Melanomas with No Identified Primary Site

Most melanomas are initially discovered on the skin. However, in a small percentage (5%-10%) of people who’ve had a recent melanoma diagnosis, the disease has spread beyond their skin and into other organs or lymph nodes; with little-to-none of the initial blemish left visible.

Regression

Though the amount varies widely, to some extent we all have moles and skin growths. Occasionally, our immune system takes a disliking to one- and sets out to kill it. Once the body has set this ‘seek-and-destroy’ mission in motion the pigment, and thus the appearance and visibility of the targeted growth, slowly starts to dissipate. Sometimes, to the extent that a person can’t even tell that it was ever there at all.

If such a growth is benign (noncancerous) it’ll dissolve harmlessly. If it’s a malignant melanoma it is a real problem, and may be even more dangerous than the more traditional form of melanoma.

How can Regressive Melanoma be “More Dangerous” than Traditional Melanoma?

On the surface (so to speak) in and of itself regressive is not a deadlier version of melanoma. What makes it more dangerous though is that it’s much harder to see, and easier to misdiagnose, than a typical case. Melanoma is more often spotted by the patient than it is by his or her doctor. And the cure rate for melanoma is nearly 100% if it’s caught early enough. But regressive melanoma can metastasize (spread) without a patient even knowing it existed. Its remnants can be easily mistaken as nothing. And it’s totally natural for a medical layperson to assume that something “clearing up” is a good thing.

Our immune systems are a biological marvel; the lengths to which they go every day to protect us are truly extraordinary. Unfortunately, with regressive melanoma, their efforts to terminate cells that they believe to be harmful may be incomplete, allowing the disease to progress. In other words, they’re inadvertently helping melanoma conceal itself until it’s too late.

What can I do?

When performing your monthly skin self-exam, be sure to pay as much attention checking for moles and blemishes that appear to be fading unevenly, as you do to for those that are more visibly growing and changing. If either is found, schedule a dermatologist appointment quickly.

Here are two melanoma photos of both early and late-stage surface regression, presented respectively:

 

 

 

 

As can clearly be seen here, especially with the late-stage photo on the right, these blemishes appear to be healing. Healing marks of any kind tend to be disregarded.

That’s fine when it’s a simple, garden-variety bruise sustained from lightly bumping an arm against a countertop. But a fading skin growth, mole, or blemish should never be disregarded or ignored. They should be leant the same weight as any other suspicious change to the skin.

*Additional information sources: Melanoma Education Foundation (MEF) newsletter; Autumn 2015, Lloyd-derm.com

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

CHANGE: The Most Important Melanoma Warning Sign

The appearance of melanomas can vary widely from one to another. They develop in many difference colors, sizes and other unique visual characteristics. For this reason, trying to discern whether a mole is cancerous just by looking at it isn’t a reliable method. Even dermatologists can’t always tell the difference based solely on appearance.

However, there is one distinctive warning sign that (nearly) always identifies a melanoma: change. it’s the most important reason why performing a regular monthly skin self-examination is so vital. It’s just as significant to check any pre-existing skin growths for change as it is to look for new ones.

What to Look for

This is a list of skin growth changes to help learn what it is you should be looking for:

– An increase in its diameter or elevation

– A change in its shape; especially if that shape has become irregular

– A change in its color or shade

-Persistent itching

– Any change in its surface, including:

  • Texture
  • How it feels to your touch
  • How it reacts to light (reflects)
  • Development of one or more bumps- even if they’re small
  • An ulceration (liquid-like appearance, such as found in an open sore)
  • Bleeding spontaneously or upon minor trauma

Any of these changes that continue for 3 weeks or longer need to be checked out. Though any bleeding or ulcerations should be brought to the immediate attention of a dermatologist.

Please note that this list is a helpful guide, but it’s not all-inclusive. Any changes to skin growths that are not found here should not be ignored.

We recently published a blog post that highlighted the differences between the two primary forms of melanoma, Radial and Nodular. As it’s relevant to this one, we’ll re-post it. To read it, please click HERE.

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

A Melanoma Menu

There is a lot to learn about melanoma. On the surface, it’s a fairly-straightforward subject; yet it’s also one that carries with it many important subtopics. This piece consists of selections from our previously published posts on the subject.

To view the original Melanoma Education Foundation (MEF) article on any of the topics below, simply click the link and you’ll be brought directly to it.

