Melanoma – Symptoms, Causes and Treatment
Melanoma is the most dangerous form of skin cancer, arising from pigment-producing cells called melanocytes. Early detection is key to successful treatment and improved survival.
Wissenswertes über "melanoma"
Melanoma is the most dangerous form of skin cancer, arising from pigment-producing cells called melanocytes. Early detection is key to successful treatment and improved survival.
What is Melanoma?
Melanoma, also known as malignant melanoma or black skin cancer, is an aggressive form of skin cancer that develops from melanocytes -- the pigment-producing cells of the skin. It is considered the most dangerous type of skin cancer due to its high potential to spread (metastasize) to lymph nodes and other organs at an early stage. In Europe and North America, melanoma rates have been steadily rising over the past decades.
Causes and Risk Factors
Several factors contribute to the development of melanoma:
- UV radiation: Excessive exposure to sunlight and the use of tanning beds are the primary risk factors.
- Genetic predisposition: A family history of melanoma significantly increases the risk.
- Fair skin type: People with light skin, blue or green eyes, and red or blonde hair are at higher risk.
- Many or atypical moles: Having a large number of moles or dysplastic nevi increases risk.
- Previous skin cancer: A personal history of melanoma or other skin cancers raises the chance of recurrence.
- Weakened immune system: Immunocompromised individuals face a higher risk of developing melanoma.
Symptoms
Melanoma often appears as a changed or newly developed mole. The ABCDE rule is a helpful guide for self-examination:
- A – Asymmetry: One half does not match the other.
- B – Border: Edges are irregular, ragged, or blurred.
- C – Color: Multiple shades of brown, black, red, white, or blue within the same lesion.
- D – Diameter: Larger than 6 mm (about the size of a pencil eraser).
- E – Evolution: The mole is changing in size, shape, or color over time.
Additional warning signs include itching, bleeding, or crusting of an existing mole.
Diagnosis
The diagnostic process typically involves several steps:
- Visual examination and dermatoscopy: A dermatologist examines suspicious skin lesions using a special magnifying instrument called a dermatoscope.
- Excisional biopsy: The suspicious lesion is surgically removed and examined under a microscope (histopathology).
- Staging: Once melanoma is confirmed, imaging tests such as ultrasound, CT, or MRI are used to determine how far the cancer has spread.
- Sentinel lymph node biopsy: In deeper tumors, the first draining lymph node is sampled to check for spread to the lymphatic system.
Treatment
Surgical Excision
Surgical removal of the tumor with appropriate safety margins (based on tumor thickness, known as Breslow thickness) is the primary treatment for localized melanoma.
Immunotherapy
Modern checkpoint inhibitors such as pembrolizumab and nivolumab work by activating the body's own immune system to recognize and destroy cancer cells. These therapies have transformed the treatment of advanced melanoma.
Targeted Therapy
Approximately 50% of melanomas carry a BRAF mutation. In these cases, BRAF inhibitors (e.g., vemurafenib, dabrafenib) combined with MEK inhibitors can be highly effective.
Radiation Therapy and Chemotherapy
Radiation therapy is used primarily for brain metastases or as a palliative option. Chemotherapy now plays a limited role due to the availability of more effective modern treatments.
Prevention and Early Detection
The most effective measures for preventing melanoma include:
- Consistent use of sunscreen with SPF 30 or higher
- Avoiding intense sun exposure, especially between 11 a.m. and 3 p.m.
- Refraining from using tanning beds
- Regular skin self-examination using the ABCDE rule
- Professional skin cancer screening by a dermatologist at regular intervals
Prognosis
The prognosis for melanoma is strongly dependent on the stage at diagnosis. In early-stage melanoma with a thin tumor and no metastases, 10-year survival rates exceed 90%. In advanced melanoma with distant metastases, the outlook is significantly worse; however, modern therapies such as immunotherapy and targeted therapy have dramatically improved survival outcomes in recent years.
References
- World Health Organization (WHO) / International Agency for Research on Cancer (IARC): Skin Cancer – Melanoma. Lyon, 2022. Available at: https://www.iarc.who.int/
- National Comprehensive Cancer Network (NCCN): NCCN Clinical Practice Guidelines in Oncology – Melanoma: Cutaneous, Version 2.2024. Available at: https://www.nccn.org/
- Garbe C. et al.: European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment. European Journal of Cancer, 2022.
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Related search terms: melanoma + Melanoma + malignant melanoma