In the United States, it’s estimated that 9,500 people will receive a skin cancer diagnosis each day. Most skin cancer cases can be divided into three main subtypes: basal cell carcinoma, squamous cell carcinoma, and melanoma.
Although melanoma is less common than some other types of skin cancer, it is the deadliest form of skin cancer since it’s much more likely to spread to other parts of the body if it’s not detected and treated early.
The most aggressive form of melanoma is called nodular melanoma. It can spread internally in as little as 3 months. About 15 percent of all cases of melanoma are nodular melanoma.
This article will explain what nodular melanoma is, what causes it, and warning signs to look out for.
All forms of melanoma occur when the melanocytes in your skin reproduce too fast and cause tumors to form. Melanocytes are the cells responsible for giving your skin its color.
In nodular melanoma, a bump, or nodule, will form on your skin. If not detected and treated early, the cancerous cells can spread into your skin and then to other parts of your body.
Nodular melanoma grows faster than other forms of melanoma, making it the most aggressive type of skin cancer.
Most skin cancer screening guidelines tell you to check for the ABCDE symptoms of skin cancer. But there are additional warning signs that can alert you to possible nodular melanoma.
Also, unlike some other types of skin cancer, nodular melanomas typically begin as a new growth, rather than developing within a preexisting mole.
Warning signs to watch out for
- Color. A growth that differs in color from other spots or moles on your body should be checked out. Most nodular melanomas will appear as a blackish-blue, dark brown, or reddish-blue bump. Some nodular melanoma nodules will have no color or will be flesh toned.
- Diameter. Bumps or growths that are more than 6 millimeters in diameter or that continue to grow should get checked out by a doctor.
- Evolving. Change isn’t a good thing when it comes to growths on your skin. Be on the lookout for lesions, moles, or skin growths that change shape, color, or size over time.
- Elevation. As its name suggests, a nodule, or a dome-shaped growth on the skin, is the primary characteristic of nodular melanoma. Increased elevation of a skin bump or spot could be a red flag that something may be wrong.
- Firmness. Moles and birthmarks that rise above the skin are typically limp or give easily when pressed. Nodular melanomas are often very firm to the touch. A growth that feels hard should be evaluated by a doctor.
- Growth. A healthy freckle, spot, or mole will develop and stop growing within a few weeks. New developments that continue to grow after 2 or 3 weeks should be brought to the attention of a doctor.
Nodular melanoma happens when melanocyte cells in your skin mutate and become cancerous. Melanocytes are the cells in your skin that make melanin. This is the pigment that gives your skin its color.
Sometimes, these cells can mutate after exposure to ultraviolet (UV) radiation. The sun is by far the most significant source of UV radiation, but it can also come from other sources, such as lasers and tanning beds.
If you get too much exposure to UV radiation, it can damage the DNA of your skin cells. This can lead to mutations in the DNA, causing the cells to grow out of control.
These mutations can lead to all types of skin cancer, including nodular melanoma. More research needs to be done to determine what causes specific types of skin cancer to form.
Exposure to UV light can cause mutations in skin cells and lead to multiple types of skin cancer. Scientists don’t know exactly why DNA mutations to the melanocyte cells sometimes cause nodular melanoma and not other melanomas.
However, there are some risk factors that may increase the risk of nodular melanoma:
- Sun exposure and the use of tanning beds. Spending a lot of time in the sun and using tanning beds has been linked to a higher risk of nodular melanoma.
- Having very light skin. People of any ethnicity or skin tone can get nodular melanoma, but people with very light skin have a higher risk, especially if the skin gets sunburned easily. The risk increases if you also have light hair (blond or red) and light eyes (blue or green), and your skin freckles easily.
- Age. Nodular melanoma seems to be more common in people over the age of 50.
- Having an immediate family member with nodular melanoma. Your risk of nodular melanoma increases if you have a parent or sibling with the condition.
- Having had another type of skin cancer previously. People who have had any other type of skin cancer in the past are at an increased risk of nodular melanoma.
- Having unusual moles. You may be at a higher risk of nodular melanoma if you have five or more moles that have unusual features.
The most common growth sites for nodular melanoma are the neck, head, and trunk of the body. Unlike some other types of skin cancer, nodular melanomas typically begin as a new growth, rather than developing within a preexisting mole.
It can take as little as 3 months for this type of cancer to spread internally. Nodular melanoma can quickly progress to an advanced stage. Advanced stages of nodular melanoma are more difficult to treat than earlier stages of the disease.
