The following stages are used for melanoma:

• Stage 0: In stage 0, the melanoma cells are found only in the outer layer of skin cells and have not invaded deeper tissues.

• Stage I: Melanoma in stage I is thin:

  The tumor is no more than 1 millimeter (1/25 inch) thick. The outer layer (epidermis) of skin may appear scraped. (This is called an ulceration).
  Or, the tumor is between 1 and 2 millimeters (1/12 inch) thick. There is no ulceration.

  The melanoma cells have not spread to nearby lymph nodes.

• 
  Stage II: The tumor is at least 1 millimeter thick:

  The tumor is between 1 and 2 millimeters thick. There is ulceration.

  Or, the thickness of the tumor is more than 2 millimeters. There may be ulceration.

  The melanoma cells have not spread to nearby lymph nodes.

• Stage III: The melanoma cells have spread to nearby tissues:

  The melanoma cells have spread to one or more nearby lymph nodes.

  Or, the melanoma cells have spread to tissues just outside the original tumor but not to any lymph nodes.

• Stage IV: The melanoma cells have spread to other organs, to lymph nodes, or to skin areas far away from the original tumor.
• Recurrent: Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may have come back in the original site or in another part of the body.

Treatment Choices by Stage for Melanoma

The following are brief descriptions of the treatments most often used for each stage. (Other treatments may sometimes be appropriate.)

• Stage 0

  People with Stage 0 melanoma may have minor surgery to remove the tumor and some of the surrounding tissue.

• Stage I

  People with Stage I melanoma may have surgery to remove the tumor. The surgeon may also remove as much as 2 centimeters (3/4 inch) of tissue around the tumor. To cover the wound, the patient may have skin grafting.

• Stage II or Stage III

  People with Stage II or Stage III melanoma may have surgery to remove the tumor. The surgeon may also remove as much as 3 centimeters (1 1/4 inches) of nearby tissue. Skin grafting may be done to cover the wound. Sometimes the surgeon removes nearby lymph nodes.

• Stage IV

  People with Stage IV melanoma often receive palliative care. The goal of palliative care is to help the patient feel better—physically and emotionally. This type of treatment is intended to control pain and other symptoms and to relieve the side effects of therapy (such as nausea), rather than to extend life.

  The patient may have one of the following:

  Surgery to remove lymph nodes that contain cancer cells or to remove tumors that have spread to other areas of the body

  Radiation therapy, biological therapy, or chemotherapy to relieve symptoms

Melanomas don’t always begin as a mole, although most do. It can also occur on normal skin. That’s why it is very important to do self-skin exams to detect for possible melanomas.

Melanocytes and Skin

Melanocytes and Moles

Melanocytes are the skin cells which produce the skin pigment Melanin. Melanin is the pigment which lends skin its natural color. When skin is exposed to the sun, melanocytes produce more pigment causing the skin to darken.

Sometimes melanocytes and surrounding tissue can form darker noncancerous growths called moles. Moles are very common, and most people have up to 40 moles ranging from pink to tan to dark brown. Moles can be raised or flat,and are generally round or oval and smaller than 1/4 inch in diameter. (Technically a mole is properly called a nevus; the plural is nevi.)

Melanoma occurs when Melanocytes turn malignant.

Diagnosis of Melanoma

If your doctor suspects that a spot on your skin might be melanoma, She will generally take a small tissue sample called a biopsy. This is generally done by numbing up the skin around the mole, and using a small scalpel to remove the suspicious tissue along with a small margin of healthy tissue. The sample is then sent to an expert pathologist who will review the cells under magnification and determine whether the tissue is healthy or malignant. A biopsy is the only way to make a definite diagnosis. During the biopsy the doctor tries to remove all of the suspicious-looking growth so that the diagnostice procedure is also curative.

Staging

If the diagnosis is melanoma, the doctor needs to learn the extent of the disease before planning treatment. The medical team establishes how thick the tumor is, how deeply it has invaded the skin, and whether the malignant cells have spread to the lymph nodes or other parts of the body.

This process is called Staging, and the melanoma is assigned a stage. The stage of the melanoma will help indicated the course of treatment.

Depending on the apparent stage of the malignancy, the doctor might order removal of nearby lymph nodes (as both a diagnostic and therapeutic measure). If the tumor is thick, may order chest x-rays, blood tests, and scans of the liver, bones, and brain.

