Melanoma is the most serious form of skin cancer, and Florida residents face one of the
highest risks in the country. With more days of intense sun exposure than nearly any
other state, Palm Beach County residents are at elevated risk for developing melanoma
— and knowing the warning signs early can make a significant difference in outcomes.
At Hematology Oncology Associates of The Palm Beaches, our board-certified
oncologists treat patients diagnosed with melanoma and other skin cancers across our
three locations in Lake Worth, Boynton Beach, and Loxahatchee. Understanding how
melanoma develops, how it is detected, and what treatment options are available can
help patients and their families feel more informed and prepared.
What Is Melanoma?
Melanoma is a type of skin cancer that begins in melanocytes — the pigment-producing
cells found in the lower layer of the skin’s outer surface (the epidermis). While
melanoma accounts for only a small percentage of all skin cancer diagnoses, it is
responsible for the majority of skin cancer deaths because of its tendency to grow
quickly and spread to other parts of the body if not detected early.
Unlike basal cell carcinoma and squamous cell carcinoma — the two most common
types of non-melanoma skin cancer — melanoma is more likely to metastasize (spread
to lymph nodes and distant organs). This makes early detection critically important.
According to the American Cancer Society, melanoma is among the most commonly
diagnosed cancers in the United States, with tens of thousands of new cases identified
each year. In Florida, where UV exposure is year-round and intense, the risk is
particularly significant.
Warning Signs of Melanoma: The ABCDEs
One of the most effective tools for identifying suspicious moles or skin lesions is the
ABCDE method, a widely used clinical guideline developed to help both patients and
healthcare providers recognize potential warning signs of melanoma.
A — Asymmetry: A normal mole is typically symmetrical. If you draw a line through the
middle and the two halves do not match, that asymmetry can be a warning sign.
B — Border: Benign moles have smooth, even borders. Melanomas often have
irregular, ragged, notched, or blurred edges.
C — Color: A single, uniform color is typical of a benign mole. Melanomas often contain
multiple shades — varying combinations of brown, tan, black, red, white, or blue within
a single lesion.
D — Diameter: Most benign moles are smaller than 6 millimeters in diameter (about the
size of a pencil eraser). While melanoma can be detected at smaller sizes, lesions
larger than 6mm warrant evaluation.
E — Evolution: Any mole or skin spot that is changing in size, shape, or color — or that
begins to bleed, itch, or crust — should be evaluated by a physician. The “E” for
evolution is often considered the most important criterion because change over time is
one of the most reliable indicators of melanoma.
In addition to the ABCDEs, individuals should watch for the appearance of any new
growth that looks unusual, a sore that does not heal, or a pigmented area that spreads
into the surrounding skin. Melanoma can also develop in areas not typically exposed to
the sun, including the feet, palms, under fingernails, and on mucosal surfaces.
Risk Factors for Melanoma
Anyone can develop melanoma, but certain factors increase the risk. Understanding
your personal risk profile can help guide decisions about sun protection and skin cancer
screenings.
UV exposure: Prolonged or intense exposure to ultraviolet (UV) radiation — from
sunlight or tanning beds — is the most significant risk factor for melanoma. In South
Florida, where the UV index regularly reaches extreme levels, this risk is compounded
by the number of days per year residents spend outdoors.
Fair skin and light features: Individuals with lighter skin, hair, and eyes have less
melanin, the pigment that provides some natural protection against UV damage. This
population faces a higher risk of sunburn and, over time, an elevated risk of melanoma.
History of sunburns: Having five or more blistering sunburns during adolescence
doubles the lifetime risk of melanoma, according to research from the Melanoma
Research Foundation.
Personal or family history: A personal history of melanoma or any form of skin cancer
significantly increases the risk of developing another. Having a first-degree relative
(parent, sibling, or child) who has had melanoma also increases risk.
Many moles or atypical moles: People with more than 50 common moles, or any
atypical (dysplastic) moles, face a higher risk. Dysplastic nevi — moles that are larger
than average with irregular borders — can sometimes progress to melanoma.
Weakened immune system: Individuals with compromised immune systems, whether
from disease or certain medications, face an increased risk of melanoma and other skin
cancers.
Age and gender: While melanoma can occur at any age, risk increases with age. In
younger populations, it is more commonly diagnosed in women; in older adults, it is
more frequently diagnosed in men.
How is Melanoma Diagnosed?
If a physician suspects a lesion may be melanoma, diagnosis is confirmed through a
biopsy — the removal of the suspicious tissue for examination under a microscope.
There are several types of biopsy procedures, and the choice depends on the location
and size of the lesion.
