Melanoma

What is it?

Melanoma is a skin cancer that starts in melanocytes, the cells that give skin its colour.^1,5 It is more likely than other skin cancers to grow into nearby tissue and spread to other parts of the body.¹ It can also start in moist linings of the body (mucous membranes) or in the eye.¹

The most common cause is ultraviolet (UV) light from the sun and sunbeds.^6,4 It is more common in older people, and it is diagnosed most often at ages 65 to 74, but younger people get it too.^6,5 The risk is higher with pale skin that burns easily, red or blonde hair, blue or green eyes, many moles or freckles, a lot of sunburn, or if you or your family have had skin cancer.⁶ People with black or brown skin get it less often; for them it is most often on the soles, palms or under a nail.⁶

The first signs

The first sign is often a change in a mole. A new mole can be a sign too.^2,7

• has an uneven shape, with two halves that do not match, or ragged edges;^7,2
• has two or more colours, or a black or blue-black area;^7,2
• is larger than usual, often over 6 mm wide;⁷
• changes in size, shape or colour;⁷
• is swollen, sore, itchy, bleeding or crusty.⁷

Melanoma can appear anywhere, but most often on skin that gets a lot of sun.⁷

How doctors find out

Your family doctor looks at the mole, asks about your family, and may photograph it to send to a skin specialist (dermatologist).⁷ The specialist checks your skin, sometimes with a magnifying device, and removes the mole with a small area of skin around it (biopsy) to test it in a lab.⁸

If it is melanoma, you may have CT or MRI scans, tests to see if it has reached the lymph glands, and blood tests.⁸ These show how deep it is and how far it has spread, which guides treatment.^8,1 Results usually take about 2 weeks.⁸ A specialist nurse is your main contact.⁸

Current treatment

Surgery to remove the melanoma with a margin of healthy skin is the main treatment; immunotherapy or targeted medicines are used when it cannot be removed or has spread.Source: NHS

Will it get worse?

Melanoma that has not spread beyond where it started is highly curable. Finding melanoma as early as possible can mean it is easier to treat.^9,7 How it goes depends on how thick the melanoma is and where it is, whether it has broken the skin or bled, whether it has reached the lymph glands or other parts of the body, and your age and general health.¹

Advanced melanoma can be very hard to treat and may not be curable.³ Treatment then aims to hold the cancer back, ease symptoms and help you live longer, and a palliative care team helps with symptoms.³

Medicines: what helps, and what to watch for

Medicines are used when the melanoma cannot be removed with surgery or has spread to the lymph glands or further.³ Immunotherapy helps your immune system attack the cancer.³ Targeted medicines kill cancer cells or slow their growth; a sample of the melanoma is usually tested first for changes in certain genes, to see whether they are likely to work.³ Chemotherapy does not work as well for melanoma as targeted medicines and immunotherapy. It is sometimes used to treat advanced melanoma.³

Good to know:

• Your care team will explain the treatments, benefits and side effects, and work with you to create a treatment plan;³
• You will have regular check-ups during and after treatment, and depending on the stage you may have tests and scans;³

Sun safety and skin checks help too

Staying safe in the sun is the best way to lower the chance of skin cancer.⁶

Surgery, for most people

Surgery is the main treatment, mainly for early melanoma.³ The surgeon removes the melanoma with a margin of healthy skin around it, which lowers the chance of it coming back.³ If it has reached the lymph glands, swollen glands can be removed, and melanoma that has spread elsewhere can sometimes be removed too.³ On the face, a plastic surgeon may operate, and a large wound may be covered with skin from another part of your body (skin graft).³ Radiotherapy can shrink large melanomas and ease symptoms.³

Is there a cure?

Melanoma that has not spread beyond where it started is highly curable. Finding melanoma as early as possible can mean it is easier to treat.^9,7 Advanced melanoma may not be curable, but treatment can help you live longer.³ New treatments, such as vaccines for melanoma that can be removed by surgery, are being tested in clinical trials.¹

Median survival

About 6 years with two immunotherapy medicines, once it is advancedSource: NCI PDQ, 2025

Measured in: Previously untreated patients with unresectable stage III/IV melanoma: CheckMate 067 (945 patients)

Sources

1. NCI PDQ: Melanoma Treatment (PDQ) – Patient Version
2. MedlinePlus: Melanoma
3. NHS: Melanoma skin cancer – Treatment
4. NHS: Melanoma skin cancer – What is melanoma skin cancer?
5. NCI SEER: Cancer Stat Facts: Melanoma of the Skin
6. NHS: Melanoma skin cancer – Causes
7. NHS: Melanoma skin cancer – Symptoms
8. NHS: Melanoma skin cancer – Tests and next steps
9. NCI PDQ: Melanoma Treatment (PDQ) – Health Professional Version