Melanoma

May 4, 2020

4 min read

Melanoma is a skin cancer developing when cells known as melanocytes begin growing out of control. These are the cells providing skin with brown color. Because melanomas can spread to various organs in the body, it can prove fatal. When detected early, melanomas are curable.

Many people can avoid melanoma by staying out of the sun in the heat of the day, always wearing sunscreen when outdoors, and not using tanning beds or lights. Wear hats, long-sleeved shirts, and other protective clothing when in the sun. Stay in the shade as much as possible.

Do a monthly inspection of your moles or have your partner do them, and note any changes. Go to a dermatologist annually and have the doctor view all moles.

Signs of Melanoma

Suspect a possible melanoma if you notice changes in a mole or new mole development. While melanomas may appear anywhere on the body, they most frequently show up on the legs of women and the backs and chests of men.

Doctors use the ABCDE format to identify potential melanomas. This involves:

A – asymmetrical moles
B –borders that are irregular
C- changes in mole color
Diameter –the mole is growing
Evolving –changes in the mole, including bleeding or itching.

If you notice any change in a mole, contact your doctor as soon as possible. Keep in mind that not every melanoma starts out as a mole. Some may appear as oddly pigmented skin or another type of growth.

Hidden Melanomas

Some melanomas develop in areas with little sun exposure. These so-called hidden melanomas are often found between the toes and fingers or underneath the nails. The soles of the feet and palms of the hand are other frequent locations. Dark-skinned people are more likely to experience hidden melanomas.

Sometimes, melanomas develop in the mucous membranes. These growths are especially hard to find. Areas in the mucous membranes vulnerable to melanomas include the:

Anus
Esophagus
Mouth
Nose
Vagina
Urinary tract

Risk Factors

Anyone can develop melanoma, but some people are at higher risk than others. Risk factors for the disease include:

Light skin
Compromised immune system
Excessive tanning or use of tanning beds
History of sunburns
Excessive amount of moles
Melanoma family history

Men tend to develop melanomas more often than women. Melanomas can strike at any age, and it is among the most commonly found cancers in those aged 30 and under.

Melanoma Diagnosis

The doctor takes a health history and performs a physical examination, including examination of suspect moles. The doctor will likely excise the mole surgically and send the sample to a laboratory for a biopsy. The biopsy will determine whether the tissue is malignant.

If melanoma is diagnosed, the patient must undergo additional testing. Based on test results, the melanoma is staged. This indicates the severity of the disease based on tumor size, lymph node involvement, and whether cancer has metastasized, or spread:

Stage 1 –No more than 1 millimeter thick, and no indication of spreading.
Stage 2 –Thicker than a stage 1 tumor. There is no indication of spread, but metastasis is more likely than in stage 1.
Stage 3 –The cancer has spread into the skin, lymph nodes, or lymph vessels.
Stage 4 –The cancer has spread to other parts of the body. Melanoma most often affects the brain, gastrointestinal tract, liver, and lungs.

There are subtypes among all of these stages, generally based on tumor size and thickness.

Melanoma Treatment

For those with early-stage cancer, removal of the mole and some underlying and adjacent tissue may prove curative. However, if the cancer has spread beyond the skin, additional treatment is necessary. The type of treatment depends on the cancer stage. Such treatments may include:

Surgical removal of affected lymph nodes
Chemotherapy –Drugs are given either intravenously or orally to kill cancer cells.
Radiation –Radiation therapy targets cancer cells. In melanoma treatment, it is often used on the lymph nodes if the disease was discovered there. It is also used to relieve the symptoms of metastasized cancer.
Targeted therapy drugs –Roughly 50 percent of melanoma patients have BRAF gene mutations. Those with this mutation may benefit from targeted therapy drugs such as a BRAF inhibitor. These medications include Vemurafenib, marketed under the trade name Zelboraf, dabrafenib (Tafinlar), and encorafenib (Braftovi). MEK inhibitors are another class of targeted therapy drugs for melanoma.
Immunotherapy –This treatment focuses on boosting the immune system so the body can fight the cancer. Cancer cells create proteins that help them elude immune system cells. Immunotherapy disrupts that process.

Treatment will also depend on the patient’s preferences once they discuss their options with their doctor. Considerations include the patient’s age, cancer stage, potential side effects, and the treatment’s benefits.

The patient may want to discuss the possibility of enrolling in a clinical trial for new drug therapies with the doctors.