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The skin, the largest organ of the body, is made up of living
cells that grow and divide. Cancers can develop in the skin as well as in
other parts of the body. When melanocytes (cells
that give pigment [color] to the skin) become
cancerous, this is called melanoma. Melanoma is
less common than the other main types of skin cancer (basal cell and squamous cell
cancers) but is much more likely to metastasize
(spread to other organs) and to be fatal. The December 8, 2004, issue of
JAMA includes an article about melanoma.
Melanoma experts advise looking for the
ABCDs of melanoma:A. Asymmetry—the different halves of the skin lesion do not look the
sameB. Borders—irregular, shaggy, or
ill-formedC. Color—not the same
throughout the lesionD. Diameter—larger than 6 millimeters (1/4 of an inch, about the size of
a pencil eraser)
The current JAMA
article recommends the addition ofE. Evolving—changes in size, shape, shades of color, symptoms (itching,
tenderness), or surface (especially bleeding)
Any suspicious moles or skin lesions should be examined by your
doctor and may require referral to a dermatologist
(physician with specialized training in diseases of the skin). Skin biopsy (removal of the lesion, or a piece of it, for
testing) is a simple procedure and is done routinely in the doctor's
office. For advanced melanomas, other testing may include chest x-ray,
computed tomography (CT) scan, magnetic resonance imaging (MRI), positron
emission tomography (PET) scan, or bone scan. These tests look for possible
spread to other organs.
Avoid prolonged exposure to the sun, especially during
peak hours of 10 AM to 4 PM.
Avoid tanning booths.
Wear sunglasses in sunlight because melanoma can occur
in the pigmented areas of the eyes.
Wear a hat and clothing that covers the arms, legs, and
the rest of the body.
Protect children from the sun and tanning booths
because the risk of melanoma greatly increases in persons who had excessive
sun exposure before age 18.
Use sunscreen when exposed to the sun for more than 10
minutes. The Sun Protection Factor (SPF) of sunscreen should be at least 15
(preferably higher) and definitely higher for children or fair-skinned
Examine your skin for changes in existing moles or
development of new skin lesions. See your doctor if any skin area appears
to have a melanoma warning sign (one of the ABCDEs).
Treatment options depend on the size, depth, and spread of melanoma.
Melanomas need to be surgically removed. Other treatments for advanced or
metastatic melanomas include chemotherapy, radiation therapy, and
National Cancer Institute
American Academy of Dermatology
Skin Cancer Foundation
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at
http://www.jama.com. A Patient Page on detecting skin cancer was
published in the February 17, 1999, issue.
Sources: National Cancer Institute;
American Cancer Society; American Academy of Dermatology; National
Comprehensive Cancer Network
The JAMA Patient Page is a public service of JAMA. The information and recommendations
appearing on this page are appropriate in most instances, but they
are not a substitute for medical diagnosis. For specific information
concerning your personal medical condition, JAMA
suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA
approval. To purchase bulk reprints, call 718/946-7424.
Torpy J, Lynm C, Glass RM. Melanoma. JAMA. 2004;292(22):2800. doi:10.1001/jama.292.22.2800