Melanoma (malignant melanoma) is a type of skin cancer where melanocytes grow out of control. Melanocytes are skin cells that produce melanin, a pigment imparting color to one’s hair, skin, and eyes. According to the National Institute of Health (NIH), although rare, melanoma is the third most common skin cancer type in children, commonly affecting teens between 15 and 19 years (1). Generally, melanoma can develop anywhere on the skin (epidermis), but it can also occur in the eye (2). Medically, melanoma is considered the most dangerous skin cancer type because it can rapidly spread to other body parts, including vital organs (3). Hence, timely detection and prompt treatment of melanoma in children are crucial. Keep reading while we tell you about the types, signs and symptoms, possible causes, diagnosis, and treatment of melanoma in children.
Types Of Melanoma
Melanomas are of three different types (2). Identifying the exact melanoma types is crucial to ensure proper testing and treatment of the disease, but this is normally done by a health professional.
Signs And Symptoms Of Melanoma
Most melanomas don’t cause any specific symptoms in the early stages. However, as the disease progresses, signs and symptoms could appear. The most common sign of melanoma is the change in color, shape, size, and feel of a mole. So, parents and caregivers should keep an eye on a mole or growth that (2) (4) (5):
Changes or grows fast Has an odd shape or is large Feels bumpy to touch and sticks out from the surrounding skin Has whitish, yellowish, pink color, or no color Has more than one color Itches, pains, or forms a scab and bleeds Looks like a sore that doesn’t go away
Besides these, the appearance of a dark spot under a toenail/fingernail that’s not caused by an injury or trauma to the nail should also be checked. Do note that most moles aren’t melanoma, and their appearance is often common in children until puberty (4).
Causes Of Melanoma In Children
The precise reason why children develop melanoma is unknown. But, certain risk factors are known to raise a child’s chance of developing melanoma (2).
Family history of melanoma Fair skin, light-colored hair, blue eyes, and freckles Many small moles or several large moles on the skin History of blistering sunburns Chronic or frequent exposure to X-rays Immunodeficiency or immunosuppression History of retinoblastoma (eye cancer type that starts in the retina) Certain congenital conditions, such as xeroderma pigmentosum, Werner syndrome, and melanocytic nevi
Diagnosis Of Melanoma In Children
After collecting the child’s medical history and noting their risk factors, a doctor performs the following tests to diagnose melanoma in children (6).
1. Physical examination
In this test, the doctor examines the mole (or any abnormal spot on the skin) using the ABCDE rule developed by dermatologists. The ABCDE rule checks different features of a mole. If one or more of the features show progression, increase, or change, it could be considered a red flag.
A – Asymmetry
B – Border
C – Color
D – Diameter
E – Evolving
Source: American Academy of Dermatology Association Generally, melanomas in children are almost the same as melanoma in adults. However, doctors follow the ABCDE rule with additional detection criteria in children aged ten years and younger. For instance, melanoma in children usually has one color, which may not be black or brown. Likewise, melanomas tend to be flatter in adults, whereas they often appear like a firm, raised bump in children (5).
2. Biopsy
If a doctor suspects a melanoma, they will remove the affected area and send it to a specialized laboratory to see if the cells are cancerous. In addition, they will also see how deep the cancer cells are in the skin to determine the risk of melanoma spreading.
Treatment For Melanoma In Children
The treatment for melanoma depends on its stage (stage 0, 1, 2, 3, 4). As the stage progresses, the treatment course varies. (2) (6). Early detection and treatment of melanoma raise a child’s five-year survival by more than 90 percent. The survival rate is 70 percent if the melanoma has spread only to the nearby lymph nodes. However, if melanoma spreads to other blood vessels and body parts, the five-year survival rate is 25 percent.
Possible Complications Of Melanoma Treatment
Here’s a brief list of side effects and complications a child may experience due to different methods of melanoma treatment (7).
Localized damage to the healthy surrounding skin Swelling, reddening, or blistering of the skin around the operated area Pain or itching on the operated area Scarring or skin color change after skin removal Secondary infection at the surgery site Bleeding during and after surgery Reaction to medication or drug-drug interactions Recurrence after treatment, especially at a distant site (metastatic melanoma)
Besides these, if a child’s lymph nodes have been removed, they may develop swelling on the neck, arm, or leg due to fluid retention (lymphoedema).
Prevention Of Melanoma In Children
Knowing the risk factors associated with melanoma and keeping a close watch on children may help with a timely detection of the disease. Here’s what you can do (8).
