Anatom3D
ENCZDE
Download

Melanoma

Melanoma malignum · Melanom

What it is

Cancer of the skin's pigment cells, driven mostly by sunburn in fair skin; far rarer than the other skin cancers but the cause of most skin-cancer deaths. Found thin it is nearly always cured; diagnoses have risen far faster than deaths, partly from overdiagnosis.

Symptoms & signs

  • New or changing mole (asymmetry, border, colour, diameter, evolution)
  • a mole unlike the others ('ugly duckling')
  • itching, crusting or bleeding mole
  • dark streak under a nail
  • lumps in the nodes

🚩 Get help if…

  • see a doctor soon A mole changing in size, shape or colour
  • see a doctor soon A new mole that looks different from your others
  • see a doctor soon A mole that bleeds, itches or crusts
  • see a doctor soon A dark streak under a nail that is new or widening

Where it strikes

Medical treatment

  • Dermoscopy and excision biopsy
  • Wide local excision trials support
  • sentinel node biopsy for staging
  • Removing all nodes after a positive sentinel node — no survival gain, more lymphoedema (MSLT-II) not confirmed in trials
  • Adjuvant anti-PD-1 (nivolumab, pembrolizumab) after surgery for stage III — fewer relapses; survival benefit less certain trials support
  • Nivolumab + ipilimumab for advanced melanoma — over 40% alive at ten years (CheckMate 067), serious side effects in over half trials support
  • BRAF/MEK inhibitors (dabrafenib + trametinib) for BRAF-mutant melanoma
  • TIL therapy (lifileucel, Amtagvi) after immunotherapy — FDA accelerated approval 2024; treatment-related deaths occurred

Natural & lifestyle

  • SPF 50, hats and shade
  • no sunbeds
  • avoid sunburn, above all in childhood
  • monthly self-checks
  • skin checks if many moles or family history

Emerging & experimental

  • Immunotherapy before surgery for stage III — better event-free survival than after it (NADINA trial, 2024) trials support
  • mRNA-4157 (intismeran) personalised vaccine with pembrolizumab — fewer relapses in a phase 2b trial; phase 3 under way

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Nicotinamide (vitamin B3) — cuts keratinocyte cancers; for melanoma only observational and laboratory data early / small studies
  • Mistletoe injections — popular in German-speaking countries; no convincing melanoma trial anecdotal / traditional
  • Black salve — burns the skin, leaves melanoma to spread not confirmed in trials

ICD codes