Melanoma: Symptoms, Diagnosis, and Treatments

Melanoma represents a serious form of skin cancer. It develops from melanocytes, the cells responsible for producing melanin, the pigment that gives skin its color and protects it from ultraviolet (UV) rays. This cancer can appear on healthy skin or from an existing mole (nevus). Early detection and treatment significantly improve the prognosis.

What is melanoma?

Melanoma is a type of skin cancer. It originates in melanocytes. These cells are found primarily in the epidermis, the outermost layer of the skin. Melanoma can manifest in various forms, including superficial spreading melanoma, nodular melanoma, acral lentiginous melanoma (on the extremities), and lentigo maligna (often on the face of elderly individuals). Each type has specific growth and appearance characteristics. It is essential to recognize the warning signs for prompt management.

Causes and risk factors

Several factors increase the risk of developing melanoma. Exposure to ultraviolet (UV) radiation from the sun and tanning beds is the primary risk factor. Sunburns, particularly during childhood or adolescence, significantly increase this risk. Individuals with fair skin, those who tan with difficulty, who have blonde or red hair, and light eyes are more vulnerable. The presence of numerous moles (more than 50) or atypical moles (dysplastic) also represents a significant risk factor. Finally, a family history of melanoma indicates a genetic predisposition. A weakened immune system also increases vulnerability to melanoma.

Symptoms and signs of melanoma

Signs of melanoma generally consist of a change in the appearance of an existing mole or the appearance of a new dark lesion on the skin. Dermatologists use the ABCDE rule to help identify these signs. This rule includes Asymmetry (the lesion is not round or oval), irregular Borders (scalloped, notched), heterogeneous Color (several shades of brown, black, red, blue, or white), increasing Diameter (larger than 6 mm), and Evolution (rapid change in size, shape, color, elevation, itching, or bleeding). Regular self-examination of your skin can help detect these changes early and act quickly.

Diagnosis: How is it detected?

Melanoma diagnosis often begins with a clinical skin examination performed by a dermatologist. This specialist uses a dermatoscope, an optical instrument, to examine skin lesions under magnification. Dermoscopy helps the doctor visualize the internal structures of a mole, which facilitates the distinction between a benign lesion and a potential melanoma. If the dermatologist suspects melanoma, they perform an excisional biopsy. This procedure involves surgically removing the suspicious lesion in its entirety for microscopic analysis. Histopathological analysis determines the exact nature of the lesion and confirms the melanoma diagnosis. Additional examinations, such as lymph node ultrasound or PET scan, may be used to assess the extent of the disease.

Treatments and management

The main treatment for localized melanoma consists of surgical excision. The surgeon removes the melanoma with a safety margin of healthy skin around it. The size of this margin depends on the melanoma’s thickness. In some cases, a sentinel lymph node analysis may be performed to check if cancer cells have reached the lymph nodes. If the melanoma is more advanced and has spread (metastases), other treatment options are available to patients. Immunotherapy stimulates the patient’s immune system to attack cancer cells. Targeted therapies identify and block specific molecules involved in the growth of tumor cells. Radiation therapy can also be used in specific situations, often to manage symptoms or treat recurrence areas.

Recent scientific advances (June 2025)

Melanoma research is very active. The first half of 2025 has seen notable advances, particularly in personalized therapeutic approaches. Studies focus on improving adjuvant therapies (administered after surgery to prevent recurrence) and neoadjuvant therapies (before surgery to reduce tumor size). Researchers are exploring new combinations of immunotherapies and targeted therapies. Progress in understanding biomarkers allows for more precise patient selection. These biomarkers indicate the potential response to treatments. Clinical trials are multiplying, paving the way for even more effective and less toxic treatment options in the near future. The goal is to optimize management strategies based on the molecular profile of each melanoma.

Melanoma prevention: Is it possible to reduce the risk?

Melanoma prevention primarily relies on sun protection. It is crucial to avoid sunburns, particularly during childhood. Seek shade when the sun is intense (between 12 PM and 4 PM). Wear protective clothing, a wide-brimmed hat, and sunglasses. Apply sunscreen generously with a high protection factor (SPF 30 or higher) and reapply every two hours, or after each swim or intense sweating. Absolutely avoid artificial tanning beds, as they significantly increase the risk of melanoma. Monthly self-examination of the skin helps to quickly detect any suspicious changes. An annual dermatological examination is also recommended, especially if you have risk factors.

Living with melanoma

Living with melanoma involves regular medical follow-up. After initial treatment, follow-up visits to the dermatologist are essential to detect any local recurrence or the appearance of a new melanoma. These follow-ups include a skin and lymph node examination. Patients with melanoma may face physical and emotional challenges. Psychological support, support groups, and sharing with other patients can help better manage the disease and its consequences. Adopting a healthy lifestyle, with a balanced diet and regular physical activity, contributes to overall well-being. Constant vigilance for sun protection remains an important part of daily life.

Frequently Asked Questions (FAQ)

Is melanoma always serious?

It always requires medical attention. If detected and treated early, it is curable in the vast majority of cases. At an advanced stage, it can become aggressive. Therefore, rapid diagnosis is essential.

Can one fully recover from melanoma?

Yes, complete recovery is common, especially if melanoma is diagnosed early. Surgery removes the lesion in most cases. For more advanced stages, new therapies significantly improve the chances of success.

What is the difference between a mole and melanoma?

A mole is a benign lesion. Melanoma is malignant. The ABCDE rule helps distinguish melanoma by its asymmetry, irregular borders, heterogeneous color, increasing diameter, and evolution. A dermatologist will make a definitive diagnosis.

Can melanoma recur after treatment?

Yes, recurrence is possible, either at the same spot or distantly. That is why regular medical follow-up is essential after initial treatment. This allows for rapid detection of any new appearance.

Can children get melanoma?

It remains rare in children but is possible. The risk is higher in children with numerous moles or a family history. Sun protection from an early age is fundamental.

Additional resources

• WHO

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