Cancer of the skin (melanoma)

Overview

Melanoma is a type of skin cancer that can spread to other organs in the body.

  • The main cause of melanoma is ultraviolet light, which comes from the sun and is used in sunbeds.
  • Things that increase your chances of getting melanoma include your age and having pale skin, a large number of moles and a family history of skin cancer.
  • It's often possible to prevent skin cancer by being careful in the sun – for example, by using sunscreen and reapplying it regularly.
  • How melanoma is treated depends on where it is, if it has spread to other areas of your body and your general health. Surgery is the main treatment.

There's another type of skin cancer called non-melanoma skin cancer. It's more common and usually less serious than melanoma.

Important:Get your symptoms checked

It's important to get any symptoms of melanoma skin cancer checked as soon as possible.

Symptoms

A new mole or a change in an existing mole may be signs of melanoma.

Melanomas can appear anywhere on your body, but they're more common in areas that are often exposed to the sun.

Some rarer types can affect the eyes, soles of the feet, palms of the hands or genitals.

Check your skin for any unusual changes. Use a mirror or ask a partner or friend to check any areas you cannot see.

Mole with an uneven shape or edges

Normal moles are usually round with smooth edges.

Melanomas are often an uneven shape. They may have 2 different shaped halves and uneven edges.

Mole with a mix of colours

Normal moles are usually only 1 colour.

Melanomas are often a mix of 2 or more colours.

Large mole

Normal moles are usually small.

Melanomas tend to be bigger, often more than 6mm wide.

Mole that changes over time

Normal moles usually do not change over time.

A mole that changes size, shape or colour may be a melanoma.

Other signs to look out for include moles that are:

  • swollen and sore
  • bleeding
  • itchy
  • crusty

See a GP if:

  • you have a mole that's changed size, shape or colour
  • you have a mole that's painful or itchy
  • you have a mole that's inflamed, bleeding or crusty
  • you have a new or unusual mark on your skin that has not gone away after a few weeks
  • you have a dark area under a nail that has not been caused by an injury

Finding a melanoma as early as possible can mean it's easier to treat.

What happens at the GP appointment

You will be asked some questions about your health, family medical history, medical conditions and your symptoms.

Tell the GP if you have a mole, freckle or other area of skin that's recently changed. Also tell them if you or a member of your family have had skin cancer in the past.

The GP will look at your mole and any other areas of affected skin. They may ask you if they can take a photograph of it to send to a specialist (dermatologist) to look at. This is called teledermatology.

Referral to a specialist

The GP may refer you to a specialist in hospital for more tests if they think you have a condition that needs to be investigated.

This may be an urgent referral, usually within 2 weeks, if you have certain symptoms. This does not definitely mean you have cancer.

Find out more

Who can get it

Ultraviolet (UV) light is the most common cause of melanoma. It comes from the sun and is used in sunbeds.

Melanoma is more common in older people, but younger people can also get it.

You're also more likely to get melanoma if you have:

  • pale skin that burns easily in the sun
  • red or blonde hair
  • blue or green eyes
  • a large number of freckles or moles
  • had a lot of sun exposure and you've had sunburn a lot in the past
  • used sunbeds a lot
  • a history of skin cancer in your family or you've had skin cancer before

If you have black or brown skin, you have a lower chance of getting melanoma, but you can still get it.

People with black or brown skin most often get melanoma on the soles of the feet, palms of the hands, or under a nail.

Find out more

How to lower your chance of getting melanoma

Staying safe in the sun is the best way to lower your chance of getting skin cancer (both melanoma and non-melanoma).

Do

  • stay out of the sun during the hottest part of the day (11am to 3pm in the UK)
  • keep your arms and legs covered and wear a wide-brimmed hat and sunglasses that provide protection against ultraviolet (UV) rays
  • use sunscreen with a sun protection factor (SPF) of at least 30 and at least 4-star UVA protection – make sure you reapply it regularly
  • make sure babies and children are protected from the sun – their skin is much more sensitive than adult skin

Find out more

Diagnosis

Main test for melanoma (excision biopsy)

If a GP refers you to a specialist (dermatologist) because they think you could have skin cancer, you'll have tests to check for melanoma.

