Understanding Melanoma: Symptoms, Diagnosis, and Treatment

Melanoma is a malignant skin cancer, and early detection of its symptoms is crucial for treatment effectiveness. This cancer typically originates from melanocytes in the skin and may present as a new growth or abnormal changes in existing moles. If not diagnosed early, melanoma can rapidly spread to lymph nodes or internal organs, leading to severe consequences. Therefore, understanding its symptom characteristics is key to prevention and treatment.

The symptoms of melanoma are often related to skin lesions, but the manifestations vary significantly at different stages. Early symptoms may only involve slight changes in moles, while late-stage symptoms may be accompanied by systemic signs. Patients should pay particular attention to any abnormal changes in the shape, color, or size of new growths or existing moles, especially when accompanied by itching, pain, or bleeding, as these warrant increased vigilance.

Early Symptoms and Signs

The early symptoms of melanoma are often mistaken for changes in ordinary moles, so careful observation of their "ABCDE" characteristics is necessary:

• A (Asymmetry): One half of the mole is not symmetrical compared to the other, commonly seen in malignant lesions.
• B (Border): The edges are blurred, irregular, or serrated.
• C (Color): Multiple colors are mixed within a single lesion, such as black, brown, red, or white.
• D (Diameter): The diameter exceeds 6 millimeters or increases rapidly within a short period.
• E (Evolution): There are noticeable changes in shape, color, or size over weeks to months.

Additionally, early lesions may be accompanied by mild symptoms, such as a gritty sensation when touched or scaly protrusions on the surface. Some patients may occasionally feel itching in the affected area, but such symptoms are easily overlooked and should be combined with visual observation.

Common Symptoms

Changes in Skin Surface

The most common symptom of melanoma is a noticeable abnormality on the skin surface. Lesions typically appear in areas exposed to ultraviolet light, such as the extremities, back, or face. Common visual features include:

• The edges of the lesions are irregular and serrated, contrasting with the smooth borders of normal moles.
• The color distribution is uneven, possibly presenting patches of varying shades of black, blue, red, or white.
• The lesion diameter exceeds 6 millimeters or increases rapidly within a short time.

Some cases may present with surface ulceration or bleeding, especially after scratching or friction from external forces. These signs may resemble benign moles or skin inflammation, requiring professional medical evaluation.

Accompanying Physiological Reactions

In addition to visual changes, melanoma may trigger local tissue reactions, including:

• Persistent itching or burning sensation at the lesion site, possibly accompanied by slight swelling.
• A firm feeling upon touch, with clear boundaries from surrounding tissue.
• Formation of non-healing wounds after ulceration, which may ooze tissue fluid or bloody secretions.

These symptoms, while not unique indicators, strongly contrast with the stability of traditional benign moles and should be considered warning signs. Some patients may delay seeking medical attention due to mild symptoms, leading to increased treatment difficulty.

Disease Progression and Symptom Changes

Local Lesion Deterioration

As melanoma enters the progressive stage, lesions may rapidly enlarge and invade surrounding tissues. Symptoms at this stage may include:

• The lesion diameter may double in a short time, with edges becoming more blurred and irregular.
• The area of ulceration expands and repeatedly breaks down, forming a persistent non-healing wound.
• Hard lumps may appear in the surrounding tissue, with significantly increased pain upon pressure.

This stage may be accompanied by local lymphadenopathy, especially near lesions in the limbs, where movable hard lumps may be palpable, indicating that cancer cells may have begun to metastasize.

Symptoms of Distant Metastasis

When melanoma metastasizes to internal organs or distant sites, the symptoms become more complex:

• Lung metastasis may lead to persistent cough, difficulty breathing, or chest pain.
• Brain metastasis may cause headaches, blurred vision, or neurological dysfunction.
• Liver metastasis may result in abdominal swelling, jaundice, or tenderness in the liver area.

Systemic symptoms such as unexplained weight loss, persistent fatigue, or bone pain may indicate widespread metastasis. At this stage, symptoms are often not directly related to the primary site, requiring imaging studies to confirm the metastatic pathways.

When to Seek Medical Attention

Immediate medical attention should be sought when:

• The shape, color, or size of an existing mole changes significantly within weeks.
• Skin lesions are accompanied by persistent itching, pain, or bleeding.
• Lymph nodes surrounding the lesions are swollen and tender to touch.

It is recommended to perform self-skin examinations monthly, using a mirror to check hard-to-see areas. If lesions that meet the "ABCDE" criteria are found, even in the absence of obvious discomfort, early consultation is advised. Early diagnosis can improve the success rate of surgical removal and prevent cancer cells from spreading to deeper tissues or the lymphatic system.

High-risk groups (such as those with multiple sunspots or a family history) should undergo professional skin examinations every 3-6 months. Even if symptoms seem mild, professional visual examination and biopsy are key steps for diagnosis, and one should not self-diagnose as ordinary skin issues, delaying treatment.

 

Frequently Asked Questions

How can one distinguish between the appearance characteristics of ordinary moles and melanoma?

Observation can be done using the "ABCDE" rule: A (Asymmetry) abnormal moles are often asymmetrical; B (Border) edges are irregular or blurred; C (Color) color is uneven and may show multiple color mixes; D (Diameter) a diameter exceeding 6 millimeters requires attention; E (Evolution) shape, size, or color changing rapidly in a short time. If these characteristics are observed, immediate medical examination is necessary.

What should be done immediately upon discovering a suspected melanoma lesion?

Avoid scratching or scraping the lesion and document any changes in size and shape. Seek medical attention promptly for a dermatoscopic examination or biopsy, as early diagnosis can improve treatment success rates. Do not delay diagnosis simply because the lesion is painless.

What care should be taken in daily life after melanoma treatment?

Post-treatment, strict adherence to medical advice for wound cleaning is necessary, avoiding direct sunlight on the surgical site, and regular follow-ups for signs of recurrence. Patients should self-examine their skin daily and avoid chemical tanning products to prevent skin irritation.

What specific recommendations are there for daily sun protection to prevent melanoma?

It is recommended to use broad-spectrum sunscreen with SPF 30 or higher, reapplying every two hours, and to combine with physical barriers (such as wide-brimmed hats and long-sleeved clothing). Avoid strong sun exposure between 10 AM and 4 PM, and seek shade during outdoor activities.

What advanced methods are currently available for treating melanoma?

Currently, in addition to surgical removal, immunotherapy (such as PD-1 inhibitors) and targeted therapy (aimed at genetic mutations) are used to delay progression. Early-stage patients with localized lesions may undergo Mohs surgery for precise removal; late-stage metastatic patients may combine chemotherapy and immunotherapy to enhance survival rates.