Malignant Melanoma: Definition, Diagnosis, Symptoms, Treatment, Stages

Malignant tumors can originate in almost every tissue or organ in the body. Being the largest organ, the skin is not excluded. While there are different types of skin cancers, malignant melanoma is the most invasive, aggressive and deadly.

The most interesting thing about this cancer is that chances of survival and recovery greatly depend on the stage in which it is in. In the early stages, it is very treatable. This changes drastically as it approaches its final stages. It is for such reasons that a lot of emphasis is put on learning about its causes and, most importantly, the early signs.

All types of cancer require medical attention. In fact, a doctor should be consulted immediately after suspicious symptoms are noticed. The good thing is that malignant melanoma is not very common. It accounts for about 15% of all skin cancer related cases.

What is malignant melanoma; definition and pictures

Malignant melanoma definition takes the form of any other cancer definition, only that it exclusively is cutaneous in its initial stage.

Cancer develops when a part of DNA structure is damaged or mutates. DNA is a chemical substance that controls how cells reproduce and carry out their normal functions. When damaged, it means that some function or body process will be interfered with. The most common interference that leads to cancer involves rapid uncontrolled cell division. As more and more unwanted cells are produced, they accumulate to form a mass, known as a cancerous lump. Other than uncontrollable cell division, damaged DNA may take away the ability of cells to self-destruct. Cells normally ‘commit suicide’ when their DNA is damaged or they are no longer needed.

When the above explained complications occur in epidermal cells that give the skin its pigment, malignant melanoma develops. Note that the resulting lump will not be caused by any foreign cells or microbes. It will be the normal skin cells, just that they will have gone rogue. Therefore, it is expected that the cancerous lump will develop roots in attempt to become part of skin tissue.

During this ‘normal’ developmental stage, some cells may leave the original tumor, enter the blood or lymphatic system and finally settle on a healthy body tissue or organ. This is known as metastasis, one of the factors that make advanced stage cancer so hard to treat. The logic is that even if you succeed in treating one tumor, there probably are several other, maybe even more advanced tumors elsewhere in the body.

So what is malignant melanoma? It is a growth or a neoplasm that originates from melanocytes. It can also originate in cells that root from melanocytes. Don’t worry if this is a bit vague to grasp. As we continue, the facts will become more clear, especially how to identify it even on pictures.

Rarely, melanoma spreads to the layer of the eye that contains blood vessels. This is known as melanoma of the eye. It develops after the eye has been over-exposed to UV rays. Another rare case is when melanoma on lip occurs.

Malignant melanoma symptoms and signs

A symptom is any indication of a health problem that cannot be seen by an observer. Pain is, for example, a symptom. A sign is, on the other hand, something that is visible to the outside world. A lump is a sign, for example. Malignant melanoma manifests both.

The most common sign is growths on skin that resemble moles. Some people refer to the growths as ugly moles. The growths may originate in skin areas that had no moles before or manifest in form of evolving moles. Since this is the most common symptom, an evaluation system has been developed for self-examination. It is referred to as the ABCDE rule.

So what does it involve? If you are to notice a new growth on your skin or one that has suddenly started evolving, check for the following;

  • A (asymmetry) – normal growth should have two almost equal halves.
  • B (borders) – it is a characteristic of melanoma growths to be irregular at borders. If you closely checked a normal mole, you will notice that it is very smooth at its edges.
  • C (color) – suspicious growths will have multiple colors which can range from black, brown, blue, white or red. Red coloration can arise from bleeding. Pink melanoma can also occur.
  • D (diameter) – normal moles don’t exceed 5mm in diameter. Malignant ones continue to grow indefinitely.
  • E (elevation) – if a spot on your skin manifests any or all the above characteristics and is raised above the skin, it is high time you saw a dermatologist.

It is common for cancer growths to not cause any pain, especially in the initial stages. In fact, the presence of a suspicious lesion or growth may be the only noticeable sign at first.

Malignant melanoma symptoms may include headaches, swollen lymph nodes, lumps elsewhere in the body and fever. These are indications that the cancer has spread.

Malignant melanoma causes

What causes this deadly disease? We have discussed how cancer develops. In this section, let’s look at risk factors:

Direct exposure to sun

When exposed to direct sunlight for a long time, melanocytes tend to migrate and accumulate in some spots. Continued exposure may end up in destruction of the cells’ DNA by harmful UV rays. People who rarely get exposed to sun or are prone to sunburns, such as children, are more vulnerable. Note that exposure to artificial UV rays may have the same effects. It is also possible to get melanoma on body regions rarely exposed to direct sunlight. A good example is melanoma on penis.

Some skin types

More cases have been reported in people with skin types I and II. Slightly higher cases occur in light skinned people compared to dark skinned individuals. Similar results are seen in people with a higher number of moles.

Hereditary factors

If a close member of your family has ever been diagnosed with this type of cancer, there are slightly higher chances that you may also develop the same.

