What to Know About Mucosal Melanoma

Medically Reviewed by Stephanie S. Gardner, MD on July 24, 2023
4 min read

Skin cancer is the most common type of cancer diagnosed in the United States. Melanoma is the least common type of skin cancer, but it’s the most lethal.  Over 100,000 Americans get melanoma every year. While treatable, melanoma still leads to more than 7,000 deaths in the U.S. each year.

A very small number of people who have melanoma will have a type called mucosal melanoma. Most melanomas appear in places you can see, such as your legs or your neck. Mucosal melanomas occur on your mucus membranes, which are tucked away inside your nose, mouth, anus, and vagina.

Most melanomas are associated with sun exposure. Sun causes damage to cells, which can lead to cancer. Protecting your skin from sun exposure can reduce your risk of most types of melanomas. Unlike those types of skin cancer, mucosal melanoma is not affected by sun exposure. Doctors are not sure what leads to mucosal melanoma.

All melanomas are a form of skin cancer. It affects cells called melanocytes, which give skin its pigment. Typically, melanomas form on the surface of the skin. This is known as cutaneous melanoma. The most common locations for melanoma are the chest, back, legs, neck, and face.

Mucosal melanomas also affect the melanocytes, but they don't form on the skin you can see. Instead, they develop on the mucous membranes inside your body. You can have mucosal melanoma of the mouth, nose, anus, vagina, or, very rarely, in the gastrointestinal tract.

‌‌Mucosal melanoma is far less common than cutaneous melanoma. Fewer than 1% of melanoma diagnoses are mucosal melanomas.

Unlike cutaneous melanomas, mucosal melanomas are hard to diagnose because they are hidden inside your body. The typical skin exams that help locate cancer lesions on visible skin aren't practical for the skin you can't see.

There are symptoms of mucosal melanoma. They vary depending on the location of the cancer.

Head and neck. Almost half of mucosal melanoma cases are in the mouth, nose, or throat. Symptoms include mouth ulcers, unexplained nosebleeds, and a lump in the neck, jaw, or mouth. You may have mouth pain or difficulty talking. You may be able to see lesions inside your mouth.

Anus. Melanoma of the anus may cause bleeding from the anus. You may feel a growth or something protruding from your anus. You may also experience constipation, pain, or discomfort.

Vagina and vulva. Melanoma of the vagina or vulva can lead to unexplained vaginal bleeding. You may be able to feel a mass inside your vagina. You could have visible lesions on your vulva. You might experience pain or discomfort.

Treatment for mucosal melanoma depends on the location of the tumor and whether the cancer has spread to other parts of your body. Surgery is often the first step in treatment. Your doctor will remove as much of the original tumor as possible.

If there is only one melanoma tumor and the cancer hasn't spread, surgery may be the only treatment you need. Cancer that has spread beyond the original site requires more aggressive treatment. There are tests, including blood tests and imaging, such as an MRI, that can help doctors see if the cancer has spread.

If you need treatment in addition to surgery, there are different strategies that doctors may try, including:

Immunotherapy.Immunotherapy drugs stimulate your own immune system to attack cancer cells. Your doctor can tell you if immunotherapy will likely be an effective part of your treatment.

Targeted therapy. Targeted therapy drugs work by attacking only cancer cells. They differ from traditional chemotherapy drugs that affect other cells in the body as well as the cancer cells. Some melanomas respond well to targeted therapy.

Chemotherapy. Traditional chemotherapy can be effective against melanoma. Some chemo regimens can be taken as pills. Other chemotherapy drugs have to be administered intravenously, or through an IV. Chemotherapy can have significant side effects, such as fatigue, nausea, and hair loss. You can talk to your doctor about how to manage these side effects.

Radiation. Radiation therapy uses targeted X-rays to destroy cancer cells. Your doctor may use radiation instead of surgery, depending on the location of a tumor. You may also need radiation after surgery, particularly if there is cancer in your lymph nodes.

If you suspect you have any kind of melanoma, speak with your doctor right away. When melanoma is detected early, the 5-year survival rate is 99%. Melanoma can be treated, but the earlier the cancer is detected, the more effective treatment will be.