What Is Mucosal Melanoma? The Hidden Cancer You Need to Know About

We often hear about skin cancers, but did you know that cancer can also form inside your body where you cannot see it? That is true for a rare and serious type of cancer called mucosal melanoma. While hearing about a rare cancer can feel scary, you do not need to panic. Today, we will talk about this condition in simple terms so you can understand it easily.

When you know the signs to look for, you can talk to your doctor right away if anything feels unusual. Let us explore what mucosal melanoma is, where it can happen, and how doctors diagnose and treat it.

What Is Mucosal Melanoma?

Simply put, mucosal melanoma is a rare form of melanoma cancer. It starts in the mucous membranes of your body. You might wonder what a mucous membrane is. It is the smooth, moist lining that covers the inside of organs and passages in your body, such as inside your nose, mouth, anus, and vagina. Think of it like the soft, moist skin lining your mouth.

Mucosal melanoma can develop in any area of the body that has a mucous membrane. However, doctors most commonly find it in three main areas:

• Head and neck areas: Especially inside the nose, on the lips, and inside the mouth.
• Anorectal region: The area around your anus and inside your back passage where stool leaves your body.
• Vulvovaginal region: The vaginal canal and surrounding external genital areas in women.

This condition usually affects adults who are over 70 years old. Unfortunately, doctors often discover the cancer after it has already spread to other parts of the body, which is called metastasis. Doctors can treat mucosal melanoma with surgery. However, doctors usually work together as a multidisciplinary team to combine different treatments for the best care.

How Common Is It?

No, it is not common at all. In fact, it is very rare. According to the American Cancer Society, thousands of new melanoma cases are diagnosed every year. However, mucosal melanoma accounts for only about 1 percent of all melanoma cases. That means it is extremely uncommon. Knowing this helps you understand why many people have never heard of it before.

What Are the Symptoms?

This is where things can get tricky. Mucosal melanoma symptoms are very easy to miss. The reason is that the cancer grows inside your body in hidden places that you cannot easily check every day, like inside your nose or near your anal area.

Also, these symptoms can look like signs of other, much less serious health problems. Because of this, many people do not realize these changes point to a bigger issue. Your symptoms will depend entirely on where the cancer starts.

Head and Neck Symptoms.

Between 31 percent and 51 percent of all mucosal melanoma cases start in the head and neck region. There are three main types in this area, each with its own symptoms.

Oral Mucosal Melanoma.

This cancer affects the inside of your mouth and lips. Common symptoms include:

• A lump on your tongue that does not heal and keeps getting larger.
• A sore inside your mouth that does not go away.
• Pain in your mouth.
• Bleeding inside your mouth.
• Dentures that no longer fit right if you wear false teeth.

Sinonasal Mucosal Melanoma.

This cancer forms inside your nasal passages and sinuses. Common symptoms include:

• Bleeding from only one side of your nose that keeps happening, known medically as epistaxis.
• Feeling like something is stuck inside your nose, known as nasal obstruction.
• A runny nose that does not stop.
• Pain in your face.

Laryngeal and Pharyngeal Mucosal Melanoma.

This affects your throat and voice box. It is the least common type in the head and neck. Symptoms include:

• Hoarseness or a raspy voice.
• Trouble swallowing food, which doctors call dysphagia.
• Sore throat or throat inflammation, known as pharyngitis.
• A lump or swelling on the outside of your neck.

Anorectal Symptoms.

Anorectal mucosal melanoma develops in your anal canal or rectum. This type accounts for 17 percent to 24 percent of cases. Symptoms include:

• Pain in your rectum or anus.
• A lump or growth in or near your anal area.
• Bleeding from your rectum.
• Constipation or trouble having regular bowel movements.
• Itching around the anal area, called pruritus ani.

Vulvovaginal Symptoms.

Vulvovaginal mucosal melanoma develops on the walls of the vagina and external genital areas in women. About 18 percent of cases belong to this type. Symptoms include:

• Bleeding from your vagina between periods or after menopause, when monthly periods have completely stopped.
• Pain in your vaginal area.
• An unusual discharge from your vagina, which may contain blood.
• A lump or growth in your vaginal or vulvar area.
• Itching in your vaginal area that does not get better with treatment.

What Are the Causes?

To put it simply, medical researchers still do not know the exact cause of mucosal melanoma. Like other types of melanoma, it starts in cells called melanocytes. Melanocytes are the cells that make melanin, the pigment that gives color to your eyes, hair, and skin. Melanin helps protect your skin and eyes from damage caused by sunlight.

Interestingly, these protective melanocytes live inside mucous membranes where sunlight rarely or never reaches. Researchers are still studying why this happens.

