Melanoma Survival Rate

What Is Melanoma?

There are different types of cells in the top layer of skin (epidermis), such as squamous cells, basal cells, and melanocytes.

Melanoma, malignant melanoma, or cutaneous melanoma, is a type of skin cancer that begins in melanocytes, the cells of the epidermis that produces the brown pigment melanin. Melanoma is a less common but the most dangerous type of skin cancer. The tumors are black or brown in appearance, but rarely melanomas do not produce any melanin and hence appear as pink, tan, or white.

Melanomas usually develop on the trunk in men and, in women, typically appear on the legs. Melanomas can also develop in areas of the body not exposed to sun or from a long-standing mole. Melanoma is a highly aggressive skin cancer that can spread to other parts of the body. [¹] [²]

Types of Melanoma

There are different types of melanoma, but here we are discussing the most prevalent and important forms of this skin cancer; [³] [⁴]

Superficial Spreading Melanoma

It is the most common form of melanoma and accounts for almost 60-70% of all melanoma cases. It is usually diagnosed in individuals between 30 to 50 years of age.

Superficial spreading melanoma grows along the outer layer of skin, outwards rather than deep into the skin. It is a slow-growing melanoma type which may be brown with black or pink irregular borders.

Nodular Melanoma

Unlike superficial spreading melanoma, nodular melanomas grow downwards into the skin rather quickly. Cancer appears as a nodes or bumps on the skin's surface. Nodular melanomas are the second most common melanoma form.

Lentigo Maligna Melanoma

This is an uncommon form of melanoma, usually diagnosed in people above 60 years of age. Lentigo maligna melanoma is mostly found in body areas exposed to the sun, like the face, arms, legs, and neck. It is slow-growing cancer that first grows outwards and then later invades the deeper layers of the skin.

Amelanotic Melanoma

Amelanotic melanoma is a rare form of melanoma in which there is no melanin formation, and cancer appears as skin-colored or red rather than having its characteristic brown color. The fatality rate of this melanoma is higher than other types since amelanotic melanoma usually remains undiagnosed because of its lack of color.

Acral Lentiginous Melanoma

This is a rare type of melanoma most commonly seen in darker-skinned people (70% of melanoma cases in African Americans and 46% of melanoma cases in Asians). It typically develops on the palms, soles, and under the nail beds.

What Are the Signs and Symptoms of Melanoma?

The ABCDE checklist is commonly used to explain the signs and symptoms of melanoma; [⁵]

A. Asymmetrical

A melanoma differs from a normal mole in that it is asymmetrical, which means that two halves of a cancerous mole are of different shapes and sizes.

B. Border

Melanomas have irregular, jagged, or blurred borders. Normal moles have regular borders.

C. Color

Melanomas have an uneven color, usually containing more than one shade of pink, brown, or black.

D. Diameter

Melanomas are wider than 6mm as compared to normal moles, which are smaller in size.

E. Evolving

If a new or existing mole changes its color, size, and shape, like becoming crusty, growing in size, or bleeding, it can be cancerous.

So if you notice the following signs, you must immediately see your doctor;

• An itching or painful mole
• A mole that is bleeding and becoming crusty
• Formation of an unusual lump on the skin that lasts for more than a few weeks
• Formation of a dark area under the nail bed
• Any of the ABCDE signs described above.

Melanoma Diagnosis and Staging

Early diagnosis of melanoma can ensure better treatment and even a complete cure. Even if a person doesn't possess risk factors for melanoma, they must see a doctor immediately as soon as they notice any abnormalities in their skin texture and moles.

How Is Melanoma Diagnosed?

If someone sees a change in the pattern of normal blemishes, moles, and freckles of their skin, they must conduct a proper skin self-examination and then discuss with a doctor the potential areas of skin that concerns them.

A dermatologist will conduct a specialized skin procedure like dermoscopy or excision biopsy to determine whether a blemish on the skin or mole is cancerous or not.

