Can a 7-Year-Old Get Melanoma?

It’s technically possible for a young child to get melanoma, but it’s vanishingly rare. Only about 400 cases of melanoma a year affect Americans under 20.

Melanoma is a serious type of skin cancer that develops when melanocytes (the cells that give the skin its pigmentation, or color) grow out of control. Untreated melanoma can spread (metastasize) to internal organs and can be life-threatening. It is less common than other types of skin cancers such as basal or squamous cell skin cancers but can be more deadly.

The average age of patients when melanoma is diagnosed is 65, though it’s one of the most common cancers in young adults (especially young women). 

Melanoma is the most common skin cancer in children, though is it very rare. The National Cancer Institute estimates that about 400 cases of melanoma are diagnosed each year in patients under the age of 20 years in the U.S., which accounts for less than 1% of all new cases of melanoma.

Symptoms of melanoma include changes in skin lesions or moles, or the development of new moles that can be remembered by the ABCDE’s: 

• Asymmetry: Irregularly shaped, each half looks different
• Border: Jagged, uneven, irregular edges
• Color: Mole is several different colors
• Diameter: Size greater than ¼ inch (about the side of an eraser on the end of a pencil)
• Evolution: Changes in size, shape, or color

Other symptoms of melanoma skin lesions include:

• Bleeding 
• Swelling
• Redness
• Crusting
• Itching
• Burning

When melanoma spreads (metastasizes) symptoms may include:

• Feeling unwell (malaise)
• Headaches and seizures (symptoms of spread to the brain) 
• Shortness of breath (symptoms of spread to the lungs)
• Bone pain and fractures (symptoms of spread to the bones)

In some cases, melanoma is caused by acquired genetic mutations, that is, changes to the genes that happen during a person’s lifetime, rather than genetic mutations a person is born with. 

Exposure to ultraviolet (UV) rays from the sun and artificial sources such as tanning beds is a major cause of melanoma. The UV rays damage the skin cells and cause mutations, which lead to cancer. 

Less commonly, people inherit a genetic mutation, that is, the gene is passed on in families, that causes them to develop melanoma. 

Risk factors for developing melanoma include:

• Ultraviolet (UV) exposure from the sun or tanning beds
• Having certain types of moles 
• Having fair skin that freckles or burns easily, light hair, and blue or green eyes
• Family history of melanoma
• Personal history of melanoma or other skin cancers such as basal or squamous cell skin cancers
• Having a compromised immune system, such as people who have HIV/AIDS, are organ transplant recipients, or are receiving certain medical treatments such as chemotherapy
• Older age: the risk increases as people age
• Being male
• Xeroderma pigmentosum (a rare, genetic condition)

A doctor will examine the skin all over the body. If melanoma is suspected, a biopsy will be performed. In a biopsy, a sample of skin from the abnormal lesion is removed. In some cases, the entire abnormal area is removed. This is examined under a microscope to diagnose melanoma. 

Treatment for melanoma usually depends on the stage of the cancer and includes:

• Surgery to remove the cancer
• Chemotherapy
• Radiation therapy
• Immunotherapy 
• Targeted therapy

The staging system most often used for melanoma is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 factors:

• T: The extent of the primary tumor (T)
• N: Has cancer spread to nearby lymph nodes (N)
• M: Has the cancer spread (metastasized – M) to different sites

Following is a full description of melanoma staging:

