Main
- Early detection of melanoma remains the main condition for a favourable outcome, and delay noticeably complicates care.
- A change in a mole — growth, uneven edges, uneven colour, itching or bleeding — is a reason to see a dermatologist or oncologist.
- Melanoma can appear on apparently healthy skin and on areas that hardly ever see the sun, including amelanotic forms.
- Risk factors: fair skin, many moles, sunburns in childhood, solarium use and cases of melanoma in close relatives.
- Examination is built up step by step: skin examination, dermatoscopy, biopsy with tissue testing, then clarification of the stage.
What is melanoma
Melanoma is a malignant tumour that develops from the pigment cells of the skin. Below is an explanation of what exactly happens in the body, what causes this condition and who is affected by it more often.
What happens in the body
The pigment cells of the skin produce a substance that gives the skin and hair their colour and protects the underlying tissues from the effects of sunlight. Under the influence of ultraviolet light, damage accumulates in the genetic material of these cells, and the cell loses the ability to control its division normally. Instead of the usual renewal, it begins to divide uncontrollably, gradually forming a cluster of altered cells. Such a cluster can arise in any part of the body, including those areas that hardly ever see direct sunlight. Gradually the altered cells grow into the neighbouring layers of the skin, and then can spread throughout the body via the flow of lymph or blood. The earlier such a cluster is noticed, the easier it is to deal with, so changes in the skin should be monitored carefully. Comparing a mole with how it looked in a photograph taken in advance helps to notice changes.
What causes it to develop
- Ultraviolet radiation: prolonged exposure to the sun and to sunbeds damages the genetic material of pigment cells, and the accumulation of such damage increases the risk.
- Fair skin, hair and eyes: in people with a low content of protective pigment, the skin resists ultraviolet light less well, so damage occurs faster and more easily.
- A large number of moles: the more pigmented formations there are on the body, the higher the likelihood that one of them will change unfavourably over time.
- Cases of melanoma in close relatives: a family history indicates a hereditary predisposition in which the skin cells are especially sensitive to external influences.
- Past sunburns: burns sustained in childhood are especially dangerous, since they leave a mark in the cells for life.
- Practical conclusion: knowing one's risk factors, a person can pay closer attention to changes in the skin and not postpone a visit to a specialist.
Who is affected by it more often
This condition is more often encountered by people with fair skin, fair hair and eyes, as well as those who have many moles on their body. Family history also matters: if close relatives have had a similar disease, attentiveness to one's skin should be increased. A considerable role is played by a lifestyle involving prolonged exposure to the open sun, especially during the hours of high ultraviolet activity. People who frequently got sunburns in childhood are in the group requiring increased attention, along with those who regularly use sunbeds. Age itself does not protect: changes can appear in young people too, so one should not rely only on the number of years lived. Heredity and appearance cannot be changed, but monitoring the skin is available to everyone regardless of these circumstances. Regular self-examination of the skin and a careful attitude to new or changed formations help to notice changes earlier.
What symptoms can occur?
Melanoma is noticed by a change in an existing mole or by a new pigmented spot on the skin. A careful examination of the body helps to see such changes before complaints appear.
How it is noticed at the very beginning
Melanoma often begins as a change in an existing mole or as a new pigmented spot on the skin. A person may notice that a mole has become darker or lighter than it was before. Sometimes its shape changes: the edges become uneven or blurred. The formation may increase in size, and this is visible when compared with its previous appearance. Itching, burning or soreness appears in the area of the mole, which was not there before. Some note bleeding or weeping of the surface, as well as the appearance of a new dark spot on the skin. Such changes are often attributed to fatigue, friction from clothing or accidental injury, so a visit to the doctor is postponed. If a mole has changed or a new pigmented formation has appeared, it is reasonable to show it to a dermatologist or oncologist without waiting for other symptoms.
Signs that occur most often
- Change in the colour or shape of a mole: the shade or outline becomes different, and this is the first reason to show the formation to a doctor.
- Increase in the size of the formation: the mole or spot grows more noticeably than before, which indicates the need for an examination by a specialist.
- Uneven or blurred edges: the border loses its clarity, and such a sign is assessed during a skin examination by a dermatologist.
- Itching, burning or soreness: unpleasant sensations in the area of the mole appear without an obvious cause and require attention.
- Bleeding or weeping: the surface of the formation is damaged or releases fluid, and this is a reason to seek help without delay.
- A new dark spot on the skin: a formation appears where there was nothing before, and it should be shown to a doctor.
When to seek help urgently
Examinations and tests
Examination for suspected melanoma is built up step by step: from a skin examination to a biopsy and further clarifying tests. Below is a breakdown of what each of them shows and at what point it is ordered.
How the examination begins
The examination begins with a skin examination and dermatoscopy, when the doctor studies the lesion under magnification. Dermatoscopy makes it possible to examine structures invisible to the eye and to assess their nature. If the signs raise concern, a biopsy is ordered — the taking of a tissue sample for laboratory testing. It is the microscopy of the tissue that gives the answer as to whether there are tumour cells in the lesion. Further examinations are needed to clarify the stage and to understand whether the lymph nodes are affected. An ultrasound examination of the lymph nodes shows their size and structure in the areas where drainage is possible. If necessary, computed tomography or magnetic resonance imaging is added to assess the internal organs. Collect all previous reports and scans: they will help the doctor see the whole picture.
What is ordered and what it shows
What is worth preparing for the appointment
- Discharge summaries: take all medical documents describing previously removed lesions — this helps the doctor compare the past and the present.
- Scans and reports: bring the results of previous dermatoscopies, biopsies and tomographies so that the tests do not have to be repeated.