It’s important to see a doctor right away for any moles or skin growths that look unusual or have concerning characteristics. It’s especially important to get medical attention as soon as possible for nodular melanoma due to how quickly it can spread to other parts of your body.
See a doctor immediately if you have a skin bump, growth, mole, or lesion that:
- is larger than most regular moles or spots on your body
- used to be flat but is now elevated or thicker than it used to be
- is dome-shaped or has a firm lump
- is either a single color (black, brown, red, pink or flesh colored) or a mix of colors (e.g., blue-black, brown-red)
- has either a smooth or rough, crusted surface
- has changed in its appearance
- itches or stings
If you’re not sure whether a bump or growth meets these criteria, it’s better to be safe and have it checked out. There is no downside to being cautious and careful when it comes to your health.
To determine whether you have melanoma, a doctor will begin by first asking for details about:
- your exposure to the sun
- any personal or family history of skin cancer
- when you first noticed the growth on your skin
- how or if it has changed in shape, color, size, or elevation
During your visit, your doctor will also carefully examine your skin with a high quality magnifying glass that allows them to get a much more detailed view of the growth on your skin. They will likely also check for enlarged lymph nodes.
The next step may involve a biopsy of the mole or growth. This is the most accurate way to diagnose nodular melanoma.
A biopsy is done by numbing the area around the skin growth and then removing all or part of it. You will be awake during this procedure, which is usually done in your doctor’s office. A sample of the skin tissue will then be sent to a laboratory to test for cancerous cells.
Treatment of nodular melanoma typically involves surgically removing the melanoma and some of the healthy skin surrounding the growth. A doctor may also recommend a lymph node biopsy so they can see if any cancer cells have spread to your lymph nodes.
Melanoma that has spread to lymph nodes or internal organs requires additional treatment to destroy the cancer cells. This may include:
- Immunotherapy. Immunotherapy uses drugs to help your immune system more effectively recognize and fight off cancer cells. Checkpoint inhibitors are the most commonly used immunotherapy drugs for melanoma. These drugs work by unleashing T cells, which are immune cells that target and kill tumors.
- Targeted therapy. Targeted therapy involves the use of drugs that can target and destroy cells that have specific DNA mutations. This can cause cancerous tumors to shrink or to stop growing. Targeted therapy is often used along with other treatment, such as immunotherapy.
- Radiation therapy. Radiation therapy uses concentrated radiation beams to kill cancer cells in specific parts of your body. It is often used after surgery to ensure that all the cancer cells have been destroyed, and to decrease the risk of melanoma returning.
- Chemotherapy. Chemotherapy isn’t used as often as it once was, but it may still be the best treatment for some cases.
Each type of treatment has its own side effects. It’s important to discuss the side effects of these treatments with your doctor so you can make the most informed choice about your treatment.
Nodular melanoma can happen to anyone, but taking certain precautions may help lower your risk of this type of cancer:
- Use sunscreen. Apply a broad spectrum sunscreen with a sun-protective factor (SPF) of 30 or higher whenever you’re outside, even in the winter.
- Reapply sunscreen often. Reapply your sunscreen every 2 hours, especially if you’re swimming or sweating.
- Protect your lips. Protect your lips with SPF lip products.
- Stay out of the sun. Avoid direct sun exposure between 10 a.m. and 4 p.m. every day. Seek shade and protection from the sun when possible.
- Cover your skin. Wear sun-protective clothing, wide-brimmed hats, sunglasses, long-sleeve shirts, and long pants when outside to protect your skin from the sun’s harmful UV rays.
- Avoid tanning beds. Tanning beds and indoor tanning booths are also dangerous sources of UV radiation. It’s best to avoid them.
Nodular melanoma is
According to research, the 5-year survival rate for nodular melanoma is
This is why early detection is extremely important. If you have a concern that you may have melanoma, talk with a doctor as soon as possible. It’s always better to err on the side of caution when it comes to possible signs of cancer.
Nodular melanoma is an aggressive form of skin cancer. It occurs when skin cells called melanocytes are damaged by UV radiation.
Although this type of skin cancer can happen to anyone, it’s more common in lighter-skinned people who’ve had multiple sunburns or a lot of exposure to the sun or tanning beds.
Nodular melanoma most often appears on the neck, head, and trunk, but it can develop anywhere on the body. The main sign of nodular melanoma is a lump or node that rises above the surface of your skin and is firm to the touch. It often grows quickly and changes in appearance as it grows.
If you notice any skin growth that looks unusual or has concerning characteristics, get it checked by a medical professional at your earliest opportunity. The sooner nodular melanoma is diagnosed and treated, the higher the chance of a successful outcome.