We Know: The Facts About Melanoma


What is melanoma?
Melanoma, or malignant melanoma, is the deadliest form of skin cancers, comprising 4% of all skin cancers. It is brown or black in color and occurs on the trunks predominantly in people with fair skin or red hair. It is curable when detected in its early stages. Melanocytes, located in the epidermal layer of skin, produce pigments that protect deeper skin layers from the sun's rays. Melanoma results when abnormal melanocytes proliferate.

What causes melanoma?
The primary cause of melanoma is overexposure to ultraviolet (UV) radiation from the sun, tanning lamps or tanning booths. Other causes of melanoma include:

  • Mutations or loss of tumor suppressor genes
  • Age - older people are more likely to get this type of skin cancer, although it has been found in younger individuals.
  • Number and size of moles on your body
  • Fair skin and red hair
  • Family history of melanoma

How is melanoma diagnosed?
It certainly helps to understand the pattern of moles, freckles, and marks on your body. Conduct self checks monthly to determine if any abnormal moles appear. How do you know if a mole is abnormal? Experts suggest that you follow the ABCDE rule to assess for the following changes:
  • A = asymmetry
  • B = border irregularity
  • C = color
  • D = diameter
  • E = evolution
If you suspect melanoma, have a dermatologist check out the particular mole. A doctor will perform a biopsy under anesthesia. The types of biopsies are:
  • Punch biopsy - takes a small piece of skin (to the subcutaneous layer) from the suspected mole using a scooping tool
  • Excisional biopsy - a doctor cuts through skin and removes a wedge of skin from the suspected mole using a surgical knife. when the whole tumor is removed, the process is known as excisional; if only part of the tumor is removed, the process is known as incisional
  • Shave biopsy - shaves off the top layers of the epidermis
  • Lactate dehydrogenase (LDH) is used to determine whether the melanoma has spread
For melanomas that have metastasized, the treatment modalities that are available include:
  • Fine needle aspiration biopsy (FNA)
  • surgical lymph node biopsy
  • X-rays
  • Sentinel node biopsy
  • CT scan
  • PET scan
  • CT scans

If I have melanoma, how serious is it?
Melanoma staging reveals the depth and degree of metastasis of the melanoma. The staging scale ranges from 0 to 4. The higher the stage, the more likely the spread of the melanoma. Staging is split into clinical staging from physical exams, biopsies, X-rays, and CT scans, and pathological staging, derived from an examination of the biopsies taken from the lymph nodes.

In a Breslow measurement, skin samples are taken to determine how deep beneath the epidermis the melanoma has spread.. If the melanoma is less than 1/25 inches in depth, then there is little chance that the cancer has spread. The thicker the skin sample, the more likely the spread of disease.

How is melanoma treated?
Treatment modalities depend on the depth of the melanoma in the epidermis. Different types of treatments are available, depending on the stage of the melanoma.

Surgery is normally used to remove melanomas that have not spread all over the body. The types of surgery include:
  • Simple excision for thin skin melanomas
  • Re-excision for melanomas confirmed by biopsies, and for which more skin needs to be removed
  • Amputation may be necessary if the melanoma is found on the fingers or toes
  • Lymph node dissection may be needed to ascertain whether the sentinel nodes or closest lymph nodes to the melanoma site has any signs of cancer. If cancer is found, it may be necessary to remove the lymph node.
The other modes of treatment include:
  • Chemotherapy - for Stage IV melanoma
  • Radiation therapy
  • Immunotherapy

How can I prevent melanoma?
Avoiding exposure to the sun and its ultraviolet radiation decreases your risk on developing melanoma. Wear protective clothing and use sunscreen and lip balm with SPF 15 or greater. Using sunglasses with 99% UV absorption helps protect your eyes, another source of melanocytes. You also want to check your body for any suspicious or abnormally colored moles.

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