Melanoma: Symptoms, Causes, Risk factors, Prevention, and Treatment

What is Melanoma?

Melanoma is a deadly type of skin cancer that develops in the melanocytes (cells that produce melanin). Melanin is the pigment responsible for the coloration of the skin. Melanoma can also form in your eyes, but rarely attack internal organs.

Timely or early detection and treatment is vital in fighting melanoma. Knowing the warning signs of skin cancer can help ensure that cancerous changes are detected and treated before the cancer has spread.

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The exact cause of all melanomas is vague, however, exposure to ultraviolet (UV) radiation or tanning lamps and beds increases your risk. To reduce your risk of melanoma, limit your exposure to UV radiation.

Symptoms of Melanoma

Melanomas mostly develop in areas that are exposed to sun, such as arms, face, legs, and back. It can develop anywhere on your body. Melanomas can also occur in areas that don’t receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds. These hidden melanomas are more common in people with darker skin.

The first melanoma signs and symptoms often are:

  • An unusual-looking growth on your skin
  • A change in an existing mole

Melanoma doesn’t always begin as a mole. It can also occur on otherwise normal-appearing skin.

Causes of Melanoma

Melanoma mostly occurs when something goes wrong in the cells that gives color to the skin. This melanin-producing cells are called melanocytes. Normally, skin cells develop in a controlled and orderly way. Healthy new cells push older cells toward your skin’s surface, where they die and eventually fall off.

However, when some cells develop DNA damage, new cells may begin to grow out of control and can eventually form a mass of cancerous cells. It isn’t clear what damages DNA in skin cells leading to melanoma. Though environmental and genetic factors may be responsible for the development of melanoma, but experts believe exposure to ultraviolet (UV) radiation from the sun and from tanning lamps and beds are the main causes.

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Note that not all cases of melanomas are caused by UV light, especially the hidden melanomas that aren’t exposed to sunlight. This shows that other factors may contribute to your risk of developing melanoma.

Distinguishing Normal moles from Unusual Moles

Normal moles: Normal moles are usually a uniform color, such as tan, brown or black with a different edge separating the mole from your surrounding skin. They’re oval or round and usually smaller than 1/4 inch (about 6 millimeters) in diameter. Normal moles may change in look over time, some may even disappear with age.

Unusual moles: The letters ABCDE may help you identify features of unusual moles that may hint to melanomas or other skin cancers:

  • A is for asymmetrical shape.Look for moles with irregular shapes, such as two very different-looking halves.
  • B is for irregular border.Moles have irregular, uneven or jagged borders.
  • C is for changes in color.Moles have many colors or an uneven distribution of color.
  • D is for diameter.New growth in mole is larger than 1/4 inch (about 6 millimeters).
  • E is for evolving.Moles constantly change over time, such as a mole that grows in size, becomes painful, changes color, changes shape, or starts bleeding.

Cancerous (malignant) moles vary greatly in appearance. Some may show all of the changes listed above, while others may have only one or two unusual characteristics.

Hidden melanomas

It is possible for melanomas to develop in areas of your body that have little or no exposure to the sun. Such condition is called hidden melanomas. Examples may include the genitals, scalp, soles, or spaces between your toes and on your palms. People with darker skin are more likely to develop hidden melanomas.

Hidden melanomas include:

  • Acral-lentiginous melanoma: This is a rare form of melanoma that can develop under a fingernail or toenail, palms of the hands or the soles of the feet. It’s more common in blacks and in other people with darker skin pigment.
  • Mucosal melanoma: This type of melanoma develop in the mucous membrane that lines the esophagus, digestive tract, anus, mouth, nose, urinary tract or vagina. Mucosal melanomas are hard to detect because they can easily be mistaken for other far more common conditions.
  • Ocular melanoma: Ocular melanoma develops in the eye. It mostly occurs in the uvea — the layer beneath the white of the eye (sclera). An eye melanoma may cause vision changes.

Risk factors

Factors that may increase your threat of developing melanoma include:

  • Fair skin.Less pigment or melanin in your skin exposes you more to the damaging UV radiation. People with light-colored eyes, blond or red hair, freckle or sunburn easily, are more likely to develop melanoma than someone with a darker complexion. However, melanoma can also develop in Blacks and Hispanics, who are dark-complexioned.
  • Exposure to excessive ultraviolet (UV) light.Exposure to UV radiation, which comes from the sun and from tanning lights and beds, can increase the risk of melanoma.
  • Living closer to the equator.People living closer to the earth’s equator, where the sun’s rays are more direct, are more likely to develop melanoma.
  • Weakened immune system.People with weakened immune systems have an increased risk of melanoma.
  • Having many moles or unusual moles.Having more than 50 ordinary moles on your body or having an unusual type of mole indicates a high risk of developing melanoma.
  • A family history of melanoma.If a close relative has had melanoma, you have a greater chance of also developing melanoma.