However, researchers have found two genetic mutations that can help cause some mucosal melanomas. These are somatic mutations, meaning you are not born with them. Instead, they happen inside your cells during your lifetime. Doctors find mutated KIT genes and BRAF genes in a small percentage of mucosal melanoma patients:

• KIT Gene: KIT genes control how fast certain cells, including melanocytes, grow. Just like BRAF genes, KIT genes make a protein that helps cells grow. When a KIT gene mutates, the protein sends the wrong signals, causing cells to divide and multiply much faster than normal. Studies show that KIT gene mutations happen in 7 percent to 17 percent of all mucosal melanoma cases. They also appear in about 30 percent of vulvovaginal mucosal melanoma cases in women.
• BRAF Gene: BRAF genes manage proteins that control melanocyte cell populations. These proteins get instructions from BRAF genes on how fast cells should divide and multiply. When a BRAF gene mutates, those instructions change. The cells multiply without control and eventually turn into cancer tumors. However, doctors find BRAF mutations in only 3 percent to 15 percent of all mucosal melanoma patients.

Does Sunlight Cause Mucosal Melanoma?

No, it does not. Mucosal melanoma forms in areas that are not exposed to sunlight, such as inside your nose, mouth, or rectum. Therefore, sun exposure is not a direct cause of this cancer.

How Do Doctors Diagnose It?

Doctors use several different tests to diagnose this condition. These tests include:

• Imaging tests like Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) scans. These tests let doctors look inside your body to see tumors, check their size, and see if the cancer has spread.
• Biopsies. A doctor takes a tiny sample of cells or tissue from the suspicious area so pathologists can look at it under a microscope. This confirms if cancer is present and tells doctors what kind it is.
• Genetic tests to check if specific genetic mutations are present.

Cancer Staging.

Doctors use cancer staging systems to plan treatments and determine your prognosis, which is the expected outcome of the disease. In general, early-stage mucosal melanoma means the cancer has not spread beyond the place where it started.

However, this can be complicated. Every type of mucosal melanoma, such as oral, nasal, or anal, has its own specific staging system with very different details. Understanding cancer staging can feel overwhelming. If you do not understand what your doctor tells you or if you feel scared, be sure to ask your doctor for more details.

How Is It Treated?

Because mucosal melanoma is a complex disease, a multidisciplinary team of specialists usually manages your care. This team may include surgical oncology specialists, radiation oncology specialists, and medical oncology specialists. Treatment options include:

• Surgery to remove the tumor and surrounding tissue. Surgery mostly depends on where the tumor is located. Some tumor locations are very challenging to reach with surgery.
• Radiation therapy given after surgery as an adjuvant therapy. This helps destroy any cancer cells that might be left behind.

Medical researchers are also running clinical trials for cancer immunotherapy and targeted therapy for cancer. Clinical trials are studies that test whether new treatments are safe and successful. If you have mucosal melanoma, it is worth asking your doctor if you qualify for one of these clinical trials.

What to Expect Living With This Condition.

Mucosal melanoma is a life-threatening illness. Doctors use surgery and other treatments to remove tumors and get rid of cancer cells. However, mucosal melanoma tumors have a high chance of returning, which doctors call recurring. If you have mucosal melanoma, you might need extra surgeries or other treatments in the future.

Prognosis.

When talking about recovery or survival time, results vary from person to person. However, studies show that overall, the five-year survival rate after a mucosal melanoma diagnosis is about 25 percent. While this number might seem low, remember that it is only a general average.

Survival rates also change based on the specific type of mucosal melanoma:

• Head and neck: Studies generally show that less than 30 percent of people are alive five years after diagnosis, with survival rates ranging from 14 percent to 48 percent.
• Vulvovaginal: About 36 percent of people with this condition live for five years after diagnosis.
• Anorectal: About 20 percent of people with this condition live for five years after diagnosis.

How to Take Care of Your Health.

Mucosal melanoma is a serious condition that can return even after treatment. If the cancer keeps coming back, you might consider palliative care to help manage your symptoms and treatment side effects. Palliative care focuses on improving your quality of life and reducing pain rather than curing the disease.

When to See a Doctor.

Although there are several types of mucosal melanoma, all types can return after treatment. Depending on your situation, your doctor will schedule regular checkups to monitor your overall health and check if the cancer has returned. Attending these appointments without missing them is very important.

Questions to Ask Your Doctor.

Here are some helpful questions you can ask your doctor:

• What specific type of mucosal melanoma do I have?
• What is the stage of my cancer?
• What treatment choices do I have?
• How will the treatments affect me, including side effects?
• What is my prognosis and expected outcome?

Take-Home Message.

We hope this information helps you understand mucosal melanoma better. Remember these key points:

• This is a rare cancer that forms in the moist mucous membranes inside your body.
• Symptoms are easy to miss and can look like normal illnesses. If you have unusual symptoms in your mouth, nose, rectum, or vagina that do not go away, talk to a doctor.
• Doctors often discover this cancer after it has already spread.
• Treatment requires support from a specialized medical team.
• Because the cancer can return, long-term medical monitoring is essential.

We hope this information is useful to you. Staying informed about health conditions helps you take action quickly if you ever need to. Always take good care of your health!