Understanding Melanoma
- Mom Ashley Daly of Wheaton, Illinois, is warning about the dangers of skin cancer ahead of sunburn season after her own metastatic melanoma diagnosis.
- She first was diagnosed with early-stage melanoma after noticing a suspicious mole in 2020. Years later she was diagnosed with metastatic melanoma. After undergoing immunotherapy and surgery, she is now cancer-free, but continues to get regular skin checks and urges others to take sun exposure and skin changes seriously.
- Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
- Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.
Daly’s melanoma journey began in 2020 when she found a suspicious mole on her right calf, was diagnosed at an early stage, and had it removed. Several years later, a lump that started as a dime-sized bump and reached the size of a ping-pong ball turned out to be metastatic melanoma.
Read MoreHer warning comes as the summer is approaching, with TikTok users once again highlighting how frequently sunburns still happen.
@edisacapric another day of me being burnt on vacation 🌴#florida #trending #contentcreator #albanian
Board-certified dermatologist Dr. Jarrett Casale often takes to TikTok to feature bad sunburn cases, resharing videos from other social media users.
“These are some of the worst sunburns I’ve ever seen,” he says at the start of a recent video compilation, showing a men as red as a lobster, a woman with large blisters on her back, and a man with a face mask tan after working in his garden.
“Sunburn season is right around the corner and this is your daily reminder to not end up looking like this guy with a mask mark on your face that’s going to eventually fade into hyperpigmentation and accelerate your aging.”
He continued, “Please protect yourself people. It’s top priority.”
@drjcasale This is what happens when you treat sunscreen like it’s optional. #sunscreen #sunburn #skincancer #dermatology #skinhealth
Dr. Bonnie Hodge, a board-certified dermatologist, also took to TikTok to warn social media users about the dangers of sun.
After showing a video of a young woman with purple skin after getting sunburned, Dr. Hodge said, “If you woke up one morning and your skin was purple and it hurt. Would you not go to the hospital? You would absolutely go to the emergency room, if you had not been in the sun.
“Sunburns have become so normalized that people don’t realize how bad that is. Sunburns are not normal.”
@bonniehodge.md When we know better we do better 🫶🏼 #sun #sunburn #tan #tanning
How to Protect Your Skin From Cancer
The Skin Cancer Foundation estimates that more than 5 million cases of skin cancer are diagnosed in the United States every year, making it the most common cancer in the U.S.
As the warmer weather months are upon us it’s important to remember to protect your skin from skin cancer this summer.
Dr. Dendy Engelman, a board-certified dermatologic surgeon and associate at Manhattan Dermatology and Cosmetic Surgery, previously told SurvivorNet that protecting your skin is easy with these simple steps:
- Sun avoidance during peak hours: This means from 10 a.m. to 2 p.m. It doesn’t mean you should never go outside during the middle of the day, but make sure you’re protected when you go outdoors.
- Cover your skin and eyes: Wearing a wide brim hat or sunglasses will protect your face, the top of your head, your ears and the delicate skin around your eyes.
- Wear an SPF of 30 or higher: Plenty of facial moisturizers have SPF built into them. Dr. Engelman recommends reapplying every few hours, or after excessive sweating or swimming.
- Get an annual skin check: If you happen to notice anything out of the ordinary in between checks (like the signs outlined in this article), schedule an appointment to talk to your doctor as soon as possible.
- No-go to tanning beds: Tanning beds can significantly increase your risk of developing melanoma. If you feel like you’re just too pale, Dr. Engelman recommends a sunless tanner.
The Dangers of Tanning Beds
If you’re considering visiting a tanning bed, we highly suggest you think again. Just one indoor tanning session can increase the risk of skin cancer melanoma by 47%, squamous cell carcinoma by 58% and basal cell carcinoma by 24%, according to the American Academy of Dermatology.
When you hop into a tanning bed, you are exposing yourself to the very same dangerous rays you expose yourself to outside, but those rays are only 6-8 inches away. And in a study recently published in Cancer, a peer-reviewed journal of the American Cancer Society, researchers suggested that banning tanning beds among minors would prevent thousands of cases of melanoma in adolescents, along with millions of dollars in health care costs.
So, even if the temptation of achieving a nice “glow” seems irresistible, you should note that health experts warn against using tanning beds.
Dr. Anna Pavlick, an oncologist specializing in skin cancer at Weill Cornell, explained to SurvivorNet that tanning beds increase your chances of skin cancer “exponentially.”
“We know there is a direct correlation with (melanoma) patients who go to indoor tanning salons,” Dr. Pavlick said, noting that the exposure “is about 6 inches from your body.”
Tanning Salons Pose a Big Risk of Melanoma
The sun is millions of miles away when you’re on a beach, “so you have to think of the intensity that you’re exposing your skin to when you go to a tanning salon,” she added.
Learning More About Melanoma
Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.
WATCH: How do you perform a skin check using the ABCDEs?
You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:
- The palms of your hands or soles of your feet
- On your eyes or mouth
- Under your nails
SurvivorNet experts recommend avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma. Tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided. Many dermatologists recommend using spray tans to reduce the risk of melanoma skin cancer.
What Are the Symptoms of Melanoma?
The most important thing to look out for when it comes to finding melanoma is a new spot on your skin or a spot that is changing in size, shape, or color, SurvivorNet’s medical experts say.
When you check your skin, use the acronym ABCDE as your guide:
- Asymmetrical moles: If you drew a line straight down the center of the mole, would the sides match?
- Borders: Is the mole irregular or jagged?
- Colors: Are there multiple distinct colors in the mole?
- Diameter: Is the mole larger than 6 millimeters (mm), about the size of a pencil head eraser?
- Evolution: Has the mole’s color, shape, or size changed over time?
RELATED: The Genetic Mutation That Drives Many Metastatic Melanomas
If you answered “yes” to any of these questions, our experts say it’s time to see your dermatologist for a skin check.
Melanoma Treatment Options
Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.
If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery, but which kind you’ll have.
WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma
For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.
In general, stage I melanoma surgery consists of the simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.
The removal of stage II and III melanomas are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes, and possibly to other organs. Where the cancer is will dictate your treatment.
After surgery, the removed tissue and lymph nodes will go to a specialist called a pathologist, who will measure the melanoma and find out if it has clear margins. Having clear margins means the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.
Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.
Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is recurrent disease.
Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022. The combination of two immunotherapies is called Opdualag.
For those with the BRAF mutation, targeted drugs which shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:
- Zelboraf (vemurafenib) and Cotellic (cobimetinib)
- Braftovi (encorafenib) and Mektovi (binimetinib)
- Tafinlar (dabrafenib) and Mekinist (trametinib)
- Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.
“Every patient is different and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.
There Is No “Cookie Cutter Recipe” for Treating Stage Four Melanoma
Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”
So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.
Questions to Ask Your Doctor
If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests some of the following to help you on your cancer journey.
- What type of skin cancer do I have?
- What treatment options exist for my type of melanoma?
- Will insurance cover this treatment?
- Would treatment through a clinical trial make sense for me?
- What resources exist to help manage my anxiety because of this diagnosis?
WATCH: Clinical trials can be life-saving
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
