NCCN Guidelines for Patients
Part 1: About melanoma
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The second layer
of skin that is beneath the
top layer (epidermis)
A spot on the skin
formed by a cluster of
cells that make melanin
(substance that gives skin
1.5 Signs and symptoms of melanoma
Often, the first sign of melanoma skin cancer is a mole or spot on the skin that
looks abnormal. It may be a new mole or an existing mole that has changed
over the past few weeks or months. Finding melanoma before it grows deep in
the skin is important. This is because deeper melanomas are more likely to have
spread to other parts of the body. Treatment is more likely to cure melanoma if it
has not spread.
Skin self-exam: A mole that changes is very important
You should learn about the differences between normal and abnormal moles.
Normal moles have an even tan, brown, or black color. Most normal moles are
less than ¼ inch in size—about the width of a pencil eraser. However, normal
moles may be larger than ¼ inch and some melanomas are smaller than ¼
inch. Normal moles are round or oval and can be either flat or raised. They
stay the same size, shape, and color for many years. Later in life, they often
In contrast, melanoma may cause moles to change size, shape, or color.
Itching, scaling, oozing, bleeding, redness, swelling, and tenderness are also
possible signs of melanoma. The “ABCDE rule” is an easy way to remember
how to tell a normal mole apart from melanoma (Figure 6).
After learning how to notice abnormal moles, you should check your skin on a
regular basis. Use a full-length mirror and a hand-held mirror for areas that are
hard to see. Your partner may be able to help. Inspect all areas of your body.
Remember, change is important. Know your skin so you can tell if there are
any changes. Be sure to show your doctor any spots that have changed or that