Resources, Organizations and Support Information for Melanoma

Melanoma Research Foundation

Melanoma Treatment Centers

Skin Cancer Foundation

American Academy of Dermatology


International Resources

Melanoma International Foundation

Early Detection

Alternative Treatment for Melanoma

Navigating Melanoma

Melanoma Forum

Melanoma Bulletin Board