Melanoma 101: Introduction to a Deadly Skin Cancer
Medical Authors: Alan Rockoff, MD and Michael S. Lehrer, MD
Medical Editors: Frederick Hecht, MD, FAAP and Melissa Conrad Stöppler, MD
Melanoma Skin Cancer of U.S. Senator John McCain
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
 In August of 2000, U.S. senator and presumptive Republican presidential nominee John McCain was found to have a dangerous form of skin cancer, melanoma, for the second time. The
senator had a superficial (meaning less dangerous because it has not invaded deeply into the tissues) melanoma diagnosed in 1993. Melanoma is the most dangerous form of skin cancer and is frequently associated with prolonged exposure of the skin to sunlight.
The cancer identified in 2000, located on the left side of his face, had penetrated the skin more deeply than the superficial cancer removed in 1993. The cancer diagnosed in 2000 was removed by a surgical procedure that also included removal and examination of multiple lymph nodes to determine the extent of
the spread of the cancer. His staff reported at the time that there was no evidence of spread of the cancer. According to press reports, McCain has also had two more superficial melanomas removed since his surgery in 2000.
Melanoma can occur on any skin surface. In men, it is often found on the trunk (the area from the shoulders to the hips) or the head and neck. In women, melanoma often develops on the lower legs or the trunk. Melanoma is rare in people with deeply pigmented skin. When it does develop in dark-skinned people, it tends to occur under the fingernails or toenails, or on the palms
of the hands or soles of the feet. Melanoma affects people of all age groups, but the chance of developing this disease increases with age.
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Introduction
Melanoma is a cancer that develops in melanocytes, the pigment cells
present in the skin.
It can be more serious than the other forms of skin cancer because it may spread
to other parts of the body (metastasize) and cause serious illness and death.
About 50,000 new cases of melanoma are diagnosed in the United States every
year.
Because most melanomas occur on the skin where they can be seen, patients
themselves are often the first to detect many melanomas. Early detection and
diagnosis are crucial. Caught early, most melanomas can be cured with relatively
minor surgery.
This article is written from the standpoint of the patient. In other words,
instead of describing the disease in exhaustive detail, I will try to help
answer the questions: "How do I know if I have melanoma?" and "Should I
should be checked for it?"
Spots on the skin
Guideline # 1: Nobody can diagnose him- or herself. If you see a spot that
looks as though it is new or changing, show it to a doctor. When it comes to
spots on the skin, it is always better to be safe than sorry.
Everybody gets spots on their skin. The older we are, the more spots we have.
Some of these are freckles, others are moles, and still others are made up of
collections of tissue, such as blood vessels or pigment cells. Most of these
spots are benign. That means they are neither cancerous nor on the way to
becoming cancerous.
Moles
Guideline # 2: The vast majority of moles stay as moles and do not turn into
anything else.
Some people are born with moles (the medical name is "nevus" plural "nevi").
Almost everyone develops them, starting in childhood. On the average, people
have about 25 moles, though some have fewer and others many more. Moles may be
flat or raised, and they may range in color from tan to light brown to black.
Next: What does melanoma look like? What are the symptoms and signs? »
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