When detected early, the prognosis of most melanomas is dramatically improved. If allowed to spread internally to lymph nodes or other organs, melanoma can be deadly. It can progress quite rapidly, and therefore patients should always see a physician with any questions or concerns regarding spots on the skin.

When melanoma is caught late, this typically indicates a poor prognosis, which makes the story of former President Jimmy Carter so promising. He was diagnosed earlier this year [http://www.cbsnews.com/news/jimmy-carter-addresses-cancer-diagnosis/] with a melanoma that had metastasized to his brain, but after receiving treatment with radiation and a new immunotherapy drug, pembrolizumab, he recently announced he is currently cancer-free.

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“There are many variables, some of which are still poorly understood, that contribute to each individual’s melanoma prognosis,” said Cort McCaughey, MD, a dermatologist at Logan Regional Hospital’s Budge Clinic. “We do know that more advanced stages of melanoma have a significantly worse 5- and 10-year survival rate than early stage melanomas, but with targeted therapies such as perbrolizumab, life expectancy at times can be improved.”

As a dermatologist, Dr. McCaughey does initial examinations and surgically removes some early melanomas. With more advanced melanomas, a multidisciplinary approach is often needed, incorporating general surgeons and oncologists.

What are some contributing factors of melanoma?

• The use of tanning beds is still high in Utah despite clear evidence that use of tanning beds can cause melanoma.
• Family history is important, as a family history of melanoma can increase your risk. Yearly skin checks are recommended to any person with a first-degree relative who has been diagnosed with melanoma.
• Living in Utah can be a contributing factor to melanoma, because of the higher elevation. The Earth’s atmosphere provides some protection from the sun’s harmful rays – but higher elevations mean less atmosphere, thus less protection.

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What are the warning signs of melanoma?

Symptoms of melanoma and other skin cancers vary, but the following guidelines may help you identify something that should be more closely examined by a doctor:

• A change on the skin – this could be a new spot, or a change in color, shape or size of a current spot
• A sore that fails to heal
• A spot or sore that becomes painful, itchy, tender or bleeds
• A spot or lump that looks shiny, waxy, smooth or pale
• A firm red lump that bleeds or appears ulcerated or crusty
• A flat, red spot that is rough, dry or scaly

Note that not all skin cancers and melanomas fall into these categories, so the above list should only be used as a guideline.

“Even those who are careful to protect themselves from the sun should conduct regular self-skin examinations,” said Dr. McCaughey. “Melanomas can appear anywhere on the body and can even involve less typical locations including the eyes, inside the mouth or under the toenails. Check your skin once a month, including areas you may be reluctant to check, to detect anything that might be new or changing.”