• Stage 0: The cancer is confined to the outermost skin layer (Tis). It has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). 
• Stage I: The tumor is no more than 2mm thick and might or might not be ulcerated (T1 or T2a). Cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). This stage is also known as melanoma in situ.
• Stage II: The tumor is more than 1 mm thick (T2b or T3) and may be thicker than 4 mm (T4). It might or might not be ulcerated. Cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0).
• Stage IIIA: The tumor is no more than 2 mm thick and might or might not be ulcerated (T1 or T2a). Cancer has spread to 1 to 3 nearby lymph nodes, but it is so small it is only seen under the microscope (N1a or N2a). It has not spread to distant parts of the body (M0).
• Stage IIIB: There is no sign of the primary tumor (T0) AND:
  • Cancer has spread to only one nearby lymph node (N1b) OR 
  • It has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor (without reaching the nearby lymph nodes) (N1c)
  • It has not spread to distant parts of the body (M0). OR
  • The tumor is no more than 4 mm thick and might or might not be ulcerated (T1, T2, or T3a) AND:  
  • Cancer has spread to only one nearby lymph node (N1a or N1b) OR 
  • It has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor (without reaching the nearby lymph nodes) (N1c) OR
  • It has spread to 2 or 3 nearby lymph nodes (N2a or N2b)
  • It has not spread to distant parts of the body (M0).
• Stage IIIC: There is no sign of the primary tumor (T0) AND:
  • Cancer has spread to 2 or more nearby lymph nodes, at least one of which could be seen or felt (N2b or N3b) OR
  • It has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor, and it has reached the nearby lymph nodes (N2c or N3c) OR
  • It has spread to nearby lymph nodes that are clumped together (N3b or N3c)
  • It has not spread to distant parts of the body (M0). OR
  • The tumor is no more than 4 mm thick, and might or might not be ulcerated (T1, T2, or T3a) AND: 
  • Cancer has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor, and it has reached nearby lymph nodes (N2c or N3c) OR
  • Cancer has spread to 4 or more nearby lymph nodes (N3a or N3b), or it has spread to nearby lymph nodes that are clumped together (N3b or N3c) OR
  • It has not spread to distant parts of the body (M0).
  • The tumor is more than 2 mm but no more than 4 mm thick and is ulcerated (T3b) OR it is thicker than 4 mm but is not ulcerated (T4a).
  • Cancer has spread to one or more nearby lymph nodes AND/OR it has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor (N1 or higher).
  • It has not spread to distant parts of the body. OR
  • The tumor is thicker than 4 mm and is ulcerated (T4b) AND: 
  • Cancer has spread to 1 to 3 nearby lymph nodes, which are not clumped together (N1a/b or N2a/b) OR
  • It has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor, and it might (N2c) or might not (N1c) have reached 1 nearby lymph node)
  • It has not spread to distant parts of the body (M0).
• Stage IIID: The tumor is thicker than 4 mm and is ulcerated (T4b) AND: 
  • Cancer has spread to 4 or more nearby lymph nodes (N3a or N3b) OR
  • It has spread to nearby lymph nodes that are clumped together (N3b)
  • It has spread to very small areas of nearby skin (satellite tumors) or to skin lymphatic channels around the tumor, AND it has spread to at least 2 nearby lymph nodes, or to lymph nodes that are clumped together (N3c) OR
  • It has not spread to distant parts of the body (M0).
• Stage IV: The tumor can be any thickness and might or might not be ulcerated (any T).
  • Cancer might or might not have spread to nearby lymph nodes (any N). 
  • It has spread to distant lymph nodes or to organs such as the lungs, liver or brain (M0).

Life expectancy for melanoma depends on the stage of the cancer and whether it has metastasized. Life expectancy is often expressed in 5-year survival rates, that is, how many people are alive 5 years after diagnosis. 

If melanoma is localized, which means it has not spread beyond the initial tumor, the 5-year survival rate is 99%, meaning 99% of people will be alive 5 years following diagnosis. 

Melanoma that is regional, meaning it has spread to nearby structures and lymph nodes has a 65% 5-year survival rate. 

Melanoma that is distant, meaning it has spread to distant parts of the body, such as the lungs, liver, or skin on other parts of the body has a 25% 5-year survival rate.

Melanoma can be prevented by protecting your skin from the sun's ultraviolet (UV) rays. 

• Wear sunscreen at least SPF 50, and reapply every 2 hours or after sweating or swimming
• Avoid the mid-day sun (from 10 a.m. to 4 p.m.)
• Wear sun-protective clothing such as a wide-brimmed hat, long-sleeved shirt, and long pants
• Do not use tanning beds
• If you are in a high-risk group for developing melanoma, get your skin checked by a dermatologist regularly