Melanoma

Melanoma begins when pigment-making cells (melanocytes) develop DNA changes that cause uncontrolled growth. It most often starts on the skin, but it can also arise on mucous membranes or in the eye (uveal melanoma). Early detection is critical—most deaths from skin cancer are due to melanoma, but when found early, melanoma is highly treatable. Illinois CancerCare provides timely diagnosis, modern treatments, and supportive care tailored to you.

Understanding Melanoma & Other Skin Cancers

Skin cancers include basal cell carcinoma, squamous cell carcinoma, and melanoma. Melanoma is less common but more likely to spread (metastasize) than the other types, which is why prompt recognition and treatment matter.

Melanoma can appear anywhere; sun-exposed skin, normally covered areas, under the nails, on the scalp, and (less commonly) on mucosal surfaces; a separate entity, uveal melanoma, arises in the eye.

Signs & Symptoms

Typical warning signs include a new or changing spot or changes in an existing mole. The ABCDEs can help you remember what to watch for:

Asymmetry
Border irregularity
Color variation
Diameter ≥6 mm (or any size if changing)
Evolving (any change in size/shape/color or new symptoms like itching/bleeding).

If you notice a spot that looks different from your other moles (the “ugly duckling”), or a mole that itches, bleeds, or grows, get it checked.

Risk Factors

Ultraviolet (UV) exposure from the sun or tanning beds (including childhood blistering sunburns)
Fair or sun-sensitive skin, light eyes/hair; large numbers of common or atypical (dysplastic) moles
Personal or family history of melanoma; certain inherited syndromes (e.g., CDKN2Aassociated)
Immunosuppression (e.g., post-transplant, specific medicines) and prior radiation to skin

Illinois snapshot: In 2021, 3,731 Illinois residents were diagnosed with melanoma; in 2022, 285 died from melanoma of the skin—underscoring the importance of prevention and early detection. [dph.illinois.gov]

Prevention

Protect your skin from UV: seek shade (especially 10 a.m.–4 p.m.), wear UPF clothing, broad-brim hats, and UV-blocking sunglasses. Apply broad-spectrum SPF 30+ sunscreen to exposed skin and reapply every two hours (or after swimming/sweating).
Avoid tanning beds and deliberate tanning.
Know your skin: do monthly self-checks; ask a clinician about how often you should have a professional skin exam, especially if you’re high-risk.

Screening

There is insufficient evidence that population wide screening (routine total body skin exams for everyone without symptoms) reduces mortality. Still, visual skin examination by you and your clinician remains the practical way to find suspicious lesions early, particularly for people with risk factors.

Diagnosis

If melanoma is suspected, evaluation may include:

and clinical photography (when helpful)

(preferred when feasible) to remove the lesion with a narrow margin for accurate diagnosis and measurement of Breslow thickness (how deep the tumor grows, key for staging)

or labs for higher stage disease or specific symptoms. Careful pathology review confirms sub-type, thickness, ulceration, and other features that guide treatment.

Staging

Melanoma uses the AJCC TNM system and is strongly influenced by:

Tumor

features (Breslow thickness, ulceration, mitotic rate)

Lymph nodes

(microscopic or palpable involvement; sentinel node status)

Metastasis

(organ spread; LDH)

Stage IV

Cancer has spread to distant organs

Early stages (0–II) are localized to the skin; Stage III involves regional nodes/intransit disease; Stage IV indicates distant metastasis.

Treatment Options

Treatment is personalized based on stage, tumor/pathology details, molecular profile, overall health, and your goals—delivered by a multidisciplinary team (dermatology, surgical oncology, medical oncology, radiation oncology, pathology).

Stages 0–II (Localized)

Surgical excision with stage appropriate margins is the mainstay. Your surgeon may recommend a sentinel lymph node biopsy (SLNB) for tumors meeting specific depth or high risk criteria (commonly ≥0.8–1.0 mm with/without ulceration), to check for microscopic spread.

Stage III (Regional nodes or intransit disease)

Therapeutic lymph node management (if nodes are clinically involved) and/or excision of intransit lesions when feasible.
Adjuvant systemic therapy (after surgery) or neoadjuvant approaches (before surgery in selected cases) may include immunotherapy (PD1–based regimens) or, for BRAF-mutant melanoma, BRAF/MEK–targeted therapy.

Unresectable Stage III / Stage IV (Metastatic or Recurrent)

Immunotherapy (e.g., PD1 inhibitors alone or in combination with other checkpoint inhibitors) is a key option that can produce durable responses in many patients.
Targeted therapy for tumors with BRAF V600 mutations (combined BRAF + MEK inhibitors).
Intralesional/regionally directed therapies, radiation for symptom control or select oligometastatic settings, and clinical trials for access to innovative treatments.

Your Illinois CancerCare physician will discuss the benefits/risks of each option—and whether a clinical trial might be the right fit—so your plan reflects the latest evidence and your personal goals.

Prognosis

Outcomes depend on stage, Breslow thickness, ulceration, sentinel node status, and response to therapy. Many early melanomas are curable with surgery, and advances in immunotherapy and targeted therapy have improved outcomes for more advanced disease. Your doctor will explain what your individual features mean.

Follow Up Care

Follow-up is tailored to stage and treatment. It often includes:

Regular skin and lymph node exams (self-exams and clinician visits)
Imaging when indicated by stage/symptoms or treatment plan
Ongoing sun safety counseling and support for skin self exams
Your team will create a personalized survivorship plan that covers schedule, symptom monitoring, prevention, and supportive resources.

Melanoma in People of All Skin Tones

Melanoma can occur in any skin tone. In people with darker skin, it may be found later and can appear on less sun exposed sites (e.g., palms, soles, nail beds). Prompt evaluation of any changing lesion—especially on acral sites—is essential.

Why Choose Illinois CancerCare

Experienced multidisciplinary team with access to advanced diagnostics, sentinel node expertise, and modern systemic therapies
Timely care and clinical trials close to home
Comprehensive survivorship support—education, prevention counseling, counseling services, and care coordination

Sources & Patient Friendly References

All information was taken from the NCI (National Cancer Institute) and ACS (American Cancer Society).