From Bad to Worse

About Radial and Nodular Melanoma, the two primary forms of the worst skin cancer.

A Bad Match: Keeping Moles Away from the Sun

The reasons why exposing moles to sunlight is a very bad idea.

Ginger Ail

A discussion on the increased risk of melanoma to redheads.

Connecting the Dots

For those with many moles, there is a tool that dermatologists can use to help keep tabs on patients’ skin health.

Which is Which?

How to tell the difference between freckles and moles

Normal and Abnormal Moles

Differentiating between normal and atypical moles.

Your Chances of Developing Melanoma

A discussion of melanoma risk factors.

Checking Up on Yourself

How to examine yourself for early signs of melanoma.

Skin Cancer: Not Child’s Play

The differences and similarities between childhood melanoma and melanoma in adults.

Melanoma: A Color-Blind Cancer

Information on Acral Lentiginous Melanoma, which is more common in blacks, Hispanics and Asians than it is in whites.

Stage 0 Melanoma

The best form of the worst skin cancer.

The Eyes Have It

Ocular Melanoma is a rare, deadly cancer that is not caused by UV (ultraviolet) ray exposure.

Can You Identify the Bad Guys?

A quick visual quiz that tests your ability to tell benign moles from those that are cancerous.

Action, Not Fear

What to do if a suspicious growth is found during a skin self-examination.

Survey Says?!

The excellent results from teachers who were surveyed regarding the effectiveness of the Melanoma Education Foundation’s (MEF) classroom melanoma lessons.

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Moles and Sun: A Dangerous Combination

Benign moles (or nevi) are so common that pretty much every human being on earth has them. In the language of medicine, “benign” means noncancerous. However, exposure to dangerous ultraviolet (UV) rays from our sun can create mutations on moles that cause nevi to turn from safely benign, to dangerously malignant (cancerous). UV rays even often promote a common mole’s formation to begin with.

In a report cited within an article posted by the Helen Diller Family Comprehensive Cancer Center, researchers in California have discovered a way to determine the direction moles take as they transform from skin lesions (“precursors”) to reaching their fully malignant, potentially fatal, forms.

This easy to remember chart shows the progression to melanoma upon UV exposure:

Normal mole (1 mutation) —-> Atypical mole (several mutations) ——> Melanoma (many mutations).

It was the data gathered by this group of scientists that confirmed the negative impact UV rays have on skin by initiating the growth of moles, as well as turning them cancerous. It also confirmed the existence of “intermediate lesions”, which are lesions whose benign or malignant status is not easily determined. The latter discovery will be greatly beneficial to dermatologists when choosing the treatment for their melanoma patients.

So, what does all of this mean to those of us who are non-medical laypersons? That has been neatly summarized by the words of Dr. Boris Bastian; the report’s senior author:

“A lot of melanomas have been sequenced at this point, and while it’s clear they carry UV-induced mutations, no one knew when they occurred…This study shows that they occur in benign moles, in the melanoma that arises from these moles, and in intermediate lesions. UV both initiates and causes the progression of melanoma, so exposing even benign moles to the sun is dangerous.”

Just because a mole is benign doesn’t mean it will stay that way. It’s very important to always take the appropriate skin protection precautions whenever we’re exposed to the sun.

*Additional information sources: University of California San Francisco, Helen Diller Family Comprehensive Cancer Center

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Mole Mapping

If you have high skin cancer risk factors, or those who have over 50 moles, or too many moles to easily track yourself, mole mapping is a useful tool. Even better, the procedure is non-invasive and completely painless.

How Does Mole Mapping Work?

A dermatologist will take pictures and images of his or her patients that encompass the outer layer of skin. Once completed the records are archived. They’re then used later to check against future images and monitor any newly-developed moles; along with any changes to pre-existing ones.

This photograph depicts a patient undergoing mole mapping with her dermatologist:

It’s Not a Catchall

Research into mole mapping has revealed that it does increase the chances that dermatologists will discover early melanomas. (In one study, the odds increased by 17%).*

However, mole mapping should be used to augment, not replace, a person’s skin health care behaviors; as it has its limits. For instance, melanoma can develop on the scalp, which for most people is covered with hair that the cameras can’t see through. It can still miss cancerous moles, and there is always the possibility that a melanoma will develop and spread quickly during the time-gap between office visits.

For those reasons, it’s also important to perform monthly skin self-examinations, so any oddities can be brought swiftly to the attention of a dermatologist.

