Skin Cancer Melanoma

Melanoma is a cancer that usually starts in the skin. The skin is the body’s largest organ. It protects the organs inside your body from injury, infection, heat and ultraviolet light from the sun.

Most often the first sign of melanoma is a new, unusual looking growth on the skin. You may notice a change in a mole that you’ve had for a long time. Melanoma can start anywhere on your body, but it usually starts in areas that are exposed most often to the sun – the head, face, neck, hands, arms and legs.

About this Cancer

Statistics

According to the Canadian Cancer Society (CCS) Statistics for 2023, 9,700 cases of melanoma were diagnosed. Among the 9,700 cases, 5,600 males and 4,100 females were diagnosed with melanoma.The incidence of melanoma skin cancer continues to rise, despite it being mostly preventable. In 2023, an estimated 1,250 people died from melanoma.

From: Canadian Cancer Statistics 2023

Symptoms

  • A key warning sign of melanoma is the presence of a “new” spot with a new size, shape, or color. Also, a spot found on the skin that appears different from your other skin spots. 
  • ABCDE is a tool used to identify some of the usual signs of melanoma. It helps to identify spots that are characteristic of melanoma:
    • A is for Asymmetry: One half of a mole or birthmark is different from from the other half
    • B is for Border: The edges appear blurry, and ragged
    • C is for Color: The color of the mole varies throughout and may be differing shades of brown, black, including patches of pink, red, white or blue.
    • D is for Diameter: The spot is greater than 6 millimeters across.
    • E is for Evolving: There are changes to the size, shape and color of the mole
  • It is important to note that not all melanomas fit the ABCDE criteria. As such, any changes and new spots found on your skin that appear different should be reported to your doctor.

From: Signs and Symptoms of Melanoma Skin Cancer

Risk Factors

Risk factors are things that increase the risk of developing cancer. Risk factors for melanoma include:

  • Ultraviolet radiation 
  • Many moles
  • Atypical moles
  • Congenital melanocytic nevi: Congenital melanocytic nevi refer to birthmarks or moles that are found at birth or soon after. They can be small, medium or large, but the larger they are, the greater the likelihood of developing melanoma skin cancer.
  • Familial atypical multiple mole melanoma (FAMM syndrome): This is a hereditary condition that causes individuals to have more than 50 moles that generally look different from normal moles. Individuals with this condition usually have one or more close family members with melanoma, and they are at an increased risk of developing melanoma skin cancer themselves. 
  • Other hereditary conditions
  • Light-coloured skin, eyes and hair
  • Personal history of skin cancer
  • Family history of skin cancer
  • CDK2N2A gene mutation: CDKN2A is a tumor suppressor gene, and its function is to control the growth of cancer cells. A mutation in this gene can lead to excessive cell growth and may lead to the development of cancer. 5-25% of families that are at an increased risk of developing melanoma skin cancer have an inherited mutation in the CDK2NA gene.
  • Weakened immune system

References: Risk factors for melanoma skin cancer

Diagnosis

Melanoma can be diagnosed using the following tests:

  • Health history and physical exam: Your doctor may ask you about any melanoma signs and symptoms, sun exposure, abnormal moles, and family history. They may also conduct a physical exam where your skin will be analyzed for atypical moles.  
  • CT scan: A CT scan is able to produce 3D and cross sectional images of organs, tissues, bones and blood vessels inside the body and is used to assess if melanoma has spread. CT scans are conducted typically when melanoma is greater than 4mm or if cancer was detected in the lymph nodes. 
  • MRI: Magnetic resonance imaging is able to produce cross sectional images of organs, tissues, bones and blood vessels and is used to assess if melanoma has spread.
  • Chest x-ray: A chest x-ray is used to assess if melanoma has spread to the lungs.
  • PET scan: Positron Emission tomography is a scan that uses radioactive substances to identify potential metabolic changes in the body’s tissues. This scan is helpful to assess if melanoma has spread to other regions of the body and to determine if surgery is needed.
  • Blood tests: A blood test to assess for lactate dehydrogenase, a tumour marker that is used to determine melanoma staging and prognosis, may be used. Higher than normal levels of lactate dehydrogenase can indicate melanoma spread and a poorer prognosis.
  • Skin biopsy: In a skin biopsy, a piece of tissue or cells are removed from the skin to be tested for the presence of cancerous cells. There are 3 kinds:
    • Excisional biopsy: This type of biopsy is used when the doctor suspects melanoma. The entire growth is removed using a scalpel.
    • Punch biopsy: This biopsy is done if the doctor suspects melanoma and if the growth is large. It involves the removal of a round party of the growth using a punch (sharp tool).
    • Shave biopsy: This biopsy involves the removal of a growth on the skin with either a flexible razor blade or a scalpel.
    • Lymph node biopsy: This is a type of biopsy that may be ordered by your doctor if they suspect that the cancer has spread to the lymph nodes. It involves the removal of a lymph node or a portion of lymph tissue to identify the presence of cancer.

Info sourced from Diagnosis of melanoma skin cancer | Canadian Cancer Society

Treatment

Treatment of melanoma skin cancer will depend on the stage of the disease, the location of the cancer, the risk of cancer recurrence and patient preference. It may include the following:

  • Surgery: Surgery involves removing the melanoma tumor or tissue from your body. 
  • Immunotherapy: This type of treatment involves using the body’s immune system to treat melanoma. It involves strengthening the immune system.
  • Targeted therapy: Targeted therapy can be used to treat melanoma skin cancer and it involves the use of drugs designed to target specific molecules found on or within cancer cells. 
  • Radiation therapy: This involves the use of high energy radiation to destroy cancerous cells.
  • Chemotherapy: This treatment involves the use of drugs to destroy cancerous cells

Info sourced from: Treatments for melanoma skin cancer | Canadian Cancer Society

Stories from Survivors

Stories from Other Groups

If you would like to share your melanoma story, please email us at info@survivornet.ca.

Resources

Melanoma Skin Cancer Groups

Canada

  • Melanoma Canada: Melanoma Canada advocates for and supports Canadians living with melanoma and skin cancer by providing helpful resources, education, psychosocial support services, and more. 
  • Canadian Skin Cancer Foundation: The Canadian Skin Cancer Foundation was founded in 2002 by one of North America’s foremost authorities on skin cancer surgery, Dr. Barry Lycka. Dr. Lycka believes that skin cancers could be virtually eliminated if people were aware of the dangers of overexposure to the sun’s harmful UV rays and educated about how they could safely enjoy the outdoors.
  • Save Your Skin Foundation: Save Your Skin Foundation (SYSF) is a national patient-led not-for-profit group dedicated to the fight against non-melanoma skin cancers, melanoma and ocular melanoma through nationwide education, advocacy, and awareness initiatives. Save Your Skin Foundation is committed to playing an active role in reducing the incidence of skin cancer in Canada, and to providing compassionate support for all Canadians living with skin cancers.
  • Douglas Wright Foundation: The Douglas Wright Foundation is a charitable organization devoted to fighting melanoma cancer in Canada by increasing awareness, educating the public about early detection and preventative measures, and fostering partnerships between like minded organizations.
  • Canadian Skin Patient Alliance: The Canadian Skin Patient Alliance (CSPA) is a registered charity that improves the health and well-being of people across Canada affected by skin, hair and nail conditions through collaboration, advocacy and education.  
  • The David Cornfield Melanoma Fund: Recognized as a Canadian leader and a global voice, the David Cornfield Melanoma Fund raises melanoma awareness, promotes prevention and supports research. The David Cornfield Melanoma Fund was established in 2007 to take action on melanoma.