Melanoma

Melanoma [mel-uh-NOH-muh] is the rarest and most dangerous kind of skin cancer. Melanoma happens when the cells that determine your child’s skin and hair color become cancerous. Cancer cells are cells that grow and spread in ways that they aren’t supposed to, which can cause damage to organs, nerves, tissues, and other parts of the body. Melanoma can be fatal.

Melanoma often starts as a mole that shows up on the surface of the skin, but it can also appear on an area without a mole and in other areas of the body like the eyes, genitals, mouth, or anal area. If your child is born with a large mole, they may be at a higher risk for getting this kind of skin cancer. Melanoma is the most common kind of skin cancer in teenagers and young adults, especially girls, but is very rare in younger children and infants.

There are 4 major types of melanoma:

1. Acral lentiginous [AK-ruhl len-tidg-ih-nus] melanoma. This type of melanoma is the rarest and shows up most often opn the hands and feet of African Americans.
2. Lentigo maligna [len-TAHY-goh muh-LIG-nuh] melanoma. This type of melanoma is common to older people who have large patches of sun-damaged skin that have tan and brown spots on them.
3. Nodular [NOJ-uh-ler] melanoma. This type of melanoma first appears as a raised area of the skin with a dark bruised or red color.
4. Superficial spreading [soo-per-FISH-uhl SPRED-ing] melanoma. This kind of melanoma occurs most often. It first appears as a splotchy patch of black and brown on the skin.

Melanoma occurs less often than the other 2 most common kinds of skin cancer, which are:

1. Basal cell carcinoma [BEY-suhl sel kar-suh-NOH-muh]. This type of skin cancer is very common and appears on areas of the body that have had too much exposure to the sun. It occurs in cells that are deeper under the skin’s surface.
2. Squamous cell carcinoma [SKWEY-muhs sel kar-suh-NOH-muh]. This type of skin cancer appears in people who have had lots of exposure to the sun over the course of many years. It shows up on the face, neck, back, and legs. It starts in the very top layer of the skin.

The risk of melanoma and other skin cancers goes up if your child has prolonged exposure to the sun without any form of skin protection like sunscreen or clothing. Tanning beds may increase the risk of melanoma and other types of skin cancer and should be used with caution. The risk of melanoma also goes up with age. Girls between the ages of 15 and 19 years old are at the highest risk.

Melanoma starts out as a lump or sore on the skin that may get larger or change color. The spot on the skin may cause pain or bleed. Melanoma can be hard to notice since it starts out small, and might occur in a part of the body that is hard to see. Getting your child’s skin checked once a year can help with early detection of melanoma.

If you notice a mole or spot on your child that has grown, has irregular borders, has changed color, or has multiple colors inside of it, you should get them a skin check from a doctor quickly. Melanoma is easier to treat when it’s found and diagnosed early.

The exact cause of melanoma is not known, but there are many factors that can increase your child’s risk of developing the condition. Some risks include:

• Changes in the DNA that give instructions to cells about how to function
• Exposure to ultraviolet (UV) light that comes from the sun or tanning beds
• Severe sunburns during childhood

If your doctor thinks your child has melanoma, the doctor will perform a physical exam to check for signs of the disease. A common system for identifying the signs of skin cancer is the “ABCDE” method. The ABCDE method is a way to remember what to look for when conducting a skin check on your child. The acronym stands for:

• A. Asymmetry [ey-SIM-uh-tree]. Both halves of the cancerous spot are not the same. One half has a different appearance.
• B. Borders. The cancerous spot grows irregularly and doesn’t have clearly defined borders.
• C. Color. There is a mixture of colors on the cancerous spot that may include tan, brown, black, white, red, or blue.
• D. Diameter. The cancerous spot is larger than the eraser on a pencil, and keeps on getting larger over time.
• E. Evolution. The mole changes in appearance frequently over months or weeks.

If your doctor diagnoses your child with melanoma, other tests will be used to confirm the diagnosis. The first test the doctor will do is a skin biopsy, where a piece of your child’s skin will be removed and tested for signs of cancer in a lab. If the biopsy confirms that melanoma is present in your child, other tests will be done to see if the cancer has spread to other parts of the body. Other tests include:

• A CT scan or x-ray to check the areas around the cancerous spot for signs of spreading.
• A sentinel lymph node biopsy where a small sample of lymph node tissue is removed from your child and checked for signs of cancer.

Cancer occurs in stages. These tests will help your child’s doctor determine what stage the cancer is at. Knowing the stage of the cancer helps the doctor know how to treat the condition most effectively. Children with lower stage melanoma may respond to treatment better than those with late-stage melanoma.

Staging for this condition can be complex. If you don’t understand exactly how far along your child’s cancer is, be sure to ask your doctor for more information. 

Melanoma can be treated using surgery that removes the cancerous spot from your child’s skin. The amount of skin that is taken out will depend on how much the cancer has spread. If the cancer is also inside the lymph nodes in the surrounding area, those might also be taken out during surgery.

If melanoma has spread to other parts of your child’s body, it can be very hard to treat. In this case, other cancer treatment methods may be tried, including:

• Chemotherapy. This treatment uses medicine to kill cancer cells.
• Immunotherapy. This type of treatment boosts your child’s immune system so it’s more capable of fighting the cancer cells.
• Radiation is a treatment method for cancer that uses targeted external beams of energy to kill cancer cells. The radiation can’t be seen when it’s used on your child, and it does not cause any pain, though the side effects can be painful.

These methods are used in different combinations depending on where and how much the cancer has spread in your child’s body. These treatment methods can cause cancer pain. It’s important to monitor and treat any pain that arises during your child’s cancer treatment. Cancer pain can be controlled using pain medicines and therapies. Work with your child’s cancer care team to find the right pain relief strategy.

Some children may be at a higher risk for melanoma. You should take your child to the skin doctor if they have:

• Skin that’s been damaged severely by the sun
• Lots of moles
• A family history of melanoma or other kinds of skin cancer

Skin checks can also be done at home. Look over your child’s body to check for irregular spots and moles that might be growing cancer cells. Remember to use the ABCDE method when examining your child’s skin.

The risk for melanoma can be greatly reduced if you keep your child safe from too much exposure to the sun.

• Sunscreen. Have your child wear lots of sunscreen that keeps out UVA and UVB light when they go outside. Use sunscreen that doesn’t wash off if your child is going to get wet or be in a pool. Use sunscreen even when it’s cloudy or in winter time, since UV rays can still do damage during these times
• Artificial light. Don't let your child use a sunlamp, tanning bed, or tanning salon frequently.

Melanoma [mel-uh-NOH-muh] is both the rarest and most dangerous kind of skin cancer. Melanoma occurs when the cells that determine your child’s skin and hair color become cancerous. Melanoma can be fatal and is the deadliest form of skin disease. Melanoma risk can be lessened by protecting the skin from getting too much exposure to the sun.