Working in tandem, skin self-exams and mole mapping will provide an even greater chance of catching and stopping a melanoma before it’s too late.

How do I Locate Dermatologists Who Provide Mole Mapping?

If you or someone you know is interested in mole mapping and would like to find local offices that perform it, start by running an internet search for “mole mapping services, ZZ”. When you do, simply replace the “ZZ” with your state’s postal abbreviation. (For example, Wyoming = WY, Minnesota = MN, etc.)

*Additional information sources: News-medical.net/health/Mole-Mapping.aspx (Catherine Shaffer, M.Sc.)

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Freckles versus Moles

The name of this week’s skin cancer blog post may sound a bit like the title of a Grade B movie.  However, it’s actually a reference to a common confusion between the two titled skin conditions that we very often come across. Hopefully, this piece will help to alleviate any confusion.

Freckle Facts

To help illustrate the differences, we’re going to provide some of the most useful information to have regarding freckles and flat moles. We’ll begin with the most important fact. Unlike flat moles, true freckles lack any cellular structure, which makes it impossible for any of them to turn cancerous. So if that’s ever in any way been a worry to either you or someone you know, you can put it out of your mind.

 With that said, here are some answers to a few more freckle FAQ’s. A mole can be flat, raised or partially-raised. They’re often secluded on our skin, and when not they’re part of an irregular grouping of other moles. By contrast freckles, which are simply clusters of melanin (our natural skin pigment), are without exception always flat.

Unlike some moles, freckles are never present at birth. They present later, after sun-exposure, to people who are predisposed to getting them. Moles are usually darker than freckles, with the latter susceptible to lightening in the winter and darkening during the summer months. To literally illustrate the difference, here are photos of both. The left picture depicts flat moles, and the right one, freckles: 

 

 

 

 

 

We’d kindly ask you to keep one thing in mind. While freckles by themselves are totally harmless, having them usually means having a light complexion and/or sun-damaged skin. As such, extra care should be taken in the form of monthly self-examination of your skin, and meticulous sunscreen use whenever you’re outdoors.

*Additional source: Melanoma Education Foundation (MEF) Newsletter (Spring 2013)

To visit our websites, please click: Skincheck.org and/or Melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma

Normal Moles vs. Atypical Moles

When a person begins educating him or herself about melanoma, some of the first relevant information they’ll come across will be on moles. They’re very important, as 90% of all melanomas begin on the skin and pretty much everyone has them.

Although you’ve surely seen them countless times, you may not be aware that there are two types: normal moles, and atypical moles. (Officially, dysplastic nevi).

Atypical moles have a much greater chance to develop into melanoma than do normal moles. The odds are about 1 in 100 with the former; yet fewer than 1 in 3,000 with the latter. Those who have an atypical mole(s) carry a stronger risk of melanoma. Incidentally, the appearance of hair on any mole is medically irrelevant. It carries no weight with regard to an increased risk of skin cancer.

No one should ever try to tell the two apart without a biopsy; as even a dermatologist cannot be certain without one. However, they do have some distinguishing characteristics that (in general) helps to tell them apart.

For instance, normal moles maintain the same color (most often brown), are round, oval, and sometimes domed in shape. They have well-defined borders and are less than a quarter-inch wide.

These are two examples of normal moles, both raised and flat:

 

 

 

 

Atypical moles are wider than a quarter-inch and may be multi-colored (brown or pink). They have uneven borders and an irregular shape. Raised dysplastic nevi display a “fried egg” look.

These are two examples of atypical moles, both raised and flat:

 

 

 

 

One thing they both do have in common is that their surface areas are usually smooth or cauliflower in texture.

Familial Atypical Mole Syndrome

Familial Atypical Mole Syndrome is a disorder that is passed along through our genes. If any close relatives (immediate family but also including grandparents, uncles and aunts) have or have had melanoma and if a large number of atypical moles are present, there’s a high risk of developing the disease.

While monthly self-examination is important for every person of either gender, all races and skin tones, it’s even more vital to those with Familial Atypical Mole Syndrome.

These is an example of Familial Atypical Mole Syndrome:

 

 

 

*Additional source articles: Cancer.gov, Emedicine.medscape.com

To visit our websites, please click:  skincheck.org and/or melanomaeducation.net

Facebook: Melanoma Education Foundation

Twitter: @FindMelanoma