Melanoma, a skin cancer
Its types, causes, symptoms, diagnosis and treatment

What is melanoma or skin cancer? What are the types of melanoma?

Skin is the largest organ of the body in terms of weight and surface area. It acts as a barrier to protect the internal organs from the external surroundings.

Melanoma is a type of skin cancer, which though less common, is potentially life-threatening as it can spread to other organs of the body.

Melanoma can be of different types, like:

• Superficial spreading melanoma-very common type of melanoma
• Nodular melanoma– faster-developing types of melanoma
• Lentigo maligna melanoma– mostly affects old people
• Acral lentiginous melanoma– rare type of melanoma that usually occurs in the palm of the hands and soles of the feet
• Amelanotic melanoma– rare type of melanoma, with no colour or very light colour mole

Skin Cancer or Melanoma

What are the symptoms of melanoma?

Melanoma occurs mostly in people who are exposed to sun rays for a prolonged period of time. However, it can also occur in those who are not sun-exposed. Some commonly reported symptoms are:

• Brownish or multi-coloured spot(s)
• Lesion with irregular border which is blue-black, red or white in colour
• Occurrence of new mole or changes in existing mole
• Painful or inflamed mole

What are the causes of melanoma?

Melanoma is caused due to abnormality in the nature of the pigment producing cells of skin called melanocytes. Some of the common underlying causes and risk factors include:

• Family history
• High exposure to ultraviolet rays
• Having many moles or freckles
• Lowered immunity or an immunocompromised state
• Light skin complexion
• Tanning beds and lamps

What are the complications of melanoma?

Complications due to melanoma or treatment of melanoma may include:

• Accumulation of fluid in the limbs (lymphoedema) due to removal of lymph nodes
• Depression and anxiety
• Metastasis- Spread to other organs of the body
• Recurrence of skin cancer
• Scarring after removal
• Side effects of chemotherapy

How is melanoma diagnosed?

Diagnosis of Skin Cancer or Melanoma

In case of any unusual change seen in the skin, consult a dermatologist, who will examine the signs and symptoms of your skin and look into your medical history. Your dermatologist may refer you to an oncologist if there is a suspicion of skin cancer. Diagnosis can be made by:

• Medical history
• Physical examination
• Skin biopsy
  •  – Excisional biopsy- the entire mole with some healthy skin is removed
  •  – Incisional biopsy- only the mole is removed
  •  – Punch biopsy- a round piece of skin is removed

What are the stages of melanoma (skin cancer)?

After diagnosis, the stage of the melanoma is identified. A system of classifying a cancer depending on its severity is called staging. In case of melanoma, the stage is determined by factors like extent of penetration, thickness, and the extent of spread.

The melanoma is staged from 0 to IV.

• Stage 0 and I are localized early melanomas
  • – Stage 0 melanoma also known as “in situ”, is non-invasive and does not penetrate beyond the outer layer or epidermis of the skin.
  • – Stage I melanoma invades below the epidermis to the dermis, i.e the next layer of the skin but are non-invasive and pose no threat of spreading to nearby lymph nodes or other organs
• Stage II melanoma too is localized but are larger than stage 0 or 1 melanoma (>1mm) and/or may have signs like ulceration placing them at the risk of spreading.These are intermediate or “high-risk” melanomas.
• Stages III and IV melanomas metastasize to other parts of the body and may be further sub divided into sub stages.

How is melanoma (skin cancer) treated?

Treatment for melanoma depends on the stage of the cancer. Some of the treatment options include:

• Surgery for removal of the cancerous part and a part of the normal tissue around it. At times, removal of affected lymph nodes is also done.
• Chemotherapy – Use of drugs to kill cancer cells
• Radio-therapy- Use of high-powered energy beams to destroy cancer cells
• Chemo-radio therapy
• Targeted-drug therapy– Use of drugs that act on cancer cells and selectively destroy only cancer cells
• Biological therapy- Makes use of the body’s immune system to fight cancer cells
• Palliative care- Intended to improve the quality of life of cancer patients who may not be amenable to treatment

Treatment of Skin Cancer or Melanoma

What factors affect the treatment outcomes and survival after melanoma?

Some factors that influence the treatment outcomes and survival after melanoma include:

• Age and general health of patient
• Detection of specific changes or mutations in a gene called BRAF
• Extent of metastasis or spread to other organs
• Level of lactate dehydrogenase (LDH) in the blood
• Physical characteristics of the cancer like location, size and thickness
• Presence of bleeding or ulceration
• Rate of growth
• Spread of cancer to the lymph nodes

To know more about skin cancer and melanoma, you can request for a call back and our skin cancer specialists will call you and answer all your queries.

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References:

• Mayo Clinic. Melanoma. Available at: https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884. Assessed on 06 April 2018.
• National Health Services. Skin cancer (melanoma). Available at: https://www.nhs.uk/conditions/melanoma-skin-cancer/#preventing-melanoma. Assessed on 06 April 2018.
• Health Direct. Complications of melanoma. Available at: https://www.healthdirect.gov.au/complications-of-melanoma. Assessed on 06 April 2018.
• Cancer Research UK. Melanoma skin cancer. Available at: http://www.cancerresearchuk.org/about-cancer/melanoma/getting-diagnosed. Assessed on 06 April 2018.

Disclaimer:

“The content of this publication has been developed by a third party content providerwho are clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”