Melanoma: Early Detection and Immunotherapy Treatment

When melanoma is caught early, your chances of survival are nearly certain. More than 99% of people diagnosed with localized melanoma live at least five years after diagnosis. But if it spreads? That number drops to just 32%. This isn’t a distant threat-it’s a real, ticking clock. Melanoma doesn’t always look like a classic dark mole. It can be a new spot, a changing freckle, or even a scar that won’t heal. The difference between life and death often comes down to one thing: early detection.

How Melanoma Is Found Before It Spreads

For decades, the only tool doctors had was their eyes. A visual exam, sometimes with a handheld magnifier called a dermoscope. But studies show primary care providers miss up to 40% of melanomas this way. That’s why newer tools are changing the game.

One of the most promising advances is AI-powered skin analysis. Systems like SegFusion, developed at Northeastern University, combine image segmentation and deep learning to isolate suspicious skin lesions and analyze them with 99% accuracy. It doesn’t just guess-it shows doctors exactly where the abnormal cells are, using color overlays and heat maps. This isn’t science fiction. It’s already being tested in clinics across the U.S. and Europe.

Then there’s the wearable patch from Wake Forest University. It’s thin, battery-free, and sticks to your skin like a Band-Aid. It measures tiny changes in electrical resistance between healthy tissue and cancerous cells. In early tests with 10 volunteers, it clearly distinguished melanoma from benign moles. Imagine checking your skin at home every week without a doctor’s visit. That’s the goal.

The EU’s iToBoS project takes it further. A full-body scanner that takes six minutes to map every inch of your skin. It doesn’t just take pictures-it uses explainable AI to highlight which spots are most dangerous, then explains why. Dermatologists in pilot programs say it’s like having a second pair of expert eyes. But it’s not perfect. Some systems still flag harmless spots as risky. That’s why specificity matters. A device with 95% sensitivity but only 30% specificity might catch almost all melanomas-but also send half the healthy population for unnecessary biopsies.

The Tools You Can Use Today

You don’t need to wait for a scanner to protect yourself. Here’s what’s already available:

• Dermoscope: Used by dermatologists to see beneath the skin’s surface. It’s not foolproof, but it’s better than the naked eye.
• DermaSensor: An FDA-approved device for primary care doctors. It shines near-infrared light on a mole and measures how it scatters. In trials, it boosted diagnostic confidence by 87% among non-specialists. But its specificity is low-meaning it often says “maybe” when it’s nothing. Still, for clinics without dermatologists, it’s a game-changer.
• Self-checks: The ABCDE rule still works: Asymmetry, Border irregularity, Color variation, Diameter over 6mm, Evolving size or shape. If something changes, get it checked. Don’t wait.

But here’s the catch: most AI tools were trained on light-skinned patients. A 2025 JAMA Dermatology study found these systems perform 12-15% worse on darker skin tones. That’s not a bug-it’s a flaw in the data. If you have brown or black skin, your risk isn’t lower. Melanoma just shows up differently-in places like your palms, soles, or under nails. Be extra vigilant.

What Happens If It’s Already Spread?

If melanoma has moved beyond the skin-into lymph nodes or organs-your treatment options change. Surgery alone won’t cut it. That’s where immunotherapy comes in.

Before 2011, metastatic melanoma meant a death sentence. Median survival? Less than a year. Then came ipilimumab, the first immunotherapy to show real results. It didn’t attack the cancer directly. It woke up your own immune system to do the job.

Today, the standard is combination therapy. Two drugs, often a PD-1 blocker (like pembrolizumab or nivolumab) and a CTLA-4 blocker (like ipilimumab). Together, they can shrink tumors in over half of patients. Some see complete remission. And for a growing number, the cancer never comes back.

Newer drugs are even more promising. Regeneron’s fianlimab, paired with a PD-1 inhibitor, is showing higher response rates in early trials. And IMA203, a cell therapy targeting a protein called PRAME, achieved a 56% complete response rate in a Phase 1b trial. These aren’t lab curiosities-they’re in Phase 3 trials right now, with results expected by 2027.

Immunotherapy isn’t magic. Side effects can be serious-fatigue, rashes, colitis, even thyroid issues. But for many, it’s the only path to long-term survival. And unlike chemotherapy, it doesn’t destroy healthy cells. It teaches your body to recognize and kill cancer cells. That’s why survival curves for melanoma patients on immunotherapy now stretch out for years, not months.

The Real Challenges

Not every clinic has the latest tools. Not every patient can afford them. And not every system works the same way.

AI tools need time to integrate. Dermatology practices report 15-20 hours of training per provider to use full AI platforms. DermaSensor? Just 2-3 hours. But if the device doesn’t plug into your electronic health record? That’s a dealbreaker. Clinics are tired of juggling five different screens just to check one mole.

Then there’s the cost. The global melanoma diagnostics market hit $2.87 billion in 2024-and it’s growing fast. But who pays? In the U.S., insurance reimbursement for AI tools is still patchy. Google Health pulled its AI skin analyzer in late 2024 because insurers wouldn’t cover it. That’s a warning sign: even the best tech can fail if the system doesn’t support it.

And then there’s overdiagnosis. Some experts warn that finding tiny, harmless melanomas that would never harm you might lead to unnecessary surgeries, scars, and anxiety. The goal isn’t to find every mole-it’s to find the ones that matter.

What’s Next?

The future isn’t just about better cameras or smarter algorithms. It’s about combining data.

Imagine a single scan that combines:

• AI imaging of your skin
• Electrical readings from a wearable patch
• Your genetic profile (like HLA-A*02:01 status)
• Your blood pressure, oxygen levels, and even gut microbiome

That’s the direction researchers are heading. Northeastern’s team is already testing if adding patient health records improves accuracy. If it works, we could move from reactive detection to predictive prevention.

By 2030, AI-assisted screening could be standard in every dermatology clinic. But until then, the best tool you have is still you. Know your skin. Check it monthly. Don’t ignore changes. And if you’re told a spot is fine but it keeps bothering you? Get a second opinion.

Melanoma doesn’t care how smart your phone is. It only cares if you notice it early enough.