Questions About Cancer? 1-800-4-CANCER

Melanoma Treatment (PDQ®)

Patient Version
Last Modified: 05/18/2012

General Information About Melanoma

Key Points for This Section


Melanoma is a disease in which malignant (cancer) cells form in the skin cells called melanocytes (cells that color the skin).

Melanocytes are found throughout the lower part of the epidermis. They make melanin, the pigment that gives skin its natural color. When skin is exposed to the sun, melanocytes make more pigment, causing the skin to tan, or darken.

Enlarge 1
Anatomy of the skin with melanocytes; drawing shows normal skin anatomy, including the epidermis, dermis, hair follicles, sweat glands, hair shafts, veins, arteries, fatty tissue, nerves, lymph vessels, oil glands, and subcutaneous tissue. The pullout shows a close-up of the squamous cell and basal cell layers of the epidermis above the dermis with blood vessels. Melanin is shown in the cells. A melanocyte is shown in the layer of basal cells at the deepest part of the epidermis. 1
Anatomy of the skin, showing the epidermis, dermis, and subcutaneous tissue. Melanocytes are in the layer of basal cells at the deepest part of the epidermis.


The skin is the body’s largest organ. It protects against heat, sunlight, injury, and infection. The skin has 2 main layers: the epidermis (upper or outer layer) and the dermis (lower or inner layer).

There are 3 types of skin cancer:

When melanoma starts in the skin, the disease is called cutaneous melanoma. Melanoma may also occur in mucous membranes (thin, moist layers of tissue that cover surfaces such as the lips). This PDQ summary is about cutaneous (skin) melanoma and melanoma that affects the mucous membranes. When melanoma occurs in the eye, it is called intraocular or ocular melanoma. (See the PDQ summary on Intraocular (Eye) Melanoma Treatment 2 for more information.)

Melanoma is more aggressive than basal cell skin cancer or squamous cell skin cancer. (See the PDQ summary on Skin Cancer Treatment 3 for more information on basal cell and squamous cell skin cancer.)

Melanoma can occur anywhere on the body.

In men, melanoma is often found on the trunk (the area from the shoulders to the hips) or the head and neck. In women, melanoma forms most often on the arms and legs. Melanoma is most common in adults, but it is sometimes found in children and adolescents. See the PDQ summary on Unusual Cancers of Childhood 4 for more information on melanoma in children and adolescents.)

Unusual moles, exposure to sunlight, and health history can affect the risk of developing melanoma.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk for melanoma. Risk factors for melanoma include the following:

  • Having a fair complexion, which includes the following:
    • Fair skin that freckles and burns easily, does not tan, or tans poorly.
    • Blue or green or other light-colored eyes.
    • Red or blond hair.
  • Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.
  • Having a history of many blistering sunburns, especially as a child or teenager.
  • Having several large or many small moles.
  • Having a family history of unusual moles (atypical nevus syndrome).
  • Having a family or personal history of melanoma.
  • Being white.

Being white or having a fair complexion increases the risk of melanoma, but anyone can have melanoma, including people with dark skin.

Possible signs of melanoma include a change in the appearance of a mole or pigmented area.

These and other symptoms may be caused by melanoma. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

  • A mole that:
    • changes in size, shape, or color.
    • has irregular edges or borders.
    • is more than one color.
    • is asymmetrical (if the mole is divided in half, the 2 halves are different in size or shape).
    • itches.
    • oozes, bleeds, or is ulcerated (a hole forms in the skin when the top layer of cells breaks down and the tissue below shows through).
  • A change in pigmented (colored) skin.
  • Satellite moles (new moles that grow near an existing mole).

For pictures and descriptions of common moles and melanoma, see Common Moles, Dysplastic Nevi, and Risk of Melanoma 5.

Tests that examine the skin are used to detect (find) and diagnose melanoma.

If a mole or pigmented area of the skin changes or looks abnormal, the following tests and procedures can help find and diagnose melanoma:

  • Skin exam: A doctor or nurse checks the skin for moles, birthmarks, or other pigmented areas that look abnormal in color, size, shape, or texture.
  • Biopsy: The removal of as much of the abnormal mole or lesion as possible. A pathologist looks at the tissue under a microscope to check for cancer cells. It can be hard to tell the difference between a colored mole and an early melanoma lesion. Patients may want to have their biopsy sample checked by a second pathologist.

A biopsy should be done on any abnormal areas of the skin. These areas should not be shaved off or cauterized (destroyed with a hot instrument, an electric current, or a caustic substance).

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

  • The thickness of the tumor and where it is in the body.
  • How quickly the cancer cells are dividing.
  • Whether there was bleeding or ulceration at the primary site.
  • Whether cancer has spread to the lymph nodes or to other places in the body.
  • The number of places cancer has spread to in the body and the level of lactate dehydrogenate (LDH) in the blood.
  • The patient’s general health.