Regular skin exams are also essential to detect melanoma at an early stage, especially for people who are at a higher risk of developing this type of cancer. A doctor determines how and when an individual should have their skin examined from time to time. [⁶]

Melanoma Staging

Treatment of melanoma depends on the stage of cancer when it is first diagnosed. The TNM staging of melanoma is complex, but doctors are always willing to explain the outlook and survival rate to every patient.

The TNM system describes the melanoma staging as follows;

T: Describes the thickness of the tumor, whether it is ulcerated, and how deep in the skin it has grown.

N: Whether cancer has spread to lymph nodes.

M: Whether cancer has spread to distant organs.

Melanomas are categorized into the following stages;

• Stage 0: In situ
• Stage 1
• Stage 2
• Stage 3 (3A, 3B, 3C, and 3D)
• Stage 4.

The higher the number of melanoma stages, the more cancer has spread. However, every person with melanoma has a different outlook and response to treatment. [⁷]

Is Melanoma Hereditary?

While exposure to UV radiation from the sun is the biggest risk factor for melanoma, there are other factors like family history, having a lot of moles on the skin, lighter skin complexion, etc., that can increase the chances of an individual getting melanoma.

Researchers are now working to find the genetic changes that can lead to the inheritance of melanoma. [⁸]

Familial melanoma is an inherited condition in which melanoma is passed down to families when two or more first-degree relatives have melanoma. Mutations in these two genes, CDKN2A and CDK4, have been linked to familial malignant melanoma. [⁹]

Melanoma Survival Rate

The prognosis for melanoma usually considers two separate metrics: survival rate and quality of life (QOL). Doctors and researchers typically define survival rate in terms of the relative five-year survival rate, which estimates the percentage of patients who are expected to live five years after their diagnosis.

The survival rate for melanoma is highly dependent on the stage of the disease, including the thickness of the tumor, ulceration, and extent of metastasis, as well as on the underlying health status of the patient. In general, melanomas caught at earlier stages (stage 0/in situ, stage 1) have a better outlook.

If cancer has metastasized or ulcerated, treatment is more difficult, but in any case, it is important to maintain hope. It is important to understand that survival statistics represent a larger group of people - they cannot tell an individual patient their survival probability and should not be taken as prescriptive determinations of future outcomes.

What Is the Survival Rate for Melanoma?

According to SEER stat facts, the overall 5-year relative survival rate of melanoma is 93.7%. Approximately 83% of melanoma patients are diagnosed with the disease when it is still in the localized stage, which ensures better survival rates. No two melanoma patients are similar in their disease progression and response to treatment.

Melanoma Survival Rates According to Stage

The prognosis and survival rate of melanoma also depends on its individual stages. The lower the stage of melanoma, the higher the five-year relative survival rate.

Table 1: Five-Year Survival Rates According to Melanoma Stages [10]

The cancer stage at diagnosis determines the length of survival of a patient. If cancer is found in situ or when it is localized (stages 1 and 2), it means that it hasn't spread to distant body parts. In this case, treatment is most effective, the long-term survival of patients is ensured, and cancer can even be cured.

However, if the cancer is found at a later stage, such as stages 3 and 4, when it is spread to nearby regions of the body or distant sites, then survival rates are decreased. [¹¹]

The earlier we catch melanoma, the better chance the chances patient has of surviving five years after diagnosis.

Is Melanoma the Most Common Cancer?

Melanoma is the fifth most common cancer in the USA and represents about 5.2% of new cancer cases. However, the estimated deaths in 2022 due to melanoma of the skin are lesser than any other type of common cancer. New cases of melanoma are more common in White people as compared to other ethnic or racial groups. [¹¹]

The highest rates of new cases of melanoma of the skin were seen in the following people;

• Non-Hispanic White Males; 38.6 per 100,000 Persons.
• Non-Hispanic White Females; 25.5 per 100,000 Persons.

