We are all at risk for melanoma. However, some people are more at risk than others. Heredity plays a major role. If your mother, father, siblings, or children (first-degree relatives) have had a melanoma, you are part of a melanoma-prone family. Each person with a first-degree relative diagnosed with melanoma has a 50 percent greater chance of developing the disease than members of the general public who do not have a family history of the disease. If the cancer occurred in a grandmother, grandfather, aunt, uncle, niece, or nephew (second-degree relatives), there is still an increase in risk compared to the general population, though it is not as great.

About one of every ten patients diagnosed with the disease has a family member with a history of melanoma. If melanoma is present in your family, you can protect yourself and your children by being particularly vigilant in watching for the early warning signs and finding the cancer when it is easiest to treat.

Close Relatives Examined

When this skin cancer is diagnosed, it is standard practice for physicians to recommend that close relatives be examined immediately for melanoma and for the presence of unusual or atypical moles. These moles are also called "dysplastic nevi." You can read more about atypical moles here.

Family Syndrome

When atypical moles are found in an individual belonging to a melanoma family, the condition is known as FAMMM, standing for Familial Atypical Multiple Mole Melanoma Syndrome. People with this syndrome are at the greatest risk of developing melanoma. In contrast, a research study found that those family members who did not have atypical moles were much less likely to develop melanoma.

Genetic Risk Factors

A mutation (alteration) in a recently discovered gene, the BRAF, may play a part in causing melanoma. In one study, this mutated gene was found in two-thirds of the melanoma cells analyzed. BRAF is called a "switch" gene, because it turns on to allow the cells to grow and divide. Mutations in this gene can lead to uncontrolled cell growth and cancer. The discovery is an exciting research breakthrough, but physicians and patients are still years away from reaping the rewards. Ultimately, the understanding of the BRAF gene could lead to the development of diagnostic tools and drug therapies. The mutations most commonly seen in familial melanoma occur in another gene, p53. When this gene is in its normal state, its main function is to give damaged cells time to repair themselves and not progress to cancer. However, when the gene is altered, it becomes unable to perform this function, and cancer can result. A number of gene mutations in addition to p53 and BRAF have been associated with familial melanoma. In the future, families might be screened so as to identify those members who are carrying a defective gene.

Moles in an Active Stage

Moles in people belonging to melanoma-prone families are subject to change at certain times of life. They may get larger or show alterations in color or elevation, so for those periods, they are described as being active. While the reasons for these changes are not fully known, there could be a hormonal component: Moles are more active at puberty and during pregnancy. Many — but not all — physicians advise high-risk individuals not to take hormonal medications, such as oral contraceptives or hormone replacement therapy.

Examination Scheduling

Individuals with the Atypical Mole Syndrome can improve their chances of early detection by increasing the frequency of skin self-examination and by visiting a physician more often. The clinician may take photographs to document whether there are new moles or changes in older ones.

Children: A Special Case

Children in melanoma-prone families need special care, because familial melanoma is likely to make its appearance early in life. Even though these cancers usually do not appear until after adolescence, they may arise in much younger children who have a family history of melanoma. Most physicians, therefore, advise parents to make a point of studying a child's skin frequently from infancy on.

Physician examination should start at the age of ten and continue on a twice-a-year basis thereafter. Particular care should be taken at puberty and during adolescence when hormonal changes activate the moles. Here is some encouraging news: Because melanoma families are on the lookout for the disease and seek professional consultation early, the survival rate for familial melanoma is even higher than that for non-familial melanomas.