Glossary Terms

abnormal (ab-NOR-mul)
Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).
aggressive (uh-GREH-siv)
In medicine, describes a tumor or disease that forms, grows, or spreads quickly. It may also describe treatment that is more severe or intense than usual.
asymmetry (ay-SIH-meh-tree)
Lack or absence of balanced proportions between parts of a thing.
atypical mole (ay-TIH-pih-kul mole)
A type of nevus (mole) that looks different from a common mole. An atypical mole is often larger with borders that are not easy to see. Its color is usually uneven and can range from pink to dark brown. Parts of the mole may be raised above the skin surface. An atypical mole may develop into malignant melanoma (a type of skin cancer). Also called dysplastic nevus.
basal cell carcinoma (BAY-sul sel KAR-sih-NOH-muh)
Cancer that begins in the lower part of the epidermis (the outer layer of the skin). It may appear as a small white or flesh-colored bump that grows slowly and may bleed. Basal cell carcinomas are usually found on areas of the body exposed to the sun. Basal cell carcinomas rarely metastasize (spread) to other parts of the body. They are the most common form of skin cancer. Also called basal cell cancer.
biopsy (BY-op-see)
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cauterize (KAW-teh-RIZE)
To destroy tissue using a hot or cold instrument, an electrical current, or a chemical that burns or dissolves the tissue. This process may be used to kill certain types of small tumors or to seal off blood vessels to stop bleeding.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
condition (kun-DIH-shun)
In medicine, a health problem with certain characteristics or symptoms.
cutaneous (kyoo-TAY-nee-us)
Having to do with the skin.
dermis (DER-mis)
The inner layer of the two main layers of the skin. The dermis has connective tissue, blood vessels, oil and sweat glands, nerves, hair follicles, and other structures. It is made up of a thin upper layer called the papillary dermis, and a thick lower layer called the reticular dermis.
diagnosis (DY-ug-NOH-sis)
The process of identifying a disease, such as cancer, from its signs and symptoms.
epidermis (EH-pih-DER-mis)
The outer layer of the two main layers of the skin.
family history (FA-mih-lee HIH-stuh-ree)
A record of the relationships among family members along with their medical histories. This includes current and past illnesses. A family history may show a pattern of certain diseases in a family. Also called family medical history.
infection (in-FEK-shun)
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
intraocular melanoma (IN-truh-AH-kyoo-ler MEH-luh-NOH-muh)
A rare cancer of melanocytes (cells that produce the pigment melanin) found in the eye. Also called ocular melanoma.
lactate dehydrogenase (LAK-tayt dee-hy-DRAH-jeh-nays)
One of a group of enzymes found in the blood and other body tissues and involved in energy production in cells. An increased amount of lactate dehydrogenase in the blood may be a sign of tissue damage and some types of cancer or other diseases. Also called lactic acid dehydrogenase and LDH.
lesion (LEE-zhun)
An area of abnormal tissue. A lesion may be benign (not cancer) or malignant (cancer).
lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
melanin (MEH-luh-nin)
A pigment that gives color to skin and eyes and helps protect it from damage by ultraviolet light.
melanocyte (meh-LAN-oh-site)
A cell in the skin and eyes that produces and contains the pigment called melanin.
melanoma (MEH-luh-NOH-muh)
A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.
microscope (MY-kroh-SKOPE)
An instrument that is used to look at cells and other small objects that cannot be seen with the eye alone.
mole (mole)
A benign (not cancer) growth on the skin that is formed by a cluster of melanocytes (cells that make a substance called melanin, which gives color to skin and eyes). A mole is usually dark and may be raised from the skin. Also called nevus.
mucous membrane (MYOO-kus MEM-brayn)
The moist, inner lining of some organs and body cavities (such as the nose, mouth, lungs, and stomach). Glands in the mucous membrane make mucus (a thick, slippery fluid). Also called mucosa.
nurse (nurs)
A health professional trained to care for people who are ill or disabled.
ocular melanoma (AH-kyoo-ler MEH-luh-NOH-muh)
A rare cancer of melanocytes (cells that produce the pigment melanin) found in the eye. Also called intraocular melanoma.
organ (OR-gun)
A part of the body that performs a specific function. For example, the heart is an organ.
pathologist (puh-THAH-loh-jist)
A doctor who identifies diseases by studying cells and tissues under a microscope.
PDQ
PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.
personal history (PER-suh-nul HIH-stuh-ree)
A collection of information about a person’s health. It may include information about allergies, illnesses and surgeries, and dates and results of physical exams, tests, screenings, and immunizations. It may also include information about medicines taken and about diet and exercise. Also called personal health record and personal medical history.
pigment (PIG-ment)
A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair.
primary tumor (PRY-mayr-ee TOO-mer)
The original tumor.
prognosis (prog-NO-sis)
The likely outcome or course of a disease; the chance of recovery or recurrence.
recover (ree-KUH-ver)
To become well and healthy again.
risk factor (... FAK-ter)
Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.
squamous cell carcinoma (SKWAY-mus sel KAR-sih-NOH-muh)
Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
syndrome (SIN-drome)
A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
ulceration (UL-seh-RAY-shun)
The formation of a break on the skin or on the surface of an organ. An ulcer forms when the surface cells die and are cast off. Ulcers may be associated with cancer and other diseases.

Table of Links

1http://www.cancer.gov/PublishedContent/MediaLinks/305334.html
2http://www.cancer.gov/cancertopics/pdq/treatment/intraocularmelanoma/Patient
3http://www.cancer.gov/cancertopics/pdq/treatment/skin/Patient
4http://www.cancer.gov/cancertopics/pdq/treatment/unusual-cancers-childhood/Pati
ent/Page7#Section_132
5http://www.cancer.gov/cancertopics/factsheet/Risk/moles