The lowest rates of new cases of melanoma of the skin were seen in the following people;

• Non-Hispanic Black Males; 1.0 per 100,000 Persons.
• Non-Hispanic Black Females; 0.9 per 100,000 Persons.

Melanoma Survival Rates According to Age

The appearance of new cases of melanoma according to age group are as follows; [¹¹]

• The lowest percentage of melanoma cases was shown in people below 20 years of age.
• The highest percentage of melanoma cases were diagnosed in people aged between 65 and 74 years.
• The median age of patients at diagnosis of melanoma of the skin is 65 years of age.
• The lowest percentage of deaths caused by melanoma was shown in people below 20 years of age.
• The highest percentage of deaths caused by melanoma was shown in people between 65 and 74 years of age.
• The median age of patients with the highest number of deaths caused by melanoma was 72.

How Are Melanoma Death Rates Affected by Different Ethnic/Racial Groups?

The deaths caused by melanoma are higher among middle-aged individuals and the elderly. [¹¹]

• The highest number of deaths caused by melanoma were seen in Non-Hispanic White males (3.9 per 100,000 Persons).
• The highest number of deaths caused by melanoma were seen in Non-Hispanic White females (1.7 per 100,000 Persons).
• The lowest number of deaths caused by melanoma was seen in Non-Hispanic Black males (0.3 per 100,000 Persons).
• The lowest number of deaths caused by melanoma was seen in Non-Hispanic Black females and Non-Hispanic Asian females (0.3 per 100,000 Persons).

Survival Rate of Melanoma in Women vs. Survival Rate of Melanoma in Men(1)

Melanoma is more prevalent in men as compared to women. This could be due to the fact that men are more ignorant about skincare and putting on sunscreen. They also spend more time outdoors as compared to women. Those individuals who have a fair complexion or are exposed to artificial lights for long hours, like tanning beds, are also more prone to develop this type of skin cancer. [¹¹]

1 Note that here, we are using the terms "women" and "men" to refer to female and male biological sex at birth, respectively.

Melanoma Treatment Options

Doctors discuss appropriate treatment options with their patients after they determine the stage of their melanoma. Based on this stage and the extent of the disease, along with the risk-to-benefit ratio, the following treatment options are recommended;

• Surgery; Surgery is used to cure early-stage or thin melanomas with procedures like wide excision, amputation, or Mohs surgery.
• Immunotherapy; Immunotherapy with immune checkpoint inhibitors like PD-1 inhibitors, PD-L1 inhibitors, CTLA-4 inhibitors, etc., is possible.
• Targeted Therapy; Drugs that target cells with BRAF gene mutations, or BRAF inhibitors, are used to treat melanomas with gene changes.
• Chemotherapy; Certain chemo drugs and infusions travel to different parts of the body to attack and kill cancer cells.
• Radiation Therapy; Radiation therapy is an alternative to surgery to treat early-stage melanomas.

Clinical Trials for Melanoma

People with melanoma need emotional support and prompt treatment procedure, no matter what stage they are diagnosed at. However, many people choose to stop their treatments if they are no longer treating cancer. Or others choose to obtain no treatment at all because the risks associated with them outweigh the benefits.

Continuing your melanoma treatment or stopping it depends on the choice of the patient, but they can still benefit from supportive care that will alleviate the pain and symptoms associated with melanoma.

Alternatively, clinical trials can help patients find whether there is a new treatment drug or procedure in ongoing research studies that can help treat their cancer. Patients choosing to participate in clinical trials also contribute to cancer research and help future patients have a chance at receiving better treatment for their melanomas.

To find patient-friendly clinical trials within North America, you can visit Power [12] to find new treatments according to the cancer type, location, and promising new drugs.

Conclusion

Takeaway

Most melanomas can be cured if they are found in their earliest stages. So it is essential to become aware of your natural skin's texture, do regular self-skin examinations if you are at a higher risk, and immediately contact your doctor as soon as you notice any abnormalities, lumps, or dark and evolving moles and blemishes on your skin. Remember, early diagnosis means a greater possibility of a cure.