Melanoma

Last updated date: 18-Oct-2022

Originally Written in English

Melanoma

Melanoma (meaning black tumor) is the most chronic and dangerous form of skin cancer. It develops rapidly and is capable of spreading to any body organ. Since treatment success is directly linked to the depth and size of the cancer development, early diagnosis is critical. 

Melanoma emerges from melanocytes, which are the skin cells. Melanin, which is the black pigment giving the skin its color, comes from these cells. Most melanomas are usually black or brown; however, they may also be pink, purple, red, or skin-colored. Furthermore, melanoma can develop in any part of the body. Melanoma on the trunk is more common in men. Melanoma on the legs and arms is more common in women.

 

Types of Melanoma 

Typically, there are four melanoma types that doctors often diagnose. They include; 

Superficial spreading melanoma This is one of the most widespread forms of melanoma that usually develops on the limbs or trunk. The cells associated with this condition develop gradually at the beginning before they start spreading to the skin surface. 

  • Nodular melanoma 

Nodular melanoma is the second most prevalent form of melanoma that can appear on the head, neck, or trunk. It usually develops faster compared to other types of the disease. In addition, it can seem blue-black or reddish. 

  • Lentigo maligna melanoma 

This type is not usually common but can occur in older people. It can affect any section of the body, especially where it has been exposed to too much sun for many years. The face is more prone to lentigo maligna melanoma

  • Acral lentiginous melanoma

This type of melanoma is very rare. However, when it develops, it usually affects the palms of the hand, beneath the nails, and the soles of the feet. Most people with dark skin don’t usually develop other forms of melanoma. Nonetheless, they are more susceptible to this type o melanoma. 

 

Signs and Symptoms of Melanoma

Melanomas are highly treatable at their early stages. Therefore, learning how to identify one is crucial. Melanomas can occur as moles, open sores, scaly spots, and raised bumps on the skin. They are usually noticed in the regions that often get exposed to the sun, including the legs, back, face, and arms. On the other hand, they can as well develop in the body parts that don’t often get much sunlight, including the melanoma on the foot sole, fingernail beds, and palms of the hands. 

The signs and symptoms that might indicate melanoma include; 

  • A skin sore that does not heal 
  • Skin changes, including the development of a new mole or spot and changes in the shape, size, or color of the existing mole/spot 
  • A sore or a spot that gets itchy, tender, and painful 
  • A lump or spot that appears waxy, shiny, smooth, or pale 
  • A bleeding sore or spot 
  • A red, flat spot that appears scaly, rough, or dry 
  • A red, firm lump that bleeds or appears crusty and ulcerated 

 

ABCDE Examination 

ABCDE Examination 

The ABCDE mole test is a useful tool for detecting possible cancerous lesions. It outlines five basic characteristics to look for in a mole that helps you verify or rule out the presence of melanoma. The examination includes; 

Asymmetric: Refers to benign melanoma moles are usually look symmetrical and round, while cancerous moles are likely to have one side that differs from the other. 

Border:  This is usually irregular instead of smooth; hence it might look ragged, blurred, or notched. 

Color: Melanomas come in a variety of colors and shades, such as black, tan, and brown. They can as well have a blue or white pigmentation.

Diameter: A change in the standard mole size may be a result of melanoma. A mole that grows large than a quarter of an inch in diameter, for instance, might be cancerous.

Evolving: Skin cancer may be detected by a shift in the appearance of a mole for weeks or months.

 

Causes of Melanoma 

Melanoma develops if anything goes wrong within the cells that produce melanin (melanocytes). Skin cells normally grow in a regulated and orderly manner, with healthy new cells pushing out older cells to the surface, where they die and fall off. 

However, if some cells sustain DNA damage, the new cells can proliferate uncontrollably, eventually forming a collection of malignant cells. It's unclear what causes DNA damage to skin cells and how this contributes to melanoma. 

Melanoma is most likely caused by a variety of factors combination such as environmental and genetic factors. Despite this, doctors presume that UV radiation from the sun, as well as tanning lamps and beds, is the most common source of melanoma. 

