About

Exposure to ultraviolet (UV) radiation from the sun (or tanning beds) is the main cause of melanoma.  Anyone who is exposed to UV is at risk, but your chance of developing it is much higher if you:

1. Have fair/light skin, blonde/red hair, and/or blue eyes
2. Are sensitive to the sun (burn easily, no tan)
3. Were ever diagnosed with skin cancer in the past
4. Have many moles or birthmarks on your body
5. Have a family history of melanoma
6. Are taking certain medications (ask your healthcare provider)
7. Are a Caucasian male
8. Had sunburn in the childhood and adolescent years

Fact:  Those with a darker skin color are not immune. Although less common, African Americans can also develop melanoma, usually on the palms of their hands and soles of their feet.

If caught early and treated, melanoma is almost always curable. However, men usually wait longer than women before getting their skin checked and are nearly twice as likely to die from melanoma. Caucasians and older men have a higher risk of developing melanoma than the general population.

• Every year, about 75,000 Americans are diagnosed with melanoma; about 10,000 of them die — that’s an average of one every hour.

FYI

There are five stages of melanoma:

1. Stage 0 – (melanoma in situ) – melanoma on top layer of skin
2. Stage I – melanoma spread deeper into skin (less than 1 mm thick)
3. Stage II – melanoma spread deeper into skin (more than 1 mm thick) but not into lymph nodes or other parts of the body
4. Stage III – melanoma spread from skin and to nearby lymph nodes in the body
5. Stage IV – (metastatic melanoma) – melanoma spread throughout the body, from skin to lymph nodes and certain organs, including the lungs, liver, bones, and brain

Symptoms

Keep an eye out for moles or birthmarks that look unusual. The ABCs of melanoma (below) can help you spot potential problems. Also, look out for ones that itch, hurt, bleed, or ooze.

1. Asymmetry: one half does not look like the other half.
2. Border: irregular, jagged, uneven edges
3. Color: more than one color (tan, brown, black, white, red, or blue)
4. Diameter: size of mole bigger than pencil eraser (6mm)
5. Evolving : changes color, size, or thickness

Prevention

It’s important to take every possible precaution to protect yourself.

1. Apply Sunscreen. Sunscreen is not “for women only”—and it could save your life. Make sure the bottle says “Broad Spectrum SPF” and “UVA/UVB.” (SPF stands for Sun Protection Factor. Sunlight is made of UVA and UVB rays; UVA reaches deep into our skin and ages us, while UVB burns the top layer of our skin).

Apply sunscreen 30 minutes before you go outside, and don’t forget about your nose, ears, lips, top of head, and toes (if you’re wearing sandals or will be barefoot). If you’re planning to be outside for a while, use a waterproof sunscreen of SPF 30 or higher and reapply every two hours. UV light is present even on cloudy, rainy, and snowy days, so be sure to use sunscreen every day.

2. Get a New Hat. Baseball caps shield your forehead and your face, but they don’t protect the sides of your face or the back of your neck. So if you’re going to be out in the sun, wear a hat with a wide brim all the way around.

3. Cover Up. Wear lightweight, light-colored clothing, long-sleeved shirts, and pants that cover up as much of your skin as possible. Yes, even on hot days.

4. Wear Wraparound Sunglasses. Make sure they provide 100% UV protection.

5. Stay Away from Sun Lamps and/or Tanning Beds. Tanning beds are popular with young people. Regular use can increase the risk of developing melanoma greatly! Even occasional use increases the risk.

Keep Cool. When outdoors, stay in the shade as much as possible, especially between 10 am to 4 pm, when the sun is highest and UV rays are strongest.

Diagnosis

If you see a questionable mole or other mark, call your healthcare provider immediately. Through a series of tests, your healthcare provider will determine whether the mole is benign (not cancerous) or malignant (cancerous). In addition, he or she will:

• Take your medical history.
• Examine your skin.
• Biopsy any suspicious spots or moles (a biopsy is removing a small piece and examining it under a microscope to see whether it’s cancerous).
• If your healthcare provider finds a cancerous area, he or she may order additional tests to see how severe the cancer is and whether it has spread to other parts of the body. These may include:
  • Blood tests
  • Imaging tests (chest x-rays or CT/MRI/PET scans)
  • Genetic testing

Again, melanoma can spread very quickly, so the sooner you get an expert to examine you, the better. Acting quickly may save your life!

Questions to Ask Your Health Care Provider

1. Please explain the different types of skin cancer? How is melanoma different?
2. What stage is my melanoma? What does this mean?
3. What are my treatment options and what do you recommend?
4. Will I need to take other tests before we decide on the best treatment option?
5. Are there short and long-term side effects. If so, what are they?
6. How often should I see you for follow-up appointments?
7. Are there any symptoms I should look out for in between follow-up appointments?
8. What clinical trials are available to me?

Treatments

If the melanoma is in the early stages, it’s usually treated with surgery (cutting off the mole and the tissue around it) at a dermatologist’s (skin doctor) office. Depending on how advanced the melanoma is, the surgery may be followed by one or more systemic therapies to kill all cancer cells in the body (systemic therapies affect cells all over your body). Your healthcare provider and oncologist (a doctor who specializes in cancer) will help you select the one that’s best for you.

1. Chemotherapy
   • Powerful drugs used to kill cancer cells in the entire body. There are a variety of chemotherapy strategies and options.

2. Immunotherapy (biologic therapy)
   • Boosts the body’s immune system to help fight the cancer cells. There are a variety of options available.

3. Lasers
   • A focused beam of light that can burn the melanoma away

4. Radiation Therapy
   • High-energy rays used to kill or shrink cancer cells

5. Targeted Therapy
   • Newer, personalized therapy for different types of metastatic melanoma
   • Targets and attacks the cancer cells that have abnormal changes (mutations) in specific genes (the BRAF, MEK, or KIT gene) without killing the healthy cells.

• The BRAF gene normally helps cells grow. Mutations in the BRAF gene cause cancer cells to grow out of control. ¹
• The MEK gene normally helps cells grow and move around. Mutations in the MEK gene cause cancer cells to grow out of control. ²
• The KIT gene normally helps control how fast cells grow and move around. ³

Fact:

• About half of all metastatic melanoma patients have mutations in the BRAF gene.
• 8% of melanomas have mutations in the MEK gene.
• 15% of melanomas have mutations in the KIT gene.

Please consult with your healthcare provider to discuss all of your therapy options and the potential side effects of each.

1. The abnormal BRAF gene can be treated using vemurafenib and dabrafenib.
2. The abnormal MEK gene can be treated using trametinib or a combination of trametinib and dabrafenib.
3. Mutations in the KIT gene can be treated using dasatinib, imatinib, or nilotinib.

Consider a Clinical Trial

Clinical trials are research studies where new drugs are tested on volunteer patients. Researchers are studying many of the treatments we’ve listed above, as well as new experimental treatments and vaccines for melanoma. More research on melanoma treatments is needed. If you’re diagnosed with melanoma, consider participating in clinical trials. Talk with your healthcare provider about which one might be right for you. Visit www.clinicaltrials.gov to see a list of available clinical trials.

Resources

American Academy of Dermatology
www.aad.org

American Melanoma Foundation
www.melanomafoundation.org

Skin Cancer Foundation
www.skincancer.org

Men’s Health Library – Melanoma
Melanoma Brochure

Men’s Health Network