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Preventing Melanoma

To prevent or reduce your risk of melanoma and other types of skin cancer, you should:

  • Avoid the sun during the middle of the day.The rays from sun is highest at about 10 a.m. and 4 p.m. for many people in North America. Avoid exposing yourself to sun at its strongest to help avoid the sunburns and suntans that cause skin damage.
  • Avoid tanning lamps and beds.Tanning lamps and beds discharge UV rays and can increase your risk of developing skin cancer.
  • Wear sunscreen year-round.Sunscreens don’t filter out all harmful UV radiation, especially the radiation that can lead to melanoma. However, they play a key role in a general sun protection program. So, ensure you use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours.
  • Wear protective clothing.Cover your skin with dark, tightly woven clothing that covers your arms and legs and a broad-brimmed hat, which provides more protection than a baseball cap. Also, go for sunglasses that block both types of UV radiation.
  • Become familiar with your skin so that you’ll notice changes.Examine your skin regularly for new skin growths or changes in existing moles, freckles, bumps and birthmarks.

Diagnosing Melanoma

  • Skin exams by a trained professional. Your doctor may conduct a head-to-toe inspection of your skin.
  • Skin exams performed at home. This can help you learn the moles, freckles and other skin marks that are normal for you so that you can notice any abnormal changes. To do this, stand in front of a full-length mirror while using a mirror to inspect hidden areas. Ensure you check your fingernails, soles of feet, spaces between your toes, the fronts, backs and sides of your arms and legs, scalp, and groin.

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Some medical organizations recommend periodic skin exams by your doctor and on your own. Others don’t recommend skin cancer screening exams because it’s not clear whether screening saves lives. Finding an unusual mole on your body could lead to a biopsy, and if the mole isn’t cancerous, could lead to unnecessary pain, anxiety and cost.  So, discuss with your doctor about what screening is best for you.

Diagnosing melanoma

Melanoma can at times be detected simply looking at your skin, but the only way to precisely diagnose melanoma is with a biopsy.

Biopsy procedures used to diagnose melanoma include:

  • Punch biopsy.This involves your doctor using a tool with a circular blade which is pressed into the skin around a suspicious mole, and a round piece of skin is removed for testing.
  • Excisional biopsy.This involves removing the entire mole or growth along with a small border of normal-appearing skin.
  • Incisional biopsy.In this procedure, only the most irregular part of a mole or growth is taken for lab examination.

Stages of Melanoma stages

Melanoma is staged using the Roman numerals I through IV. Stage I melanoma is small and has a very successful treatment rate. But the higher the numeral, the lower the chances of a full recovery. At stage IV, the cancer has spread beyond your skin to other organs.

If diagnosis confirms melanoma, your doctor will determine the extent or stage of the melanoma. To allow a stage to your melanoma, your doctor will:

  • Determine the thickness.The thickness of a melanoma is determined by cautiously examining the melanoma under a microscope and measuring it with a micrometer. The thicker the tumor, the more serious the disease.
  • Check if the melanoma has spread.To check whether your melanoma has spread to nearby lymph nodes, a sentinel node biopsy will be performed. This involves your doctor injecting dye in the area where your melanoma was removed. The dye flows to the nearby lymph nodes. The first lymph nodes to take up the dye are removed and tested for cancer cells. If these first lymph nodes (sentinel lymph nodes) are cancer-free, there’s a good chance that the melanoma has not spread beyond the area where it was first discovered.

Note that it is still possible for cancer to recur or spread, even if the sentinel lymph nodes are free of cancer.

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Treatment

Treating melanoma depends on the size and stage of cancer, and your general health.

Treatment for early-stage melanomas

For early-stage melanomas, surgery is usually performed to remove the melanoma. A very thin melanoma may be removed during the biopsy and require no further treatment.

Treatment for melanomas that have spread beyond the skin

If melanoma has spread beyond the skin, treatment options may include:

  • Surgery to remove affected lymph nodes.Surgery will be performed to remove affected lymph nodes if melanoma has spread to nearby nodes. Further treatments before or after surgery also may be recommended.
  • This involves using drugs to destroy cancer cells. Chemotherapy can be given intravenously, in pill form or both so that it travels throughout your body.
  • Radiation therapy.This has to do with using high-powered energy beams like X-rays to kill cancer cells. Radiation treatment may be recommended after surgery to remove the lymph nodes.
  • Targeted therapy.This treatment involves using medications designed to target precise exposures in cancer cells. Some targeted therapy drugs used to treat advanced melanoma includes Vemurafenib (Zelboraf), dabrafenib (Tafinlar) and trametinib (Mekinist). These drugs are only active if your cancer cells have a certain genetic mutation. Cells from your melanoma can be tested to check whether these medications may help you.
  • Biological therapy.This therapy boosts your immune system to help your body combat cancer. These treatments are made of substances produced by the body or similar substances produced in a laboratory. Biological therapies used to treat melanoma include interferon and interleukin-2, ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda).

Sources: medicalnewstoday.com, webmd.com, mayoclinic.org, specialistaustralia.com.au

Disclaimer: The content provided on healthdiary365.com is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.

 

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