Melanoma: An Uncommon Type Of Skin Cancer That Can Spread To Other Organs
Melanoma is the most severe type of skin cancer, affecting the melanocytes cells responsible for producing melanin. Melanin is the pigment that gives your skin its color. Melanoma is also present in your eyes and, rarely, inside your body, such as in your nose or throat.
No specific cause of melanoma has been found, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps can put you at a higher risk of melanoma. Limiting your exposure to UV radiation can help reduce your risk of melanoma.
How Many Cases Of Melanoma Are Diagnosed Each Year?
The American Cancer Society’s estimates for melanoma in the United States for 2020 are:
- About 100,350 new melanomas will be diagnosed (about 60,190 in men and 40,160 in women).
- About 6,850 people are expected to die of melanoma (about 4,610 men and 2,240 women).
The rates of melanoma have been rising rapidly over the past few decades, but this has varied by age.
What Does Early Signs Of Melanoma Look Like?
Melanomas can develop anywhere on your body. They most often develop in areas that have had exposure to the sun, such as your back, legs, arms, and face.
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:
- A change in an existing mole
- The development of a new pigmented or unusual-looking growth on your skin
Melanoma doesn't always begin as a mole. It can also occur on otherwise normal-appearing skin
How Quickly Does Melanoma Spread?
Melanoma can grow very quickly. It can become life-threatening in as little as six weeks and, if untreated, it can spread to other parts of the body. Melanoma can appear on skin not normally exposed to the sun.
Nodular melanoma is a highly dangerous form of melanoma that looks different from common melanomas. Nodular melanomas are raised and are even in color (often red or pink and some are brown or black). This type of melanoma grows quickly and can be life-threatening if not detected and removed quickly. See your doctor immediately if you notice any of these changes.
How does melanoma start?
Melanoma occurs when something goes wrong in the melanin-producing cells (melanocytes) that give color to your skin.
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. But when some cells develop DNA damage, new cells may begin to grow out of control and can eventually form a mass of cancerous cells.
Just what damages DNA in skin cells and how this leads to melanoma isn't clear. It's likely that a combination of factors, including environmental and genetic factors, causes melanoma. Still, doctors believe exposure to ultraviolet (UV) radiation from the sun and from tanning lamps and beds is the leading cause of melanoma.
UV light doesn't cause all melanomas, especially those that occur in places on your body that don't receive exposure to sunlight. This indicates that other factors may contribute to your risk of melanoma.
Risk Factors For Melanoma
Fair skin: Having less pigment (melanin) in your skin means you have less protection from damaging UV radiation. If you have blond or red hair, light-colored eyes, and freckle or sunburn easily, you're more likely to develop melanoma than someone with a darker complexion. But melanoma can develop in people with darker complexions, including Hispanic people and black people.
A history of sunburn: One or more severe, blistering sunburns can increase your risk of melanoma.
Excessive ultraviolet (UV) light exposure. Exposure to UV radiation, which comes from the sun and from tanning lights and beds, can increase the risk of skin cancer, including melanoma.
Living closer to the equator or at a higher elevation: People living closer to the earth's equator, where the sun's rays are more direct, experience higher amounts of UV radiation than do those living farther north or south. In addition, if you live at a high elevation, you're exposed to more UV radiation.
Having many moles or unusual moles: Having more than 50 ordinary moles on your body indicates an increased risk of melanoma. Also, having an unusual type of mole increases the risk of melanoma. Known medically as dysplastic nevi, these tend to be larger than normal moles and have irregular borders and a mixture of colors.
A family history of melanoma: If a close relative — such as a parent, child or sibling — has had melanoma, you have a greater chance of developing a melanoma, too.
Weakened immune system: People with weakened immune systems have an increased risk of melanoma and other skin cancers. Your immune system may be impaired if you take medicine to suppress the immune system, such as after an organ transplant, or if you have a disease that impairs the immune system, such as AIDS.
How Does A Doctor Diagnose Melanoma?
Tests and procedures used to diagnose melanoma include:
Physical exam: Your doctor will ask questions about your health history and examine your skin to look for signs that may indicate melanoma.
Removing a sample of tissue for testing (biopsy): To determine whether a suspicious skin lesion is a melanoma, your doctor may recommend removing a sample of skin for testing. The sample is sent to a lab for examination.
What type of biopsy procedure your doctor recommends will depend on your particular situation. Most often doctors recommend removing the entire growth when possible. One common technique, the punch biopsy, is done with a circular blade that's pressed into the skin around the suspicious mole.
Another technique, called an excisional biopsy, uses a scalpel to cut away the entire mole and a small margin of healthy tissue around it.
What Is The Most Effective Treatment For Melanoma?
If melanoma has spread beyond the skin, treatment options may include:
Surgery to remove the affected lymph nodes: If melanoma has spread to nearby lymph nodes, your surgeon may remove the affected nodes. Additional treatments before or after surgery also may be recommended.
Immunotherapy: Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body's disease-fighting immune system might not attack cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy is often recommended after surgery for melanoma that has spread to the lymph nodes or to other areas of the body. When melanoma can't be removed completely with surgery, immunotherapy treatments might be injected directly into the melanoma.
Targeted therapy: Targeted drug treatments focus on specific weaknesses present within cancer cells. By targeting these weaknesses, targeted drug treatments can cause cancer cells to die. Cells from your melanoma may be tested to see if targeted therapy is likely to be effective against your cancer.
For melanoma, targeted therapy might be recommended if cancer has spread to your lymph nodes or to other areas of your body.
Radiation therapy: This treatment uses high-powered energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy may be directed to the lymph nodes if the melanoma has spread there. Radiation therapy can also be used to treat melanomas that can't be removed completely with surgery.
For melanoma that spreads to other areas of the body, radiation therapy can help relieve symptoms.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells. Chemotherapy can be given intravenously, in pill form, or both so that it travels throughout your body.
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