Melanoma

Overview

Melanoma is the most serious type of skin cancer that develops in the cells (melanocytes) responsible for producing melanin, the pigment that gives skin its color. It can occur on the skin but can also

Understanding the disease

Symptoms

The symptoms of melanoma can include changes in an existing mole, the development of a new pigmented or unusual-looking growth on your skin, or melanoma occurring in areas that don't receive much sun exposure. Signs and symptoms of eye melanoma may include a sensation of flashes or specks of dust in your vision (floaters), a growing dark spot on the iris, or a change in the shape of the dark circle (pupil) at the center of your eye. When checking moles, remember the acronym "ABCDE" - A for asymmetry, B for border, C for color, D for diameter, and E for evolving. Melanomas can also develop in hidden areas like the palms, soles, and genitals, particularly in individuals with darker skin.

Risk Factors

Risk factors for developing melanoma include having fair skin, a history of sunburn, and excessive exposure to ultraviolet (UV) light from the sun or tanning lamps and beds. Other factors that may contribute to an increased risk of melanoma include having light-colored hair, eyes, and freckles, being under 40 years old, and having certain inherited skin disorders or genetic mutations. It's important to limit your exposure to UV radiation to reduce your risk of developing melanoma.

Development

Melanoma develops when the melanocytes, the cells responsible for producing melanin in the skin, undergo DNA damage. This damage can lead to uncontrolled growth and the formation of cancerous cells. Ultraviolet (UV) radiation from sunlight or tanning lamps and beds is believed to be the leading cause of melanoma. Exposure to excessive UV radiation can damage the DNA in skin cells, increasing the risk of melanoma. The risk of melanoma seems to be increasing in people under 40, especially women. Additionally, some melanomas can develop in areas of the body that have little or no exposure to the sun, such as the spaces between the toes or on the palms, soles, scalp, or genitals. These are known as hidden melanomas and are more likely to occur in people with darker skin.

Assessment and Diagnosis

Triage

If you notice any skin changes that seem unusual, you should make an appointment with your doctor. Early detection of melanoma is important for successful treatment. Even if you're unsure whether a mole or skin change might be melanoma, it's best to have it checked. Your doctor can evaluate the skin changes and advise you on the appropriate course of action.

Diagnosis

To diagnose melanoma, your doctor will typically start with a physical exam, where they will ask questions about your health history and examine your skin for any signs of melanoma. If there are suspicious skin lesions, your doctor may recommend a biopsy to test the tissue for melanoma. The type of biopsy procedure will depend on your situation, with most doctors recommending removing the entire growth when possible. If there's a risk that the melanoma has spread to the lymph nodes, a sentinel node biopsy may be recommended. Imaging tests like X-rays, CT scans, and PET scans may also be used to determine if the cancer has spread beyond the skin. The stage of the melanoma will be determined by examining the thickness of the tumor and whether it has spread to the lymph nodes. For eye melanoma, diagnosis may involve an eye exam, eye ultrasound, or other specialized tests to examine the interior of the eye.

Management and Treatment

Complications

Complications of melanoma can include increasing pressure within the eye (glaucoma), vision loss, eye melanoma spreading beyond the eye, and complications related to the spread of melanoma to other parts of the body such as the liver, lungs, and bones. Vision loss can occur due to large eye melanomas causing retinal detachment or other complications, while small eye melanomas can cause difficulty seeing in the center or on the side of the vision. Advanced melanomas can result in complete vision loss.

Prevention

melanoma can be prevented to some extent by limiting exposure to UV radiation from sunlight and tanning lamps or beds. You can protect yourself from melanoma and other skin cancers by following these prevention measures:

1. Avoid the sun during peak hours: Stay out of the sun during the middle of the day, as UV radiation is strongest between about 10 a.m. and 4 p.m. Schedule outdoor activities for other times of the day, even in winter or when the sky is cloudy.
2. Use sunscreen year-round: Apply a broad-spectrum sunscreen with at least SPF 30, even on cloudy days. Reapply every two hours or more often if you're swimming or sweating.
3. Wear protective clothing: Wear dark, tightly woven clothes that cover your arms and legs, and a wide-brimmed hat that shades your face and ears. Don't forget to wear sunglasses that block both UVA and UVB rays.
4. Stay away from tanning beds: Tanning beds emit UV radiation, which increases the risk of skin cancer. Avoid using tanning beds to minimize your risk of melanoma. By following these prevention measures, you can significantly reduce your risk of developing melanoma.

Home Remedies

It is essential to consult with a healthcare professional for proper diagnosis and treatment of melanoma. Home remedies cannot replace medical advice and treatment, and it is crucial to seek medical attention if you suspect you have melanoma or have any concerns about skin changes.

Treatment

Treatments for melanoma depend on the stage and severity of the cancer. Some common treatment options include:

1. Surgical removal: Melanoma is typically treated with surgery to remove the tumor and surrounding tissue. This may involve a wide local excision, which removes the tumor and some of the surrounding skin, or a sentinel lymph node biopsy, which checks for the spread of cancer to nearby lymph nodes.
2. Radiation therapy: This treatment uses high-energy X-rays or other types of radiation to kill cancer cells. Radiation therapy may be used after surgery to kill any remaining cancer cells or to shrink a tumor before surgery.
3. Immunotherapy: This treatment helps the body's immune system fight cancer. Immunotherapy drugs can help the immune system recognize and attack cancer cells.
4. Targeted therapy: This treatment uses drugs that target specific genes or proteins involved in cancer growth. Targeted therapy may be used to help slow the growth of melanoma or to kill cancer cells.
5. Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It may be used in combination with other treatments or if melanoma has spread to other parts of the body. It's important to consult with a healthcare professional to determine the most appropriate treatment plan based on the individual's specific case and needs.

Preparing for medical consultation

To prepare for an appointment for melanoma, you should:

1. Be aware of any pre-appointment restrictions and ask your doctor about any specific instructions or preparations you need to follow.
2. Write down any symptoms you're experiencing, including any that may seem unrelated to melanoma.
3. Make a list of all medications, vitamins, or supplements you're taking.
4. Bring a family member or friend with you for support and to help remember important details.
5. Prepare a list of questions to ask your doctor, including questions about your diagnosis, the size and depth of the melanoma, and any recommended treatments. By being well-prepared and actively participating in your appointment, you can ensure that you make the most of your time with your doctor and receive the best care for your situation.