Malignant melanoma stages and prognosis

Malignant melanoma stages can be divided in 5 sections. Medically, there are more classifications and divisions. Prognosis depends on the stage the cancer is in. Below is a generalized outlook of these stages and the survival rate:

  • Stage 0 – characterized by in situ tumors. This is the most treatable stage. Malignant cells have not migrated or invaded any other body part. Survival rate is more than 96%.
  • Stage I – tumors are still in situ. They however have extended roots into the dermis. This is the skin layer that lies just below epidermis. Survival rate is just above 90%.
  • Stage II – at this stage, tumors have gradually gained size to over 1mm in diameter. Survival rate is between 40% and 80%
  • Stage III – cancerous cells have metastasized to the lymphatic system. Survival rate is between 24% and 78%.
  • Stage IV – at this stage, it may even be difficult to tell where the cancer started for sure. This is because it will have invaded other body organs such as lungs or even the brain. Survival rate is very low, between 10% and 15%.

Note that there is a huge allowance in the difference between projected survival rates. This is mainly because there is no accurate way if telling for sure which stage a cancerous tumor is in. Additionally, this is generalized information just meant to drive home the basic idea.

Other than stage, other factors used for prognosis include:

  • Sex – it has been observed that more women survive this type of cancer than men.
  • Thickness of the tumor – tumors that have exceeded 3 mm, measured from top to bottom-most cell, are riskier.
  • Location – logically, you are likely to notice an abnormal skin growth on limbs or face compared to one on the vulva or top of the head.

Malignant melanoma treatment

Malignant melanoma treatment usually follows a therapeutic approach, especially if it has advanced past stage I.


The cancerous tumor can easily be removed the same way you would remove a cyst; that is by making a small incision and removing it. Although it sounds simple in paper, it requires a lot of preparation and expertise. This means that only a qualified doctor should perform the surgery. Luckily, advancements in medicine have allowed for much precision. These days, only a very small skin tissue portion will be removed. Surgical removal alone is an effective melanoma in situ treatment.


Melanoma in lymph nodes or in multiple places cannot be effectively treated through surgery alone. It requires other equally or perhaps more brutal methods such as chemo. Chemotherapy relies on use of toxins that kill fast dividing cells. Rapid division is a common characteristic of cancerous cells. Unfortunately, the toxins have no mechanisms of telling healthy cells from the invasive ones. This is why patients lose their hair after chemo. Some drugs are injected while others are taken orally. The treatment is done in cycles.


This is use of X-rays to kill the invasive cells. X-rays are very high-frequency rays that damage the cell DNA. The treatment requires several appointments, especially for large tumors.


In this case, medications meant to support the immune system are administered. It is a long-term treatment option which is commonly used alongside the above discussed ones. Sophisticated treatments are available in leading centers such as Ocular Melanoma Foundation.


Not many people are able to calmly absorb the shock caused by a positive cancer diagnosis. The bad thing is that diseases tend to cause more havoc in times of stress and depression. This calls for psychotherapy as part of the overall melanoma treatment regime. It is very essential and helpful.

Malignant melanoma prevention guidelines

Although it is partly curable, malignant melanoma should be prevented at all costs. Below are some tips and guidelines on how to prevent it:

Perform self-examination

This is the most reliable self-diagnostic tool you have at your disposal. Start by keeping track of your moles. This can be tedious but definitely worth the effort. Stand in front of the mirror after shower and locate all the moles you have. It will help you catch any new growth or notice sudden changes in an existing one. As seen earlier, catching this skin cancer very early is very important. Use the ABCDE rule. Also, be on the lookout for ulcers or bleeding on moles.

Protect from UV rays

You probably have heard of many applications of UV rays. What you may not have noticed is that not all types of these rays are used. Some are incredibly dangerous especially if exposed for a long time. They not only cause damage to DNA but also encourage mutation. You can minimize the amount of UV rays that land on your skin by not staying too long in direct sun, wearing sunscreens and avoiding artificial sources of these rays.

Check with your doctor

We identified a list of risk factors earlier in this article. If you have any reason to believe that a growth on your skin is not normal, see your dermatologist immediately.


It is estimated that less than fifty individuals in a random group on hundred thousand will have malignant melanoma. This is partly because it is perhaps rarest of all skin cancers.

The earlier melanoma is caught, the higher chances of survival are. Survival rate drops significantly from one stage to another. Take advantage of melanoma images and amelanotic melanoma pictures when doing self-diagnosis.

Most if not all melanoma tumors will resemble a mole in one point of their development. This should not make you worried if you have many moles all over your body. In fact, an adult human can have up to 50 moles that develop by their twentieth birthday. Just be on the lookout for mole-like growths that keep growing, bleed, or don’t obey the ABCDE rule.

Seeking treatment is the best way forward. Although it is one of the most deadly diseases, melanoma can be cured.