Melanoma

Melanoma, most dangerous form of skin cancer, develops in the cells (melanocytes) that produce melanin, the pigment that gives skin its color. These tumors originate in the pigment-producing melanocytes in the basal layer of the epidermis. Melanomas often resemble moles, some develop from moles. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white. Melanoma can also form in eyes and, rarely, in internal organs, such as intestines.

Melanoma

The exact cause of all melanomas isn’t clear, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds increases risk of developing melanoma. Limiting exposure to UV radiation can help reduce risk of melanoma.

The risk of melanoma seems to be increasing in people under 40, especially women. Knowing the warning signs of skin cancer can help ensure that cancerous changes are detected and treated before the cancer has spread. Melanoma can be treated successfully if it is detected early.

Melanomas can develop anywhere on the body. They most often develop in areas that have had exposure to the sun, such as back, legs, arms and face.

Melanomas can also occur in areas that don’t receive much sun exposure, such as the soles of feet, palms of 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  skin

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

If a patient is diagnosed with a melanoma, examine all lymph node groups.

Early melanomas may be differentiated from benign nevi by the ABCDs, as follows:

  • A – Asymmetry
  • B – Border irregularity
  • C – Color that tends to be very dark black or blue and variable
  • D – Diameter ≥6 mm

A light complexion, light eyes, blond or red hair, the occurrence of blistering sunburns in childhood, heavy freckling, and a tendency to tan poorly and sunburn easily indicate increased risk for melanoma. Melanoma occurs when something goes awry in the melanin-producing cells (melanocytes) that give color to skin.

Normally, skin cells develop in a controlled and orderly way, healthy new cells push older cells toward skin’s surface, where they die and eventually fall off. But some cells develop DNA damage, new cells may begin to grow out of control and can eventually form a mass of cancerous cells.

What damages DNA in skin cells and how this leads to melanoma isn’t clear yet. It’s likely: 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 body that don’t receive exposure to sunlight. This indicates that other factors may contribute to risk of melanoma.

The best treatment for depends on the size and stage of cancer, overall health, and personal preferences.

Treating early-stage melanomas: Treatment for early-stage melanomas usually includes surgery to remove the melanoma. A very thin melanoma may be removed entirely during the biopsy and require no further treatment. Otherwise, surgeon will remove the cancer as well as a border of normal skin and a layer of tissue beneath the skin.

Treating melanomas that have spread beyond the skin: If melanoma has spread beyond the skin, treatment options may include:

  • Surgery to remove affected lymph nodes: If melanoma has spread to nearby lymph nodes, surgeon may remove the affected nodes. Additional treatments before or after surgery also may be recommended.
  • Chemotherapy: Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can be given intravenously, in pill form or both so that it travels throughout body. Chemotherapy agents used include the following:
  • Dacarbazine (DTIC),
  • Temozolomide,
  • Cisplatin, vinblastine, and dacarbazine (CVD),
  • Cisplatin, dacarbazine, carmustine, and tamoxifen (Dartmouth regimen),
  • Carboplatin and paclitaxel (sometimes combined with sorafenib).
  • Radiation therapy: This treatment uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy may be recommended after surgery to remove the lymph nodes. It’s sometimes used to help relieve symptoms of melanoma that has spread to another area of the body.
  • Biological therapy: Biological therapy boosts immune system to help body fight cancer. Biological therapies used to treat melanoma include interferon and interleukin-2, ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda).
  • Targeted therapy: Targeted therapy uses medications designed to target specific vulnerabilities in cancer cells.

Vemurafenib (Zelboraf), dabrafenib (Tafinlar) and trametinib (Mekinist) are targeted therapy drugs used to treat advanced melanoma. These drugs are only effective if cancer cells have a certain genetic mutation. Cells from melanoma can be tested to see whether these medications may help.

Make an appointment with doctor if notice any skin changes that seem unusual.

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    Andrew’s Diseases of the skin

Melanoma

TUI - Tibot Urgency Index

Melanoma, most dangerous form of skin cancer, develops in the cells (melanocytes) that produce melanin, the pigment that gives skin its color. These tumors originate in the pigment-producing melanocytes in the basal layer of the epidermis. Melanomas often resemble moles, some develop from moles. The majority of melanomas are black or brown, but they can also be skin-colored, pink, red, purple, blue or white. Melanoma can also form in eyes and, rarely, in internal organs, such as intestines.

Melanoma

The exact cause of all melanomas isn’t clear, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds increases risk of developing melanoma. Limiting exposure to UV radiation can help reduce risk of melanoma.

The risk of melanoma seems to be increasing in people under 40, especially women. Knowing the warning signs of skin cancer can help ensure that cancerous changes are detected and treated before the cancer has spread. Melanoma can be treated successfully if it is detected early.

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Dr. Lora Smith

MBBS (Dhaka), DGO (DU) Ex SR. Gynaecologist & Obstetrician

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