Melanoma

While melanoma is the least common type of skin cancer, it is by far the most virulent. It is the most common form of cancer among young adults age 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for skin pigmentation. That’s why melanomas often present as dark brown or black spots on the skin. Melanomas spread rapidly to internal organs and the lymph system, making them quite dangerous. Early detection is critical for curing this skin cancer.

Melanomas look like moles and often do grow inside existing moles. That’s why it is important for people to conduct regular self-examinations of their skin in order to detect any potential skin cancer early, when it is treatable. Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.

Melanoma is diagnosed via a biopsy. Treatments include surgical removal, radiation therapy or chemotherapy.

What to Look For

The key to detecting skin cancers is to notice changes in your skin. Look for:

  • Large brown spots with darker speckles located anywhere on the body.
  • Dark lesions on the palms of the hands and soles of the feet, fingertips toes, mouth, nose or genitalia.
  • Translucent pearly and dome-shaped growths.
  • Existing moles that begin to grow, itch or bleed.
  • Brown or black streaks under the nails.
  • A sore that repeatedly heals and re-opens.
  • Clusters of slow-growing scaly lesions that are pink or red.

The American Academy of Dermatology has developed the following ABCDE guide for assessing whether or not a mole or other lesion may be becoming cancerous.

Asymmetry: Half the mole does not match the other half in size, shape or color. Border: The edges of moles are irregular, scalloped, or poorly defined. Color: The mole is not the same color throughout. Diameter: The mole is usually greater than 6 millimeters when diagnosed, but may also be smaller. Evolving: A mole or skin lesion that is different from the rest, for changes in size, shape, or color.

If any of these conditions occur, please make an appointment to see one of our dermatologists right away. The doctor may do a biopsy of the mole to determine if it is or isn’t cancerous.

Prevention

Roughly 90% of nonmelanoma cancers are attributable to ultraviolet radiation from the sun. That’s why prevention involves:

  • Staying out of the sun during peak hours (between 10 a.m. and 4 p.m.).
  • Covering up the arms and legs with protective clothing.
  • Wearing a wide-brimmed hat and sunglasses.
  • Using sunscreens year round with a SPF of 15 or greater and sunblocks that work on both UVA and UVB rays. Look for products that use the term “broad spectrum.”
  • Checking your skin monthly and contacting your dermatologist if you notice any changes.
  • Getting regular skin examinations. It is advised that adults over 40 get an annual exam with a dermatologist.

Treatment

  • Simple Excision — The first step in treatment is removal of the primary melanoma tumor, and the standard method of doing this is by surgical excision (cutting it out). Wounds often heal rapidly, usually in a week or two.
  • Mohs Surgery — A small section of apparently normal skin beyond the visible melanoma is removed and looked at under a microscope. If abnormal cells are identified, another small section is removed and this process continues until the cells removed no longer look abnormal.
  • Radiation — This therapy uses high energy rays, like x-rays, to kill cancer cells. Although radiation is not an overly common melanoma treatment option, it is most often used as a symptom-relieving therapy in patients whose melanoma has spread to the brain or bones. In these situations, the radiation would not be expected to cure the melanoma, but it may help to make the patient more comfortable.
  • Chemotherapy — This is a medication-based, systemic therapy to treat many types of cancer, including melanoma, by destroying melanoma cells throughout the body. The success of chemotherapy in the treatment of melanoma has been shown to be limited. New immunotherapies and targeted therapies are producing much better results.
  • Targeted Therapies — Among the most revolutionary treatments for advanced melanoma, targeted therapies use drugs or other substances to identify and attack specific types of cancer cells, or to block the action of certain genes, enzymes, proteins or other molecules that promote the growth and spread of cancer cells.
  • Immunotherapy — Some of the most important recent advances in melanoma treatment are increasingly effective new forms of immunotherapy. Using synthetic, mass-produced versions of natural immune system proteins, or by inhibiting receptors that block the immune system, immunotherapies boost the body’s ability to fight disease. New agents are adding years to many patients’ lives.

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