Treatment

Options for treatment depend on different factors such as stage of melanoma, location and size, and the individual’s general health. One common treatment is surgical excision. Most people with a early case of melanoma can get it cut out. The surgery is less extensive and results in little scarring.

Other treatments include radiation therapy and lymph node dissection. Radiation therapy will direct high-energy rays at the melanoma, which kills the malignant cells. Lymph node dissection removes most or all of the lymph nodes in the region.

Consult your dermatologist or physician for more information on symptoms and treatment of melanomas.

Read more about the stages of Melanoma and the corresponding treatment regiments here.

The National Cancer Institute has a toll free information line available for patients and their familes. The specialists at the NCI’s Cancer Information Service at 1-800-4-CANCER can answer questions about melanoma and can send NCI materials

Otherwise known as unusual moles that may resemble melanoma. People who have 10 or more of these moles have 12 times the risk of developing melanoma. Those who have dysplastic nevi plus a family history of skin cancer have an extremely high risk of melanoma.

The Classic Atypical Syndrome

People with a classic atypical mole syndrome have the following three characteristics:

• 100 or more moles
• One or more moles 8 mm (1/3 inch) or larger in diameter
• One or more moles which are atypical.

Characteristics

Atypical melanocytic nevus – asymmetric, border is irregular, color varies, diameter is greater than 6mm.

SHAPE: often asymmetrical: A line drawn through the middle would not create matching halves.

BORDER: irregular and/or hazy—the mole gradually fades into the surrounding skin.

COLOR: variation and irregularity with subtle, haphazard areas of tan, brown, dark brown, red, blue or black.

DIAMETER: generally larger than 6 mm (1/4 inch), the size of a pencil eraser, but may be smaller.

LOCATION: most commonly on the back, chest, abdomen and extremities; may also occur on normally unexposed areas such as the buttocks, groin or female breasts, as well as on the scalp.

GROWTH: Enlargement of a previously stable mole or appearance of a new mole after ages 35–40 should raise suspicion.

SURFACE: Central portion often is raised, whereas the peripheral portion is usually flat, sometimes with tiny “pebbly” elevations.

APPEARANCE: greatly varied; dysplastic nevi often look different from one another.

NUMBER: From a few to well over 100 dysplastic nevi may be present.

Here’s a quick visual guide from Cancer.Gov:

For more information, please visit and/or call your physician.

Here are some great resources to learn more about Dysplastic Nevi:

SkinCancer.Org

American Association of Dermatology

Cancer.Gov

Nevus.Org

The scientist who developed a vaccine for cervical cancer is working on another inoculation against certain types of skin cancer that could be available in five years time.

Professor Ian Frazer, of the University of Queensland, said tests of the vaccine had proven successful on animals and that human trials could begin next year.

Mr Frazer, who delivered his findings to the Australian Health and Medical Research Congress, said a vaccine for children aged 10 to 12 could be available in five to 10 years.

The jab would protect against squamous cell carcinoma, the second most common skin cancer, but not the more deadly melanomas.

It works by targeting papillomavirus, a common infection which can turn abnormal cells into cancerous cells and is believed to cause at least five per cent of all cancers.

Mr Frazer helped develop the cervical cancer vaccine Gardasil, which is now used to inoculate millions worldwide. He hopes the skin cancer vaccine would work in a similar way.

“What we’ve learnt together, through the study of animal models, is that the skin has natural defences which switch off killer T cells,” he told the conference.

“We’ve also found a number of ways to overcome these blocks and let the immune system work.

“We now want to test vaccines based on this knowledge in clinical trials, to find out whether we can develop vaccines that could be used to treat people at risk of skin cancer.”

Australia suffers from the highest rate of skin cancer in the world, with 1,600 people dying from the disease each year. About 400,000 people are diagnosed with non-melanoma cancers in the county, and 400 people die as a result.

Mr Frazer warned there was still no substitute for staying out of the sun.

“In the future, just as the cervical cancer vaccine will complement the cervical cancer screening program, I hope that a skin cancer vaccine will be available to help in the prevention of skin cancer, but we’ll still need to stay out of the sun.”

But cancer specialists have agreed.

Professor Ian Olver of the Australian Cancer Council said that even if the vaccine was proved to work in humans, the normal rules of sun exposure would not change.

“The traditional prevention messages of staying out of the sun during the hottest part of the day, covering up and using sun screen still apply.

“This would be an extra layer of protection.”

Despite it limitations, Mr Olver said the discovery of the vaccine was “a good sign for the future”.

“It is possible other vaccines could flow from this,” he said.