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What Is Melanoma?

Melanoma is a type of cancer that begins in cells called melanocytes. Melanocytes make melanin, the brownish pigment that gives skin its color. Most melanomas present as skin cancer, since many melanocytes are found in the upper layer of the skin, called the epidermis. However, melanoma can also appear in other areas of the body, including the eyes and the lining of internal organs. Other names for this type of cancer include malignant melanoma and cutaneous melanoma when it presents on the skin.

Although melanoma is less common than other forms of skin cancer, such as basal cell carcinoma and squamous cell carcinoma, it is considered more dangerous because it has a greater ability to spread to other parts of the body if it is not diagnosed and treated appropriately.

Melanoma is associated with sun exposure and often arises on visible areas of skin, but it can also develop in other sites. Because most melanoma cancer cells produce melanin, the tumors are often brown or black. However, some melanomas stop producing melanin and can appear tan, pink, or even white.

According to the American Cancer Society, more than 100,000 new melanomas are diagnosed in the U.S. each year. Although melanoma accounts for only about 1% of all skin cancer diagnoses, it is responsible for the majority of skin cancer deaths because of its ability to spread to other parts of the body.

In Colorado, it is estimated that there will be around 2,000 new cases of melanoma each year. Due to the state’s higher elevation and the fact that many Coloradans love the outdoors, we are one of the 10 states with the highest death rates for melanoma. 

When detected and treated early, however, melanoma is often curable. The estimated five-year survival rate for patients who get treatment for early-stage melanoma is 99%.

Why Come to CU Cancer Center for Melanoma Cancer

CU Cancer Center doctors are experienced in providing comprehensive care for people who have been diagnosed with melanoma. As the only National Cancer Institute Designated Comprehensive Cancer Center in Colorado and only one of four in the Rocky Mountain region, we have doctors who provide top-notch patient-centered care and researchers who are focused on treatment innovations for melanoma.

Currently, there are more than 50 melanoma clinical trials being offered by providers at the CU Cancer Center. These studies are being conducted to improve our knowledge about the diagnosis and treatment of melanoma and can provide patients with additional options for cutting-edge treatments.

→ Melanoma Skin Cancer Clinical Trial Provides Hope When Options Looked Bleak

The CU Cancer Center doctors participate in a weekly melanoma multidisciplinary tumor board discussion. This program brings together medical oncologists, surgical oncologists, radiation oncologists, dermatologists, pathologists, radiologists, and doctors of other specialties to provide newly diagnosed melanoma patients or patients looking for a second opinion with care from multiple specialties at the same time.

The CU Center for Rare Melanomas is an option from the CU Cancer Center for those with rare types of melanomas that are not related to sun exposure, such as mucosal, acral and intraocular melanoma. The center’s mission is to uncover the causes of these rare melanomas and improve their prevention, diagnosis and treatment through research, clinical trials, education, and collaboration with other rare melanoma researchers around the world.

Our clinical partnership with UCHealth has produced survival rates higher than the state average for all stages of Melanoma.

Melanoma Graph

Number of Patients Diagnosed – UCHealth 1,196 – State of Colorado 3,921
Number of Patients Surviving – UCHealth 960 – State of Colorado 3,000
*n<30, 5 Year Survival – (Date of diagnosis 1/1/2010–12/31/2014)

Types of Melanoma

Types of Cutaneous (Skin) Melanoma

There are four primary types of cutaneous melanoma: superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. They can be categorized by looking at cells from the tumor under a microscope. It is important to determine the type so the doctor can understand the expected growth patterns.

Superficial spreading melanoma is the most common form of melanoma, accounting for approximately 70% of all diagnoses. It usually occurs on the chest, back, arms, and legs and can develop from an existing mole or appear as a new lesion. Superficial spreading melanoma generally grows across the surface of the skin, but it can also grow down into the skin. The tumors are usually flat and thin or slightly raised with an uneven border. Colors can include shades of tan, brown, black, red, pink, blue, grey, or white, or it may lack pigment altogether.

