About melanoma - FAQ
You will find some answers to some frequently asked questions below. Please note that the Melanoma Foundation is unable to answer individual questions about diagnosis, treatment or prognosis of melanoma. If you have any questions about melanoma please speak to your doctor.
Who gets melanoma?
Anyone and everyone can get melanoma. However melanoma is much more common in white skin and in particular in the skin which does not tan easily and freckles. Having dark hair, brown eyes and skin which tans easily is better than fair skin and hair and particularly red hair and freckles. The other main risk factor for melanoma is having a lot of moles. A small number of people have a lot of larger and more irregular moles called the "dysplastic naevis syndrome", and this has a high risk of melanoma. A family history of melanoma doubles the risk for melanoma for members of the family.
Where does melanoma occur?
Melanoma is more common on the back, arms and legs but can occur anywhere on the skin including places not exposed to sunlight. There are rare forms of melanoma which occur in body orifices such as the mouth. They also occur in the retina of the eye and, very rarely, can occur in the lymph nodes or in an internal organ without anything being visible on the skin. This is called 'occult' melanoma because no skin lesion is found. Fortunately all these forms of melanoma are very rare.
Are all melanoma the same?
There are four main types of melanomas:
- Superficial spreading melanoma (SSM) which spreads like an ink stain on the skin.
- Nodular melanoma (NM) which is a usually a small dark lump on the skin.
- Acral Lentiginous Melanoma (ALM) which is the melanoma which occurs on the sole of the foot or the palms of the hands. Interestingly, this is the melanoma which is most common in on people with dark skins. The skin on the sole of the foot and the palms of the hands is the only white skin on the dark skinned races.
- Lentigi Maligna Melanoma (LMM). This is the pigmented patch sometimes seen on the face of elderly people. It occurs in heavily sun damaged skin and is somewhat less aggressive than other forms of melanoma.
How does melanoma spread?
As a melanoma grows it becomes deeper (thicker) and the depth of penetration is directly associated with the risk for the melanoma.
As it gets deeper it gets more dangerous. Some of the cells then break free from the main area of the melanoma and get into the tissue fluid channels (lymphatics) and are swept up to the draining lymph nodes where the cells can take hold and grow in the nodes. Lymph nodes are present throughout our bodies are concentrated in the groin, the armpits and the neck. Melanomas from the leg will go to the groin nodes, from the back and the arms to the auxiliary (armpit) nodes and from the head and neck to the neck nodes. From the chest and the back these cells usually go to the auxiliary nodes but high on the back and chest can go to the neck nodes. From the abdomen and lower back in cells will generally go to the groin nodes.
Do I need a skin check?
Everyone should check their skin at least twice a year. If possible, have your back checked by someone else. And the risk for melanoma is specifically related to the number of moles you have. If you have a lots of moles, and particularly if you have large irregular moles called dysplastic naevi, it is important that you have a regular checks by your doctor, and s/he may refer you to a specialised melanoma screening clinic if you are classified as having a higher than normal risk for melanoma. For people with only a few normal moles a regular checkup by a doctor it is not necessary.