Melanoma

A typical melanoma looks like an irregularly shaped mole. It is usually dark reddish-brown or black in color, and the color is patchy. The size, shape and color can change over time.

Aside from these changes in the skin, melanoma doesn't cause any symptoms at first. People often don’t notice it, or think it's something harmless. Symptoms such as pain or bleeding generally only occur when the melanoma starts growing into the surrounding tissue or spreading to other parts of the body. So melanoma may already have reached an advanced stage by the time it is detected.

Melanoma sometimes develops inside an older mole, but it is often an entirely new skin growth.

There are a number of different factors that can increase your likelihood of developing melanoma. These include exposure to sunlight, certain skin types, your genes and your age.

Around the world, more and more people are being diagnosed with melanomas. In Germany, about 26 out of 100,000 women and 29 out of 100,000 men developed melanomas in 2018. A total of nearly 23,000 people were diagnosed with melanoma in 2018.

There are different types of melanoma, and each progresses in a different way. Some only grow on the surface of the skin for quite a long time and can be removed in a simple procedure. Others grow into deeper layers of skin and surrounding tissue after a shorter amount of time. They 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. Most people with this kind of skin cancer survive it. About 11 out of 100 men and 6 out of 100 women die of melanoma within ten years of it being diagnosed.

Doctors can often tell whether an irregular-looking spot or blemish on the skin could be skin cancer just by looking at it. They can take a closer look at it using a dermatoscope. This instrument is like a strong magnifying glass with a light on it.

If the doctor thinks that someone has melanoma, it is usually removed completely – including some of the skin around the abnormal area. The removed tissue is then examined under a microscope to find out whether it really is melanoma or something else.

If it is thought that the melanoma may have already reached a more advanced stage, other examinations are carried out. For instance, nearby lymph nodes are removed and checked for cancer cells, or they are examined using ultrasound. Other imaging techniques might be used too, such as computed tomography (CT scan) or magnetic resonance imaging (MRI scan). Further laboratory tests may be needed as well.

Skin cancer screening is meant for people who don't have any symptoms. In Germany, statutory health insurers pay for skin cancer screening every two years in people aged 35 and over. The idea is to detect melanoma or other types of skin cancer before they grow deeper into the tissue or spread to other parts of the body (metastasis), with the aim of being able to provide better treatment and increase the chances of a full recovery.

In skin cancer screening, the doctor closely inspects all of your skin, from head to toe. For the examination to be thorough, they should also look at skin folds and mucous membranes.

You can also look out for any changes in your skin yourself, and see a doctor if you notice anything unusual.

There is no surefire way to prevent melanoma skin cancer. It is generally sensible to avoid overexposure to ultraviolet (UV) light. This mainly means not spending too much time in the sun without protection and not using tanning beds.

After melanoma is diagnosed, the first step is usually to try to remove it surgically. In advanced melanoma, the tumor has already grown into deeper layers of skin or metastatic tumors have developed elsewhere.

If surgical removal is no longer possible or not effective enough at that stage, other treatments such as radiation or medication might be used. Different medications are used for different types and stages of melanoma.

You can find information about using tanning beds on the website of the German Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, or BfS).

When people are ill or need medical advice, they usually go to see their family doctor first. In our topic "Health care in Germany" you can read about how to find the right doctor – and our list of questions can help you to prepare for your visit to the doctor.