We all have moles or other small lumps and bumps that are a different color to the rest of our skin. This is perfectly normal and usually nothing to worry about. It is only rarely skin cancer.
Skin cancer comes in different forms. The main types are (malignant) melanoma, basal cell cancer (BCC) and squamous cell cancer (SCC). Basal cell cancer and squamous cell cancer are sometimes grouped together and referred to as non-melanoma skin cancer. Melanoma, which often looks like a very dark mole, is the most widely known type of skin cancer. This is probably because some types are dangerous and can spread very quickly throughout the body.
Melanoma typically looks like an irregular mole. It is usually a dark or otherwise unusual color, and its size, shape and color can change over time.
Aside from these minor changes, melanoma does not cause any symptoms at first. People often don’t notice it, or think it might be something else, so melanoma may already have reached an advanced stage by the time it is detected.
Some melanomas form inside of an older mole, but they are very often entirely new skin growths.
Causes and risk factors
There are a number of different factors that can increase your likelihood of developing melanoma. These include sun exposure, your skin type and family history.
In recent years, melanomas have been discovered at increasingly higher rates worldwide. In Germany, about 24 out of 100,000 men and 23 out of 100,000 women developed melanomas in 2010. In other words, melanoma was diagnosed in a little over 18,000 men and women in Germany that year.
|Out of 1,000 men of this age …||… this many will develop melanoma within the next 10 years:||… this many will die of melanoma within the next 10 years:|
|35||1||fewer than 1|
|45||2||fewer than 1|
|Out of 1,000 women of this age …||… this many will develop melanoma within 10 years:||… this many will die of melanoma within 10 years:|
|35||2||fewer than 1|
|45||3||fewer than 1|
|55||3||fewer than 1|
|65||4||fewer than 1|
There are different types of melanoma, and each progresses in a different way. Some grow on the surface of the skin for quite a long time and can be removed in a simple procedure. Others are more likely to spread through the bloodstream or lymphatic system and then form metastatic (secondary) tumors in other parts of the body. If left untreated, these kinds can be fatal within a few months.
In Germany, more than half of all melanomas are detected at an early stage. On average, about 15 to 20 out of 100 men who have melanoma and 10 to 15 out of 100 women who have melanoma die within ten years of diagnosis.
Screening is aimed at the largest possible number of apparently healthy people. In Germany, skin cancer screening focuses on people aged 35 and over. The idea is to detect tumors before they can invade other tissue or form metastatic tumors, with the aim of being able to provide better treatment and increase the chances of a full recovery. Screening for melanomas mostly aims to lower the risk of dying from the tumor.
In skin cancer screening, the doctor closely inspects all of your skin, from head to toe. For the examination to be thorough, folds in the skin and mucous membranes need to be checked too. You can also keep an eye out for any skin abnormalities yourself.
Nothing offers 100% protection from melanoma. It is generally a good idea to avoid too much ultraviolet (UV) radiation. This mainly means not spending too much time in the sun without protection and not using tanning beds.
You can find information about using tanning beds on the website of the German Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, or BfS).
Bundesamt für Strahlenschutz (BfS). Hinweise für Solariennutzer. September 19, 2014.
Dellavalle R (Ed. of section 2). Section 2: Skin cancer, moles, and actinic keratosis. In: Williams, H, Bigby M, Herxheimer A, Naldi L, Rzany B, Dellavalle RP et al. (Ed). Edvidence-based dermatology. London: BMJ Books; 2014. S. 223-319.
Deutsche Krebsgesellschaft (DKG), Deutsche Dermatologische Gesellschaft (DDG). Malignes Melanom; Diagnostik, Therapie und Nachsorge. S3-Leitlinie. 01.01.2013. (AWMF Guidelines; Volume 032 - 024OL).
Krebsinformationsdienst (KID). Hautkrebs: Basaliome, Plattenepithelkarzinome, maligne Melanome. February 2013.
Rivers JK. Is there more than one road to melanoma? Lancet 2004; 363(9410): 728-730.
Robert Koch-Institut (RKI), Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (GEKID). Krebs in Deutschland 2009/2010. Berlin: RKI; 2013.
Tumorregister München. Tumorstatistik: Überleben C43: Malignes Melanom. May 13, 2015.
Walter FM, Birt L, Cavers D, Scott S, Emery J et al. 'This isn't what mine looked like': a qualitative study of symptom appraisal and help seeking in people recently diagnosed with melanoma. BMJ Open 2014; 4(7): e005566.
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