Malignant Melanoma

Of the three cancers, potentially fatal melanoma is the most serious. Nearly 40,000 Americans will develop it this year. "Malignant melanoma is the emerging common cancer in young adults and in women in their 20s and 30s, second only to breast cancer," says Alan M. Houghton, M.D., the principal investigator in a melanoma vaccine study sponsored by the Memorial Sloan Kettering Cancer Center in New York. If you see any changes in the skin, such as a growth, a sore that doesn't heal, or moles that are starting to look irregular, consult your dermatologist immediately. And if a family member has had melanoma or you have a high number of moles, Dr. Houghton suggests seeing a dermatologist once or twice a year.

Melanoma usually begins as a dark brown or black patch with irregular borders and is characterized by the uncontrolled growth of pigment-producing tanning cells. It may appear anywhere on the body without warning or start near a mole. It has a tendency to spread, making it essential to treat it right away. Since melanoma is often linked to a change in one of your moles (most of us have 100 or so), you should inspect them regularly and look for any changes in their size and color, such as the appearance of a bump or the spreading of pigment around the border.

Most melanomas start in normal skin, as small brown or black marks on the skin. They are sometimes hard to distinguish from ordinary moles. About a third develop in existing moles. Signs of a malignant melanoma may include any of the following:

Major Signs:

• Change in size - the mole may become lumpy or spread outwards over the skin. Early melanomas grow, but ordinary moles in adults (especially over the age of 35) do not.
  
• Change in shape - most moles have a smooth, regular outline, but a melanoma is more likely to have an irregular, ragged edge.
  
• Change in colour - the mole may develop a reddish edge. It may become darker or appear to have different shades of colour, usually a mixture of brown and black. They can also be red, due to inflammation, or have a blue-white tinge due to partial clearing in the centre of the melanoma.
  

• Diameter - most normal moles are smaller then the blunt end of a pencil (7mm).
  
• Inflammation - many early melanomas are inflamed or have a reddish edge.
  
• Crusting or bleeding - slight oozing is a common symptom and causes the melanoma to stick to clothing.
  
• Itch - this is the only common symptom. However, ordinary moles can also itch. Pain may also be a symptom.
  
• Satellite lesions - small brown changes around the edge of a mole.