Melanoma: Only 20%-30% Of Melanoma Cases Start With Lesions Or Moles On Skin

In October 2023, Claire Turner and her husband, Mark, were taking their family on a weekend vacation. The 43-year-old mother of three, seated in the passenger seat, reached back to give her daughter some breakfast and felt as if she had pulled a muscle.

“I thought, ‘that’s painful’ but then I carried on with the day,” Turner told Kennedy News and Media via The Daily Mail. “It was pretty painful carrying a bag, and that night, it was quite painful to lean back on it.”

Turner’s shoulder was still hurting when they returned home to Didcot, a town in South Oxfordshire, England. So, she sought medical care and was told that she had a torn ligament.

“They gave me painkillers and told me to keep it strapped up and rest it for a couple of weeks and that it should settle down—and it did,” Turner said.

A few weeks later, however, Turner said her shoulder began to swell to the point where she could not carry a bag on her shoulder or wear a bra. She went back to the doctor and was told that “shoulder injuries can take a while to heal.” Turner, however, wanted a second opinion. She was referred to an orthopedic consultant.

She had an MRI and was referred to a cancer clinic. Turner was on pins and needles while waiting for the results.

“I went on a spiral over Christmas,” she told the outlet. “I was awful, and I was expecting the worst. It’s the lowest I’ve felt in the whole journey.”
The diagnosis came back as stage 4 melanoma. Turner said she never had the common signs of skin cancer, such as changed moles or skin lesions. What’s more, “there was no primary [site where the cancer started on my skin],” she said.

The National Library of Medicine reports that “approximately 3.2 percent of all melanomas present in distance sites with no known primary site.” In addition, only 20-30 percent of melanomas are found in existing moles, and 70-80 percent arise on normal-looking skin, according to the Skin Cancer Foundation..

Also, Turner said, “the cancer cells got so deep that they travelled round for months or even years and created other tumors.”

Health authorities say melanoma is the deadliest form of skin cancer, primarily due to its rapid spread to other organs. Although it represents the smallest number of cancer cases, it causes the most skin cancer deaths.

The American Cancer Society estimates that about 100,640 new melanomas will be diagnosed in 2024, while about 8,290 people are expected to die of melanoma skin cancer.

Melanoma typically starts in the epidermis, the top layer of the skin that protects the body from the outside environment. However, skin cancer can develop anywhere in the body. There are three types of skin cancer:

Basil cell skin cancer. This cancer typically develops slowly and is not very likely to spread to other body parts.
Squamous cell skin cancer. This cancer is generally more aggressive than basal cell skin cancer and has a higher potential to spread to other parts of the body if not caught early.
Malignant melanoma. This is considered the most dangerous form of skin cancer because it is more likely to spread to other parts of the body, including vital organs like the brain and liver. Melanoma begins in the melanocytes, the skin cells located in the lowest layer of the epidermis, where new skin cells are generated. Melanocytes make melanin, the pigment that gives skin its color.

What Causes Skin Cancer?

Most cases of skin cancer are caused by overexposure to ultraviolet (UV) radiation from natural sunlight, tanning beds, tanning booths, or sun lamps. Over time, UV rays can harm skin cells, leading to changes in skin texture, premature skin aging, and an increased risk of skin cancer.
The New York State Department of Health reports that some people are at a higher risk of developing skin cancer than others due to several factors, including:

Having a lighter natural skin color.
Having a family history of skin cancer.
Having a personal history of skin cancer.
Excessive exposure to the sun.
Having a history of sunburns, especially early in life.
Having a history of indoor tanning.
Having skin that burns, freckles, reddens easily, or becomes painful in the sun.
Having blue or green eyes.
Having blond or red hair.
Having certain types and a large number of moles.

The risk of melanoma rises with age, but young people can also develop the condition. In fact, melanoma is among the most common cancers in people under 30, particularly younger women. In New York State, melanoma ranks among the top four cancers for adults between the ages of 20 and 34.

How to Prevent Skin Cancer?

To reduce the risk of skin cancer, it’s important to limit exposure to UV rays, which pose a threat year-round. Although clouds may obscure the sun, they do not block UV rays, which can reflect off surfaces such as sand, water, and snow. So, avoiding exposure to direct sunlight, specifically between 10 a.m. and 4 p.m. when the sun’s rays are strongest, is one effective way to lower the risk of skin cancer.

The New York State Department of Health offers several ways to reduce UV ray exposure, including:

Wear a wide-brimmed hat, long-sleeved shirt, and long pants whenever possible.
Wear sunglasses that block both types of UV rays (UVA and UVB). Sunglasses protect the tender skin around the eyes and reduce the risk of cataracts.
Use a sunscreen labeled “broad-spectrum” with a sun protection factor (SPF) rating of 15 or higher. SPF 15 blocks out 93 percent of UV rays, while an SPF 30 blocks out 97 percent of UV rays.
Apply sunscreen to dry skin 15-30 minutes before going outdoors and again after swimming or perspiring. One ounce of sunscreen, enough to fill a shot glass, is considered the amount needed to completely cover the exposed areas of the body.

Once diagnosed, there are different treatments for skin cancer. Turner said she went through immunotherapy treatment. According to the Cleveland Clinic, this type of treatment “may help some people with cancer to live longer” because the treatment “uses your body’s immune system to find and destroy cancerous cells.”

Turner, however, could not continue the treatment because she developed complications with inflammation.

“My nurse said to me that 10 years ago, with my diagnosis, I would be given six to seven months to live. That was quite shocking,” Turner said.

While this may represent an improvement over a decade-old prognosis, Turner is not out of the woods yet.

“The doctor said I had a 50/50 chance of coming out of the other side of this.”

Source Links:

https://people.com/stage-4-melanoma-no-mole-or-lesion-tanning-beds-pulled-muscle-8743021
https://www.skincancer.org/skin-cancer-information/melanoma/
https://www.cancer.org/cancer/types/melanoma-skin-cancer/about/key-statistics.html
https://www.health.ny.gov/diseases/cancer/skin/