Understanding Melanoma

Sen. John McCain has had several episodes of melanoma. Although melanomas are relatively rare, the Arizona Republican is far from alone in this diagnosis. The American Cancer Society estimates that more than 62,000 new melanomas will be diagnosed in the United States this year. Here are some of the key things to know about the cancer.

Q: What is melanoma?

Melanoma is the most lethal type of skin cancer. It begins in the melanocytes, the cells in skin that manufacture the pigment melanin. Because of this, melanomas are often brown or black, but can be colorless. The tumors can occur anywhere on the skin. In many instances, the first sign of melanoma is a change in the size, shape, color or texture of a mole. Melanoma may also appear as a new mole.

Q: What are the risk factors for melanoma?

The National Cancer Institute says risk factors include:

* Unusual moles

* Exposure to natural sunlight or ultraviolet (tanning bed) light

* Family or personal history of melanoma

* Fair skin, blond or red hair, or blue eyes

Q: How is melanoma diagnosed?

A doctor visually checks the skin. If worrisome moles are present, the doctor cuts out all or part of the suspicious mole or lesion, which is called a biopsy. The removed tissue is sent to a pathologist, who analyzes it to check for cancer cells. This surgery may leave a scar.

When a biopsy reveals melanoma, the next step is "staging" the cancer to determine how large the tumor is and whether the cancer has spread. There are four main stages of melanoma — stages 3 and 4 are most serious because they indicate that the cancer has spread either to lymph nodes or other organs. Body imaging tests, including X-ray, CT scan and MRI, are often used to help determine the stage of melanoma.

Q: How is melanoma treated?

After a biopsy confirms melanoma, the most common treatment is to remove the entire tumor by surgery. Thicker melanomas require that larger pieces of tissue be removed.

Surgery can be combined with other therapies if the cancer has spread to other organs or reappears again in the same place or a different place. The most common treatment options include chemotherapy (using drugs to kill cancer cells), immunotherapy (using drugs to boost the patient's own immune system) and radiation therapy (using high-energy rays or particles to kill cancer cells). If melanoma has spread to other tissues, surgery usually can't cure the cancer.

Research and clinical trials are ongoing to find more effective treatments for melanoma.

Q: Is melanoma deadly?

It can be cured if diagnosed and removed early. Melanoma is an aggressive and fast-growing cancer, and if it is not removed early, cancer cells might grow downward from skin into healthy tissue. Once the cancer spreads, it can be difficult to control.

The chance of recovery depends on the stage at which the cancer is detected, the location and size of the tumor, whether there was bleeding or broken skin on the original tumor, and the patient's general health.

If melanoma is caught before it spreads, the five-year survival rate is 99 percent. If it has spread only to the lymph nodes, the rate ranges from 27 percent to 68 percent, and if the cancer has spread to other organs, the five-year survival rate is 18 percent, according to the American Cancer Society.

Even with successful recovery, some patients have a recurrence of melanoma. More than 8,000 Americans are expected to die from melanoma this year.

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