Essential Facts About Melanoma

By Tina M. St. John, MD. May 7th 2016

When you think of cancer, melanoma may not be one of your first thoughts — but perhaps it should be.

While new cancer cases are decreasing overall in the U.S., the number of people diagnosed with melanoma has increased steadily for at least three decades, according to a 2014 report from the American Cancer Society. Often mistakenly considered a rare form of cancer, melanoma is in fact the fifth most common type of cancer in men and seventh among women in the U.S.

Although your risk for melanoma increases with age, this form of skin cancer occurs with alarming frequency in young adults and can develop in teenagers. The National Cancer Institute reports that melanoma is the fourth most common cancer in people age 20 to 29 .

Melanoma affects women more frequently than men until about age 40. The trend reverses dramatically thereafter, with men affected progressively more commonly than women as they age.

In 2014, ACS estimates:

  • More than 76,000 new cases of invasive melanoma of the skin;
  • Nearly 64,000 cases of a precursor form of invasive melanoma called melanoma in situ; and
  • Approximately 9,700 deaths from skin melanoma.

Much work remains to turn the tide on melanoma. However, the news is not all bad. When diagnosed at an early stage, melanoma is a highly treatable cancer. Overall, more than 9 out of 10 people survive at least five years after being diagnosed with melanoma. Many men and women are cured of the disease with appropriate treatment.

What Is It?

Medicine divides skin cancer into melanoma and nonmelanoma (NMSC), which includes squamous cell and basal cell cancer. Melanoma and NMSC differ in important ways, including the skin cells from which they originate. Melanoma arises from specialized cells in your skin called melanocytes. These cells produce melanin, the chemical that gives your skin color. NMSC develops from other skin cells.

Unlike NMSC, melanoma tends to spread to other areas of the body, a characteristic that makes it the most life-threatening form of skin cancer. Although melanoma is the least common type of skin cancer, it is responsible for the overwhelming majority of deaths from the disease.

Role of Ultraviolet Radiation

Exposure to ultraviolet radiation (UVR) is the most significant risk factor for both melanoma and NMSC. However, the pattern of UVR exposure that poses the greatest risk differs between melanoma and NMSC. Research shows that intense “bursts” of UVR pose the greatest risk for the development of melanoma. For example, if you work indoors but spend many hours in the sun on weekends or during vacations, your skin is subject to intense bursts of UVR. This kind of sporadic exposure is particularly dangerous because your skin has not adapted to ongoing sun exposure and you are likely to get sunburned. Blistering sunburns during childhood or as an adult increase your risk for melanoma. UVR exposure from use of tanning beds, sunlamps or for medical treatments also increases your risk of developing melanoma.

Other Risk Factors

As with most cancers, several factors influence your risk for melanoma. Your racial background is important because it influences the amount of melanin in your skin. The more melanin you have, the darker your natural skin tone is. People with light skin that usually burns rather than tanning are at greatest risk. Overall, Caucasians have a far greater risk for melanoma than people of color.

Other factors that increase your risk for melanoma include:

  • Freckled skin,
  • More than 50 moles on your body,
  • A close family member who has had melanoma,
  • A personal history of any type of skin cancer, and
  • A weakened immune system due to medication or a health condition.

Melanoma Characteristics

Melanoma often resembles a mole but has characteristics that help distinguish it from other skin spots and noncancerous growths. In 1985, Dr. Robert Friedman and colleagues introduced the “ABCD” system to help people remember key melanoma characteristics.

  • Asymmetry: the spot does not have a uniform shape.
  • Border: the outer edge is jagged or splotchy.
  • Color: there are different colors or shades in the spot.
  • Diameter: the spot or growth is larger than the size of a pencil eraser.

Many health care providers add the letter “E,” which stands for evolving. This means the spot is growing.


Protecting your skin from excessive sun and other UVR exposure may reduce your risk for melanoma.

  • Limit your time outdoors during the peak sun hours of 10 a.m. to 2 p.m.
  • Wear long-sleeved shirts, full-length pants and hats to protect your skin while in the sun. Light-weight, UV-protective clothing is a good option during hot weather.
  • Avoid use of tanning beds and sunlamps.

Although sunscreen use has not been proven to reduce the risk for melanoma, the American Academy of Dermatology recommends using broad-spectrum sunscreen with an SPF of at least 30 on exposed skin when you’re outdoors — even if it’s overcast. Use the timer on your cell phone or wristwatch to remind you to reapply sunscreen at least every two hours.

Next Steps

For Patients

It’s important to know your skin. After showering or bathing, take notice of your moles and other skin spots. See your doctor for anything new, suspicious or growing. The American Academy of Dermatology offers free skin screenings throughout the year. Check for a location near you.

If you have had any form of skin cancer in the past, talk with your doctor about scheduling regular skin exams to be performed by a dermatologist.

For Family Caregivers

Being a “skin buddy” may help protect your loved ones from melanoma and other skin cancers.

  • Apply sunscreen on your children and hard-to-reach areas of your skin buddies when enjoying time in the sun.
  • Keep an eye on one another’s skin when outdoors. Take off your sunglasses periodically to check whether their skin is turning pink.
  • Pay attention to the moles and other spots on your skin buddies, especially those located in areas they cannot easily see.

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