The specialist will check your skin and ask you about any changes you've noticed. They may use a magnifying device that lets them look at the skin more closely.

The specialist may also cut out the mole and a small area of surrounding skin so it can be sent to a lab and checked for cancer. This is known as an excision biopsy.

Find out more

Getting your results

Your specialist should let you know when you can expect to get the results of the excision biopsy. They will be sent to the GP or the hospital where you had the procedure.

It should take about 2 weeks for the results to come back, but sometimes it might be longer.

Try not to worry if your results are taking longer than you expect. It does not mean anything is wrong.

You can call the hospital or GP if you're worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you're told you have melanoma skin cancer

Being told you have melanoma skin cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis, during and after treatment.

Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Get support

Melanoma Focus has a free helpline that's run by specialist skin cancer nurses.

The helpline is open 1pm to 2pm and 7pm to 9pm (Monday to Friday) and 7pm to 9pm on Sunday. You can leave a message outside these hours.

Call 0808 801 0777.

Find out more about the Melanoma Focus helpline

Next steps

If you have been told you have melanoma skin cancer, you'll usually need some more tests, which may include:

  • CT scan or an MRI scan
  • tests to see if the melanoma has spread to your lymph nodes
  • blood tests

The results of these tests will show how deep the cancer is and how far it's spread (called the stage). This will help your specialist decide what treatment you need.

Treatment

Melanoma skin cancer can often be treated. The treatment you have will depend on:

  • where the cancer is
  • if it has spread
  • your general health

Surgery is the main treatment for melanoma. Radiotherapy, medicines and chemotherapy are also sometimes used.

The specialist care team looking after you will:

  • explain the treatments, benefits and side effects
  • work with you to create a treatment plan that's best for you
  • discuss the chances of the melanoma coming back and how it will be treated if it does

You'll have regular check-ups during and after any treatments. Depending on the stage of your melanoma, you may have tests and scans.

If you have any symptoms or side effects you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Surgery is the main treatment for melanoma, especially if it's found early.

You may also need surgery if the melanoma has spread to other areas of your body or if it has come back again after being removed.

Several types of surgery can be used to treat melanoma. For example, you may have surgery to remove:

  • the melanoma and an area of healthy skin around it – this helps lower the chances of it coming back
  • swollen lymph glands (part of the body's immune system) if the cancer has spread to them
  • melanoma that's spread to other areas of your body

If the melanoma is in a visible area, such as on your face, a plastic surgeon may carry out the surgery to make sure the end result looks as good as possible.

If a large area of skin is removed, skin may need to be taken from another part of your body and used to cover the area where the melanoma was. This is known as a skin graft.

Radiotherapy

Radiotherapy is sometimes used to reduce the size of large melanomas and help control and relieve your symptoms.

You may have 1 or several sessions of radiotherapy. The amount needed depends on the area of your body being treated and if you're also having other types of treatment.

Targeted medicines and immunotherapy

Targeted medicines aim to stop the cancer growing.

Immunotherapy medicines help your immune system find and kill the cancer cells.

Targeted medicines or immunotherapy are sometimes used to treat melanomas that:

  • cannot be treated with surgery
  • have spread to nearby lymph glands
  • have spread to other areas of the body

A sample of the melanoma is usually tested before having targeted medicines. This is to check for changes in certain genes and help doctors decide if this type of treatment is likely to work.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

It's sometimes used to treat advanced melanoma (where it's spread to another part of the body).

Chemotherapy does not work as well for melanoma as other treatments like targeted medicines and immunotherapy. But it might be used if you're unable to have other treatments.

What happens if you've been told your cancer cannot be cured

If you've been diagnosed with advanced melanoma, it might be very hard to treat. It may not be possible to cure the cancer.

In this situation, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

Finding out the cancer cannot be cured can be very hard news to take in.

You'll be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They'll work with you to help manage your symptoms and make you feel more comfortable.

The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 05/07/2023 12:08:11