However, all melanomas do not occur due to UV light, particularly those that develop in areas of your body that aren't exposed to sunlight. This suggests that other factors can play a role in melanoma risk.

 

Risk Factors of Melanoma 

Some of the factors that can increase the chances of developing melanoma are; 

  • Sunburn history 
  • Fair skin or having less melanin in the skin. 
  • Too much exposure to the UV light 
  • Many moles or having the unusual types 
  • Residing near the equator or living in high elevation 
  • Family medical history of the disease 
  • A compromised immune system 

 

Melanoma Diagnosis 

The doctor can perform the following diagnostic tests and procedures if they suspect a melanoma; 

Physical examination: The doctor will inquire about your medical history and thoroughly examine the skin to check for signs of melanoma. 

Biopsy (taking a tissue sample for analysis): The doctor can suggest extracting a sample of skin for evaluation to decide if a suspected skin lesion is melanoma. The obtained sample is taken to a laboratory for this analysis. 

Imaging tests: If necessary, the doctor can use various tests to check and confirm melanomas. Examples of standard imaging tests are computed tomography (CT) scan, chest x-ray, magnetic resonance imaging (MRI), and positron emission tomography (PET) scan. 

 

Melanoma Treatment 

The treatment of melanoma usually depends on factors such as the type, overall health of a person, and the stage. The stages of melanoma include; 

Stage 0: Here, melanoma has only affected the top layer of your skin (the epidermis).

Stage I: Melanoma is at a lower risk primary but no evidence of spreading. Surgery is usually an effective treatment at this point. 

Stage II: Some characteristics suggest a higher probability of recurrence but no apparent evidence of spreading. 

Stage III: Melanoma has metastasized to the surrounding lymph nodes or skin.

Stage IV: Melanoma has metastasized to the distant lymph nodes, the skin, or the internal organs. 

In most cases, early-stage melanoma treatment includes a surgical procedure to take out the melanoma. The doctor can completely remove a thin melanoma during the biopsy; hence further treatment is not necessary. If not, the surgeon will extract cancer, including the healthy skin border and tissue layer under the skin. Typically, this could be the only necessary treatment for patients with early-stage of melanoma. 

In case melanoma has moved beyond your skin, the doctor can recommend treatment options such as; 

The surgical procedure to remove the affected lymph nodes: The surgeon can take out the infected lymph nodes if the melanoma has metastasized to the surrounding lymph nodes. Other treatments may be prescribed before or after surgery. 

Radiation therapy: The doctor can recommend this form of treatment to treat melanoma. It destroys cancer cells using high-powered energy beams, including x-rays or protons. If the melanoma has spread to the lymph nodes, the physician can direct radiation therapy to the area. In addition, melanomas that cannot be completely addressed with surgery can also be treated with radiation therapy. 

Radiation therapy

Immunotherapy: This is a drug treatment that boosts the immune system's ability to combat cancer. Since cancer cells manufacture proteins that enable them to remain invisible from immune system cells, the body's infection-fighting immune system does not target cancer. Therefore, immunotherapy works by messing with the immune system's natural processes. 

Targeted therapy: This treatment targets the basic flaws found in cancer cells. The targeted drugs can make cancer cells die, targeting these flaws. It might be possible to test cells from the melanoma to check if targeted therapy is likely to be successful against cancer.

Chemotherapy: This treatment uses medications to destroy cancerous cells. Chemotherapy may be administered intravenously or in the form of a pill or both. This is to ensure that it reaches every part of the body. Chemotherapy can also be administered through a vein in the arm or leg during a procedure known as isolated limb perfusion. 

 

Conclusion 

Melanoma is a type of aggressive skin cancer that could be dangerous if it spreads to other body parts. On the other hand, detecting the lesion early enough can be the best way of preventing further related problems and complications. The treatment to administer mostly depends on the type and stage of the disease.

In addition, the majority of skin cancers are successfully curable if diagnosed during the early stage before they spread. Nonetheless, melanoma in its advanced stages can be life-threatening. So the sooner skin cancer is detected and removed, the more likely you are to have a complete recovery.