It is the second most common kind of melanoma. Even so, nodular melanoma makes up just 14% of all melanomas. However, this type of melanoma is responsible for more than 40% of melanoma deaths. This is due to how fast it can grow.
Learn more about nodular melanoma, causes, symptoms, treatments, and prognosis.
Nodular Melanoma Symptoms
Nodular melanoma most commonly appears on exposed areas of skin like the head and neck but may appear anywhere on the skin.
Visually, nodular melanomas appear as small lumps on the skin that grow rapidly over weeks or months.
The lump may be:
Dome-shapedFirmTypically larger than a centimeter in diameter at the time of diagnosisItchyStingingBlack, white, reddish, or blueish in colorSmoothRoughCrustedWartyBleedingOozing
Notably, nodular melanomas tend to be fast-changing in shape, color, and size. For instance, bumps may go from round to oblong, or reddish to dark brown over a period of two weeks to a month.
Nodular melanoma also does not meet the ABCDE criteria of warning signs of melanoma. These warning signs include:
AsymmetryBorder irregularityColor variation/changeDifferentEvolving
The acronym EFG is used to help identify skin changes that may be indicative of nodular melanoma. These include:
ElevatedFirmGrowing
Causes
Like all melanomas, nodular melanoma is caused by mutations in a form of skin cells called melanocytes. These cells make melanin, which is the pigment that determines skin color.
When melanocytes grow out of control, they form tumors.
What triggers the melanocytes to mutate is unknown, but is believed to be due to changes to DNA.
There are several risk factors for developing nodular melanoma. These include:
Spending time in the sunSpending time in tanning bedsOlder ageAtypical or many molesLarge birthmarksFamily history of melanomaLight complexion
Diagnosis
Because nodular melanoma tends to grow aggressively, it is important to get this type of skin cancer diagnosed early so treatment can begin as soon as possible.
A doctor may use a number of tests to reach a diagnosis of nodular melanoma.
These include:
Dermoscopy. A doctor will use an instrument that both magnifies and illuminates (called a dermatoscope or dermoscope) to exam the skin. This allows the physician to see structures not visible to the naked eye as well as note the size, shape, and color of areas suspected of being nodular melanoma. Skin biopsy. A small piece of tissue from the affected area will be removed and sent to a lab for analysis under a microscope to determine if the lump is cancerous. Excision biopsy. If the lesion is suspected a nodular melanoma, a doctor will numb the area with local anesthesia and use a surgical knife to cut the whole lump or lesion to be sent to the lab for testing.
Once melanoma has been diagnosed a doctor may order additional tests to check if the cancer has spread to other parts of the body. These include:
CT scans X-rays
Treatment
Treatment of nodular melanoma is focused on curing cancer, preserving skin appearance, and stopping cancer from returning.
If found early, nodular melanoma can be cured. However, nodular melanoma can grow quickly and is often diagnosed at an advanced stage. Treatment will most often involve surgery to remove the melanoma.
During surgery, the nodular melanoma, as well as some surrounding areas of skin will be removed.
If cancer is found to have spread to lymph nodes nearby, these will also be removed in surgery.
If the cancer has spread to other organs in the body, other treatments may be necessary. These include:
ChemotherapyRadiationImmunotherapyTargeted therapySurgeryA combination of the above
Prognosis
Nodular melanoma is a fast-growing, aggressive form of skin cancer and because of this, it may not be diagnosed until the cancer is advanced. This may affect treatment and prognosis. It may also mean the cancer can spread to other parts of the body before it is found.
The 5-year survival rate for all forms of melanoma skin cancer varies based on how far the cancer has spread.
The table below shows the 5-year survival rates for melanoma skin cancer at various stages.
The American Cancer Society offers resources and tips for coping with a cancer diagnosis. These include:
Reaching out to family and friends for helpSeeking professional help if feelings of sadness or hopelessness persistStaying activeEating well-balanced mealsDoing things you enjoyNot giving up healthy habitsTalking about your feelingsGetting help with everyday tasks if necessary
Support groups
Joining a support group may be helpful for people dealing with a skin cancer diagnosis. Groups may meet online or in-person and are an opportunity to interact with others in a similar position.
In a support group you may:
Share your fears and concernsLearn how others in a similar situation have copedLearn how to deal with your emotionsLearn how to cope with side effects of treatmentsLearn to cope with family issuesLearn how to handle work or money issues while ill
Support groups can be organized based on the type of cancer, treatments, gender, age, or other factors.
Support groups could be led by:
Oncology social workersPsychologistsOncology nursesCancer survivors
To choose the right support group, you may consider:
Where and when meetings are heldIf the group is online or in-personWho the group is designed forNumber of membersWho leads itWhether the group is educational or supportive basedWhether you have to speak, or whether you can just listen
It may take visiting a few groups to find the best fit.
A Word From Verywell
Nodular melanoma is the second most common form of melanoma. It is a fast-growing, aggressive form of skin cancer. If found early, it can be cured, so it’s important to have any questionable moles, lesions, or bumps checked out by a medical professional. Early diagnosis and treatment will give you the best chance of making a full recovery.
If you are diagnosed with nodular melanoma, remember that treatment options are available and many people live a long, healthy life after their diagnosis.
Treatment often includes surgery and, if the cancer has spread, may require further treatments like chemotherapy. Don’t hesitate to find a support group or counseling, which may be beneficial in navigating the psychological toll of dealing with a cancer diagnosis and treatment.
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