Once melanoma is confirmed, additional testing is typically performed to determine
whether the cancer has spread beyond the skin. This process — called staging — may
involve:
Sentinel lymph node biopsy: To determine if melanoma has spread to the
nearest lymph nodes
Imaging studies: CT scans, PET scans, or MRI to look for spread to distant
organs
Blood tests: To assess overall health and organ function
Molecular and genetic testing: To identify specific mutations in the tumor that
may guide targeted treatment decisions
Stages of Melanoma
Melanoma is classified into stages that describe how far the cancer has progressed.
Staging is an essential step in developing an individualized treatment plan.
Stage 0 (Melanoma in Situ): Abnormal melanocytes are present only in the outermost
layer of the skin and have not invaded deeper tissues. This is the earliest and most
treatable form.
Stage I: The melanoma is thin (generally less than 2 millimeters) and has not spread to
lymph nodes or other areas. Surgery is typically the primary treatment and outcomes
are generally very favorable.
Stage II: The melanoma is thicker or has other characteristics (such as ulceration) that
increase the risk of recurrence, but it has not yet spread to lymph nodes or distant sites.
Surgery and possibly additional therapy may be recommended.
Stage III: Melanoma has spread to one or more nearby lymph nodes or to nearby skin
tissue, but has not spread to distant organs. Treatment at this stage often involves
surgery combined with immunotherapy, targeted therapy, or radiation.
Stage IV: Melanoma has spread to distant lymph nodes or organs, including the lungs,
liver, brain, or bones. While stage IV melanoma is more complex to treat, significant
advances in immunotherapy and targeted therapies have meaningfully improved
outcomes for many patients in recent years.
The stage at diagnosis is the strongest predictor of prognosis. When melanoma is
detected and treated at an early stage, survival rates are high. This is why routine skin
self-examinations and professional skin checks are so important for individuals at
elevated risk.
Treatment Options for Melanoma
Treatment for melanoma is individualized and depends on the stage of the disease, the
location of the tumor, the patient’s overall health, and specific characteristics of the
cancer identified through testing. The oncologists at Hematology Oncology Associates
of The Palm Beaches work with each patient to develop a personalized treatment plan.
Surgery
Surgery is the primary treatment for most early-stage melanomas. The goal is to
remove the tumor along with a margin of healthy surrounding tissue. For stage III
melanoma that has spread to nearby lymph nodes, surgical removal of those lymph
nodes may also be performed.
Immunotherapy
Immunotherapy uses the body’s own immune system to identify and attack cancer cells.
It has transformed the treatment of advanced melanoma and is now a cornerstone of
care for many patients with stage III and stage IV disease.
Several types of immunotherapy are used in melanoma treatment, including immune
checkpoint inhibitors — drugs that remove the “brakes” that cancer cells use to avoid
immune detection. These medications have demonstrated significant improvements in
survival for patients with advanced melanoma.
Targeted Therapy
Approximately half of all melanomas carry a mutation in the BRAF gene, which drives
tumor growth. Targeted therapy drugs — specifically BRAF inhibitors and MEK inhibitors
— work by blocking the effects of this mutation, slowing or stopping the growth of the
cancer.
Before targeted therapy can be prescribed, the tumor is tested to determine whether a
BRAF mutation is present. Patients whose melanoma tests positive for this mutation
may be candidates for targeted therapy, often used in combination with immunotherapy
or as an alternative approach.
Radiation Therapy
Radiation therapy uses high-energy beams to destroy cancer cells. In melanoma,
radiation may be used after surgery to reduce the risk of recurrence in the area where
the cancer was removed, to treat melanoma that has spread to the brain, or to manage
symptoms from metastatic disease.
Clinical Trials
Participation in clinical trials gives eligible patients access to new and emerging
treatments that are being evaluated for safety and effectiveness. Clinical trials may
include novel immunotherapy combinations, new targeted agents, or other
investigational approaches. The team at Hematology Oncology Associates of The Palm
Beaches can discuss whether a clinical trial may be an appropriate option based on a
patient’s specific diagnosis and circumstances. Learn more about clinical trial resources
available through our practice.
Melanoma Prevention and Early Detection in South Florida
Given the year-round sun exposure in Palm Beach County, proactive prevention is one
of the most effective strategies for reducing melanoma risk.
Sun protection habits that reduce risk:
Apply broad-spectrum sunscreen with SPF 30 or higher every day, even on
cloudy days — UV rays penetrate cloud cover
Reapply sunscreen every two hours when outdoors, and more frequently after
swimming or sweating
Wear protective clothing, including wide-brimmed hats and UV-blocking
sunglasses
Seek shade during peak UV hours, typically between 10 a.m. and 4 p.m.