Nodular melanoma is the most aggressive type of melanoma and accounts for about 15% to 20% of all melanoma diagnoses. It usually develops on the face, chest, back, legs, arms, and scalp. These tumors grow down into the skin layers and are more likely to spread to other parts of the body. They may appear as raised growths that stick out from the skin. Nodular melanoma tumors are usually black or blue-black, but they can also be red, pink, or the same color as the surrounding skin.

Lentigo maligna melanoma accounts for 10% to 15% of all melanoma skin cancers and usually develops in older adults. It typically appears on areas of skin that are regularly exposed to the sun, such as the face, ears, arms, or upper torso. It may look like a flat or slightly raised lesion with uneven, asymmetrical borders. The lesions are often blotchy and darken as they get bigger, varying from blue-black to tan, brown, or dark brown. It may spread outward across the surface of the skin for years before it starts to grow down into deeper layers of skin.

Acral lentiginous melanoma makes up less than 5% of all melanoma cancer diagnoses, but it is the most common form of melanoma found in people of color, including individuals of African, Asian and Hispanic heritage. Unlike most types of melanoma, it is not related to sun exposure and can appear in more hard-to-spot places, such as under the fingernails and toenails, between the toes, and on the palms of the hands and soles of the feet. Acral lentiginous melanoma tumors present as small, flat areas of discolored skin, often dark brown or black. Most tumors spread outward across the surface of the skin before starting to grow down into the skin.   

Desmoplastic melanoma is a rare type of melanoma cancer that can be mistaken for a scar. It often develops as a lump on the head, neck, or upper back and can be the same color as the surrounding skin.

Other Types of Melanoma

Although most melanomas occur in the upper layer of the skin, some rarer forms can develop any place melanocytes exist in the body.

Mucosal melanoma develops on the thin, moist lining (the mucosa or mucous membrane) of some organs and other parts of the body, such as the nasal passages, mouth, esophagus, urinary tract, rectum, anal canal, and vagina.

Intraocular melanoma starts in the eye and is the most common type of eye cancer. It is usually found in the uvea — the layer beneath the white of the eye.

The following information is focused on cutaneous melanoma, which is the most common kind of melanoma. For more information about mucosal melanoma and intraocular melanoma, talk to your doctor.

Risk Factors for Melanoma

Melanoma has multiple risk factors — behaviors or conditions that increase a person’s risk of developing the cancer. 

Ultraviolet (UV) exposure: Whether from the sun or indoor tanning, excessive or unprotected exposure to ultraviolet radiation is the main risk factor for developing melanoma. People who have had one or more blistering sunburns in their lives have a higher risk of developing melanoma, and the more sunburns someone has had, the greater the risk. People who live close to the equator experience higher amounts of UV radiation, as do people who live at a high elevation.

Many or atypical moles: Moles are bumps or spots on the skin made up of groups of melanocytes. They are usually brown or pink with smooth, regular borders. Most moles are harmless, and most people have a few moles. However, people with many moles (50 or more) and people with large or atypical moles have an increased risk for melanoma.   

Fair skin: People with fair skin, light eyes, and blond or red hair have a higher risk of developing melanoma. People with dark skin have a lower risk of developing most forms of melanoma, though they may be more likely to develop acral lentiginous melanoma, which occurs on areas of the body not normally exposed to the sun, such as the soles of the feet and palms of the hands.

History of skin cancer: People who have already had any type of skin cancer have a greater risk of developing melanoma.

Genetics: One in every 10 melanoma patients has a family member who has also been diagnosed with melanoma. Other hereditary conditions can also increase the risk of developing melanoma, including familial atypical multiple mole and melanoma syndrome (FAMMM), which is associated with an inherited mutation in the CDKN2A gene; atypical mole syndrome (AMS, also known as Dysplastic Nevus Syndrome); xeroderma pigmentosum; Werner syndrome; and retinoblastoma eye cancer.

Age and gender: The risk of melanoma increases with age, and it is more common in men than in women. However, it is also found in adolescents and young adults and is becoming one of the most common cancers in people younger than 30, especially women.

Weakened immune system: People with weakened immune systems have an increased risk of developing melanoma. Some examples include people with human immunodeficiency virus (HIV) and patients who are currently taking drugs to suppress their immune systems, such as after an organ transplant.

Latest in Melanoma from the CU Cancer Center

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Information reviewed by Camille Stewart, MD, in July 2022.