Top Videos and Slideshows

How Does Nodular Melanoma Begin?

How Does Nodular Melanoma Begin?

Nodular melanoma is a type of skin cancer. It’s a dangerous form of melanoma that grows very quickly. However, only about 15% of all melanomas are nodular. But, it causes nearly half of melanoma-related deaths. So, it’s very important to know the signs. If it’s found early on, doctors may be able to cure it. In nodular melanoma, malignant melanoma cells proliferate downwards through the skin and this is known as vertical growth. The lesion presents as a nodule that has been rapidly enlarging over the previous weeks or even months. A nodular melanoma can penetrate deeply within the skin within a few months of its first appearance.


You might not notice a nodular melanoma since these cancers don’t really have the usual warning signs of melanomas. You’ve probably heard that you should look out for moles that have:

  • Asymmetry
  • Uneven borders
  • Different colors
  • Spread or become large

But nodular melanomas are different. They don’t fit those guidelines at all. They usually appear as a round black bump. They can be blue, gray, red, or white. And it’s rare, but about 5% of the time, they don’t have an unusual color. Also, the melanoma is often solid in color with even borders.

A nodular melanoma is more likely to spread rapidly and grow more quickly than other types of skin cancer. In most cases it will present as a mole that is larger than most and as a firm symmetrical lump that is dome shaped. It can be either skin colored or red but is most often black. It might look and feel like a wart with a crusty skin, but it can be smooth as well. You could also experience some ulceration or bleeding. Nodular melanoma differs from other melanoma types because it fails to meet the criterion that is often described as the ABCD lists of warning signs (Asymmetry, Border irregularity, Color variation and large Diameter). A nodular melanoma may therefore be ignored for longer than the usual melanomas.

Who Gets It?

Anyone can develop nodular melanoma. But it’s more common in men than women. The disease is most often found in men ages 50 and older. You’re more likely to get the cancer if you have one or more of the following:

  • A family member who has or had skin cancer
  • Pale skin that burns easily
  • More than a few unusual-looking moles
  • Spending lots of time in the sun

How is nodular melanoma treated?

Early stages of melanoma are treated by surgery to remove the melanoma and some of the healthy skin surrounding the melanoma. Your 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 other organs requires other treatment methods, such as:

  • radiation
  • immunotherapy
  • targeted therapy
  • chemotherapy


First, a dermatologist will check your skin. If a spot or bump looks suspicious, you’ll get a biopsy. That’s when the doctor removes some or all of the growth and sends the tissue to a lab for testing. A pathologist will then look at the tissue and cells beneath a microscope to check if it’s nodular melanoma. The pathologist can also measure the melanoma’s thickness, which helps determine the cancer’s “stage at that point.” The thicker the melanoma, the more it has grown into the skin. If the melanoma is more than 1 millimeter thick, you’ll probably get a biopsy of your lymph nodes. This may help doctors find out if the cancer has spread to other parts of your body.

Melanoma becomes more difficult to treat and cure once it has begun to spread internally. If melanoma is found, diagnosed, and treated before it even begins to spread, the 5-year survival rate is 100 percent. It’s important to make an appointment with your doctor for a regular skin cancer screening each year. Truthfully, early detection is the best possible treatment. If you have a concern that you may have skin cancer, talk to your doctor. This cancer is very treatable if caught early. It’s always a good idea to show a doctor any skin abnormalities that you find.