Avoid tanning beds and sun lamps, which emit UV radiation that increases
melanoma risk
Regular self-examination: Performing a monthly full-body skin examination helps you
learn what is normal for your skin so that new or changing spots are easier to notice.
Check all areas of the body, including the scalp, between the toes, soles of the feet, and
under the nails.
Professional skin evaluations: Individuals with risk factors for melanoma — including
a family history, many moles, a history of sunburns, or a prior skin cancer diagnosis —
should discuss the appropriate frequency of professional skin evaluations with their
physician.
When to Seek Evaluation
If you notice any of the ABCDE warning signs described above — or any new growth,
changing mole, or skin abnormality that concerns you — do not wait to have it
evaluated. Melanoma is most treatable when detected early.
A primary care physician or dermatologist can perform an initial skin evaluation and
refer to a specialist if a biopsy is warranted. If melanoma is confirmed, a hematologist or
oncologist will become part of your care team to oversee staging and treatment.
Oncology Care for Melanoma in Palm Beach County
Hematology Oncology Associates of The Palm Beaches has been part of Palm Beach
County for nearly 50 years. Our team of board-certified hematologists and oncologists
provides advanced cancer treatment with individualized attention and compassionate
care across our three convenient locations in Lake Worth, Boynton Beach, and
Loxahatchee.
We treat patients with melanoma and a wide range of other cancers, coordinating care
with dermatologists, surgeons, radiation oncologists, and primary care providers to
ensure each patient receives a cohesive, comprehensive treatment approach.
If you or a family member has received a melanoma diagnosis — or has questions
about skin cancer risk and detection — we encourage you to reach out.
Lake Worth: (561) 965-1864
Boynton Beach: (561) 732-2440
Loxahatchee: (561)793-0106
Frequently Asked Questions About Melanoma
What is the difference between melanoma and other types of skin cancer?
Melanoma begins in the melanocytes, the cells that produce skin pigment. It is less
common than basal cell carcinoma and squamous cell carcinoma but is considerably
more dangerous because it is more likely to spread to lymph nodes and other organs if
not caught early. The other types of skin cancer — often called non-melanoma skin
cancers — are more common and generally more treatable.
What does early melanoma look like? Early melanoma often appears as a new spot
on the skin or a change in an existing mole. Common signs include asymmetry, irregular
or uneven borders, multiple colors within a single spot, a size larger than 6 millimeters,
or any change over time. Some early melanomas are flat and may resemble a bruise or
discoloration rather than a raised bump.
Is melanoma curable if caught early? When melanoma is detected at stage 0 or
stage I — before it has spread beyond the skin — surgical removal often results in
excellent long-term outcomes. The five-year survival rate for stage I melanoma is very
high. This is why early detection through regular skin checks and awareness of the
ABCDE warning signs is so important.
What causes melanoma? UV radiation from sunlight and tanning beds is the primary
cause of melanoma. UV radiation damages the DNA in melanocytes, and over time this
damage can lead to uncontrolled cell growth. Other contributing factors include a
genetic predisposition, a large number of moles, a weakened immune system, and a
personal or family history of skin cancer.
How is melanoma different from a regular mole? A typical benign mole is usually
round or oval, has a smooth border, is a single uniform color (often tan or brown), is
smaller than 6 millimeters, and does not change over time. Melanoma tends to be
asymmetrical, has irregular borders, contains multiple colors, may be larger, and
changes in appearance over weeks or months.
Can melanoma develop on areas of skin not exposed to the sun? Yes. While most
melanomas develop on sun-exposed skin, melanoma can form in areas that receive
little or no sun exposure — including the soles of the feet, palms, under the fingernails,and in mucosal areas. These locations are especially important to check during a full-
body skin self-examination.
What should I do if I am diagnosed with melanoma? A melanoma diagnosis should
be followed by a consultation with a specialist experienced in treating skin cancers.
Depending on the stage, you may need a referral to a surgical oncologist, a medical
oncologist, or a radiation oncologist. At Hematology Oncology Associates of The Palm
Beaches, we work with newly diagnosed patients to explain their diagnosis, review
staging results, and discuss treatment options in detail. Contact us to request an
appointment at any of our Palm Beach County locations.
This article is intended for informational purposes and does not constitute medical
advice. Please consult a qualified healthcare provider for questions related to your
personal health and medical history.
Reviewed by the clinical team at Hematology Oncology Associates of The Palm
Beaches.