A cancerous growth that originates from the pigment-producing skin cells and develops when unrepaired DNA damage to skin cells induces mutations, which results in skin cells turning into malignant and starting to grow out of control. This is melanoma. This malignant growth may resemble a mole. Melanoma causes are not clear, but linked to UV-overexposure. Melanoma symptoms depend on the type and location of the growth. Melanoma treatment options are usually determined by the stage of cancer, its size and overall health of the patient. Below you can find more detailed information about this condition, its symptoms, diagnostic services and melanoma treatment options.
It is the most serious type of skin cancer that develops in the cells of your skin named melanocytes that produce melanin (the pigment that gives your skin colour). This condition can also develop in your eyes and rarely in your internal organs such as your intestines.
The exact cause of melanoma is unclear but the risk of developing the condition is increased from over-exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds. To reduce the risk, limiting UV radiation exposure helps.
There seems to be an increase in the risk of developing melanoma in people under forty, especially women. Being aware of the signs and symptoms of skin cancer can help to make sure cancerous changes are detected and treated before the disease invades the body. Fortunately, this condition can be cured if detected early.
This condition can develop anywhere in your body, mostly in the areas that have the most exposure to sunlight such as your back, legs, arms and face.
It can also occur in areas that do not receive much sunlight such as the soles of your feet, palms of your hands and fingernail beds. They are known as hidden melanomas and are more common in people with darker skin tones.
WHAT ARE THE FIRST SIGNS AND SYMPTOMS OF SKIN CANCER?
- Change in an existing mole
- A new pigmented or unusual looking growth on your skin
It’s not necessary for melanoma to start as a mole. It can occur on normal looking skin as well.
- Normal moles: The characteristics of a normal mole are as follows:
- Uniform colour (tan, brown or black)
- Distinct border
- Oval or round
- Smaller than a quarter inch in diameter (the size of a pencil eraser)
- Normal moles: The characteristics of a normal mole are as follows:
Majority of people have about ten to forty five moles and many of these develop by the age of fifty. Some moles may change in appearance over time. Some may also disappear with age!
- Unusual moles that may indicate melanoma:
To help you remember the characteristics of an unusual mole that may indicate melanoma or other skin cancers, think of the letters ABCDE:
- A is for asymmetrical shape: Moles with irregular shapes such as ones with very different looking halves
- B is for irregular border: Irregular, notched or scalloped borders
- C is for changes in colour: Growths with multiple colours or an uneven distribution of colour
- D is for diameter: New growth in a mole larger than a quarter inch
- E is for evolving: Changes over time such as a growth in size or there is a change in colour and size. It may also develop new signs and symptoms such as itchiness or bleeding
Malignant moles (cancerous) vary greatly in appearance. Some may display all of the signs and symptoms listed above while others may only display one or two unusual characteristics.
- Hidden melanomas: It can also develop in areas of your body that have little or no exposure to sunlight such as the spaces between your toes and your palms, soles, scalp or genitals. This is sometimes referred to as hidden melanomas because they develop in places that are not usually checked when looking for melanoma signs. When people with darker skin tones develop melanoma, they are normally hidden melanomas. Hidden melanomas include:
- Melanoma under a nail: Also known as Acral-lentiginous melanoma is a rare form of melanoma. It occurs under a fingernail or toenail and can also be found on the palms of the hands or the soles of the feet. It is more common in African descents and people with darker skin tones.
- Melanoma in the mouth, digestive tract, urinary tract or vagina: Also known as mucosal melanoma. This type of melanoma develops in the mucous membrane that lines the nose, mouth, oesophagus, anus, urinary tract and vagina. It is especially difficult to identify as they can easily be mistaken for other far more common conditions.
- Melanoma in the eye: Also known as ocular melanoma. It occurs most often in the uvea (the layer beneath the sclera). This type of melanoma may cause vision changes and can be diagnosed during an eye examination.
MELANOMA TREATMENT OPTIONS
The size and stage of your cancer, overall health and personal preferences will determine the best treatment option for you.
- Treating early-stage melanomas: Surgery is required to remove the melanoma in the early stages. During the biopsy, a very thin melanoma may be removed completely and require no further treatment. Your surgeon may also remove a layer of tissue under the skin as well as the border of normal skin if the melanoma is bigger. This may be the only treatment needed for patients with early stage melanoma.
- Treating skin cancer that has spread beyond the skin: When melanoma has spread beyond the skin, the treatment options include:
- Surgery to remove affected lymph nodes: Your surgeon may remove affected lymph nodes if melanoma has spread to those, which are nearby lymph nodes. Additional treatments may also be recommended before or after surgery.
It uses drugs to kill cancer cells and can be given either intravenously or in pill form or both so that it travels throughout your body. It can also be administered in a vein in your arm or leg in a procedure known as isolated limb perfusion. The blood in your arm or leg isn’t allowed to move to other parts of your body for a short period of time during this procedure so that the drugs travel directly to the area around the skin cancer growth and ensure that it doesn’t affect other parts of your body.
High-powered energy beams such as X-rays are used to kill cancer cells. It may be recommended after surgery to remove the lymph nodes. When melanoma has spread to another area of the body, radiation therapy is also sometimes used to help relieve the symptoms.
This therapy boosts your immune system to help your body fight off the cancer. The substances used in these treatments are made of those produced by your body or similar substances produced in a lab. The side effects are similar to the common flu such as chills, fatigue, fever, headache and muscle aches. Biological therapies that are used to treat melanoma include application of interferon and interleukin-2, ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda).
This therapy uses medications that are designed to target specific weak points in cancer cells. The side effects of targeted therapy may vary but they tend to include skin problems, fever, chills and dehydration.
The drugs used in targeted therapy are vemurafenib (Zelboraf), dabrafenib (Tafinlar) and trametinib (Mekinist). They are used to treat advanced skin cancer and are only effective if your cancer cells have a certain genetic error or mutation. The cells from your melanoma can be tested to check whether these medications will benefit you.
History taking and physical examination.Your doctor will ask you questions about your overall health, symptoms you have and family medical history, as those, who have a family history of cancers are assumed to be more predisposed to have the same condition. Then your doctor will perform a physical examination of your body to look for any visible symptoms.
Occasionally, melanoma can be detected simply by looking at the skin. However, the only way to properly diagnose the condition is through a biopsy. During this procedure, a part or all of the suspicious mole or growth is removed and a pathologist will examine the sample to tell if it is cancerous.
- Biopsy: Melanoma can be diagnosed through biopsies. The different types of biopsies include:
- Punch biopsy: Your doctor uses a tool with a circular blade during this procedure. The blade is used to remove a round piece of skin around a suspicious mole.
- Excisional biopsy: The entire mole or growth is removed together with a small border of healthy skin around it during this procedure.
- Incisional biopsy: This procedure involves the removal of only the most irregular part of a mole or growth for lab analysis.
The type of biopsy you will undergo to diagnose skin cancer will depend on your situation. The punch biopsy or excisional biopsy to remove the entire growth whenever possible is preferred by doctors. Incisional biopsy on the other hand may only be used when the other options cannot be easily completed such as in cases where the suspicious mole or growth is very large.