- Your own observations: write down when you first noticed the lesion and how it changed in size, colour or shape.
- List of visits: indicate which doctors you have seen about your skin and what you were told at the time.
- List of questions: formulate in advance what you want to clarify with the doctor so that you do not forget anything during the conversation.
Which doctor should I see?
If melanoma is suspected, it is important to see a relevant specialist as early as possible, who will assess the formation and determine further management. Below is an outline of who manages such patients, what the care consists of, and what depends on the person themselves.
Which specialist manages this condition
Melanoma is managed by an oncologist, while the initial examination of the formation is often carried out by a dermatovenereologist. The dermatovenereologist examines the skin, assesses the borders, colour and surface of the formation, and if necessary refers the patient onwards. The oncologist is responsible for confirming the nature of the tumour and determining the stage of the process. If a relevant specialist is not available nearby, one starts with a dermatovenereologist at the place of residence, who issues a referral if melanoma is suspected. In large cities, appointments are provided at oncology dispensaries, where the necessary equipment and conditions for further investigation are available. Delaying the visit leads to the tumour growing larger and the choice of methods becoming narrower. Therefore, with any change in a mole, it is sensible not to wait but to book an appointment with an oncologist or dermatovenereologist straight away.
What the treatment consists of
- Surgery to remove the formation: this is the main method of care, in which the tumour is excised within healthy tissue so that the altered cells are removed completely.
- Follow-up with an oncologist after treatment: regular examinations allow the reappearance of the tumour or changes on the skin to be noticed in time and responded to promptly.
- Selection of systemic therapy by the doctor: in advanced disease, the oncologist individually determines what effect on the whole body is necessary in a particular case.
- Radiotherapy for certain indications: it is not used for everyone, but only when there are medical grounds for it, and the decision is made by the treating doctor.
- Individual plan: further management depends on the stage of the process and is selected by the oncologist separately for each patient; there is no single approach here.
What depends on the patient themselves
Regular follow-up with an oncologist after treatment is the part of the outcome that rests on the patient themselves. Attending at the appointed times allows the doctor to assess the condition of the skin and notice changes before they become more serious. If a person misses examinations, the reappearance of the tumour or new formations remain unnoticed for longer than they should. It is useful to monitor the condition of the skin oneself and to inform the doctor of any changes that cause doubt. It is worth keeping discharge summaries and reports to hand, so that a new specialist has the full picture at the appointment. Refusing visits "while nothing is bothering me" is a common reason why care comes later than it should. Therefore, it is sensible to treat the appointed examination times as a mandatory matter, not as a formality.
What helps prevent an exacerbation?
The section explains which daily decisions and habits are within a person's own control. Regular skin checks and protection from ultraviolet radiation help notice changes earlier and reduce the risk of flare-ups.
What to change in habits
Protecting the skin from ultraviolet radiation and paying close attention to its condition are the main things that depend on the person themselves. Prolonged exposure to the sun during peak hours increases the burden on the skin, so such periods are best spent in the shade. Sunscreen is applied to exposed areas, including the face, neck, hands and ears, and reapplied during prolonged time outdoors. Sunbeds create an additional dose of ultraviolet radiation, so they are given up completely rather than having visits reduced. Skin self-examination is carried out regularly in order to notice new growths and changes in familiar moles. A change in the size, shape, colour or borders of a mole is a reason to show it to a doctor rather than to keep watching it on your own. Calm and consistent practice of these habits matters more than one-off efforts, because risk is made up of everyday behaviour.
What to keep under control
- Skin self-examination: regularly examining the whole body helps notice new growths and changes in familiar moles that are hard to see without the habit.
- Moles: they are monitored constantly, because a change in size, shape, colour or borders requires a doctor's attention rather than waiting.
- Time in the sun: hours of high ultraviolet activity are best spent in the shade in order to reduce the overall burden on the skin during the day.
- Sunscreen: it is applied to exposed areas of skin and reapplied during prolonged time outdoors, not just once in the morning.
- Sunbeds: artificial ultraviolet radiation is given up completely, since it gives an additional dose of exposure to the skin.
- Visit to a dermatologist: a routine examination by a specialist helps notice a problem at an early stage, even if self-examination has shown nothing.
How often to see a doctor
A regular examination by a dermatologist is needed even when you feel well and have no skin complaints. Self-examination does not replace a doctor's examination, because a person sees some areas of the body poorly or does not see them at all. During an appointment the specialist examines the skin as a whole, including the back, the scalp and other hard-to-reach areas. Such an examination helps notice changes at an early stage, when they do not yet cause concern and are not visible to the person themselves. If a mole changes in size, shape, colour or borders, the visit is not put off until the scheduled date. In the absence of complaints, the frequency of visits is discussed with the doctor, guided by the condition of the skin and individual characteristics. Calm routine monitoring is not anxiety but a habit that makes watching the skin systematic.
What is worth remembering
Melanoma is one of those conditions where seeking help early noticeably changes the course of events, while delay complicates treatment. Below are the conclusions that help make a balanced decision without panic and without putting it off.
Key conclusions
Melanoma develops from the pigment cells of the skin, and its early detection remains the main condition for a favourable outcome. A tumour can appear on visibly healthy skin, so monitoring long-familiar moles alone is not enough. A change in the size, shape, colour or borders of a pigmented formation is a reason to see a specialist, rather than wait for it to go away on its own. Melanoma does not always look dark: amelanotic forms occur, which are harder to recognise. Self-examination is useful, but it does not replace an examination by a doctor, especially with fair skin and numerous moles. Putting off a visit gives nothing but lost time, when treatment is most effective. A reasonable approach is to know your risk factors, check your skin regularly and consult a doctor at any doubt.
