Skin cancer - melanoma: Treatment, symptoms, advice and help
About skin cancer - melanoma
Melanoma is a cancer of the melanocytes which are normally present in the skin, being responsible for the production of the dark pigment melanin. It usually arises in the skin but can form anywhere that melanocytes exist, such as in the bowel mucosa, the retina and the leptomeninges.
Skin cancer - melanoma: Incidence, age and sex
Worldwide, Melanoma accounts for 3% of all malignancy. It is the commonest cancer in young adults (20 – 39 years) and although it accounts for less than 5% of skin malignancy, it is the most likely cause of cancer-related death. It is more common in males and in Caucasian populations, living in sunny climates or in those who use tanning salons.
Signs & symptoms of melanoma: Diagnosis
The first sign of melanoma is a change in the size, shape, colour, or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new mole. It may be black, abnormal, or "ugly looking." Newly formed fine scales and itching in a mole also are common symptoms of early melanoma. In more advanced melanoma, it may become hard or lumpy. More advanced tumours may itch, ooze, or bleed but melanomas usually do not cause pain.
Causes and prevention of melanoma
Cutaneous melanoma is caused largely by exposure to ultraviolet radiation amongst white-skinned races. The risk factors for developing melanoma are the genetic condition xeroderma pigmentosum, past medical or family history of dysplastic naevi, previous melanoma, high total number of naevi, red hair, tendency to freckle, immune compromised conditions (HIV infection, Hodgkin’s disease, ciclosporin A therapy) and history of sunburn – especially in childhood. Only 10-20% of melanomas form in pre-existing naevi, with the remainder arising de novo in previously normally pigmented skin. Minimizing exposure to sources of ultraviolet radiation (the sun and sunbeds), following sun protection measures and wearing sun-protective clothing (long-sleeved shirts, long trousers, and broad-brimmed hats) can offer protection.
The main complications include metastatic melanoma leading to liver cancer, lung cancer and brain cancer. The other complications are - recurrent melanoma, spread to other organs, damage to deep tissue and side-effects of treatment like nausea and hair loss.
The treatment for melanoma is surgery. A complete excision with a clinical 5 mm margin is done. Local lymph nodes are tested for the presence of cancer cells, indicating that the melanoma has spread. Additional surgery, chemotherapy and/or immunotherapy may be needed if melanoma has spread beyond the skin to the lymph nodes and other parts of the body.