What is Melanoma

Each year over 76,000 patients will be diagnosed with melanoma skin cancer. Though melanoma is much less likely to be diagnosed than other types of skin cancers, such as basal cell cancer, it is a much more dangerous form of cancer.

Melanoma is curable in its early stages, but it’s more likely than the other types of skin cancers to spread into other areas of the body if it’s not detected early.

Over the past thirty years, the rates of diagnosed melanoma have steadily increased. A big factor for this increase may be attributed to more people voluntarily increasing their exposure to the sun, either by tanning or through recreational activities. It’s important to be aware of the possibility of skin cancer, particularly melanoma, including its symptoms and risk factors, as well as to be mindful of examining the skin for any changes that could be signs of skin cancer.

Skin – The Natural Shield
Our skin is the largest organ in our bodies. And it works to protect our bodies in many ways. It works as a barrier to particular germs, like bacteria. It helps to control our body temperature. It prevents our body from losing too much water, or other fluids. It protects our internal organs from injury. And it provides us with a natural shield from the sun, protecting the rest of the body from ultraviolet (UV) rays.

It’s this protection from the sun’s UV rays that is a big reason skin cancer is one of the most commonly diagnosed forms of cancer around the world.

What is Melanoma?
Melanoma is a type of skin cancer that develops from a particular type of skin cell called melanocytes. These cells produce a brown pigment called melanin, which gives a tan or brown color to the skin. The job of melanin is to help protect the deeper layers of the skin from some of the more harmful effects of the sun. When skin is exposed to the sun, the melanocytes produce more pigment, which causes the skin to get darker or to tan.

As most melanomas begin within these melanocytes, they can still make melanin, which causes most melanoma tumors to appear brown or black. Some melanomas, however, will not make melanin and these tumors will appear pink, tan or even white.

Who Gets Melanoma?
Melanoma doesn’t distinguish between ethnicity or skin color. Even though darkly pigmented skin may lower a patient’s risk of melanoma in the areas of the body where it’s most likely to occur, patients can still develop this cancer in less common areas, such as the palms of the hands, soles of the feet or even under the nails. Melanoma in these less common areas accounts for over 50% of all types of melanomas in African Americans, but fewer than 10% of diagnosed melanomas in whites.

While melanoma can develop anywhere on the skin, it is most likely to start on the chest and back area for men and on the legs in women. Other common locations may include the face and the neck. These areas are generally linked to places that have been linked to frequent sunburns, especially in childhood.

Types of Melanoma

  • Cutaneous Melanoma-This form of melanoma is the most common and occurs anywhere on the skin, but predominantly in those areas that are exposed to the sun.

  • Mucosal Melanoma – A rare form of melanoma that takes place within the mucous membranes, such as the nasal passages.

  • Ocular Melanoma – This type of melanoma occurs in the eye and is rare.

While not considered an actual type of melanoma, metastatic melanoma occurs when the cancer has spread into other areas of the body. This usually occurs first in the lymph nodes and then moves into other organs in the body, such as the liver, lungs or brain.

Risk Factors
It’s important to note that even though a risk factor is defined by anything that could increase a person’s chance of getting melanoma, having a risk factor, or even many risk factors, this does not necessarily mean a person will get this disease.

The following are some risk factors that can make a person more likely to develop melanoma:

  • Older Age – The longer we live, the higher our risk for developing a cancer, such as melanoma. On average, melanoma is detected in people around the age of 60. However, this cancer can be diagnosed in patients much younger, even below 30 years of age. In fact, melanoma is currently one of the most commonly diagnosed cancers in young adults, especially women.

  • Ultraviolet (UV) Light Exposure – We all need sunlight, but too much exposure to ultraviolet (UV) rays is a major risk for melanoma. Besides sunlight, other sources that produce UV rays would be tanning beds and sun lamps.

  • Having Many MolesHaving over 50 ordinary moles on their body, or having unusual types of moles, is considered to be an increased risk factor for melanoma. One type of unusual mole is referred to a dysplastic nevi , which tend to be larger than normal moles and have irregular borders and a mixture of colors.

  • Fair Skin – The risk of melanoma is much higher in people with fair skin that freckles or burns easily.

  • Family History -Having a direct relative (parent, sibling or child) who has had melanoma increases a person’s risk. This may be due to genetic similarities (gene mutations or fair skin) as well as a shared family lifestyle, which could lead to frequent sun exposure.

  • Personal History– People who have had melanoma have a higher chance of getting it again, as about 5% of people diagnosed with melanoma will develop a second one at some point.

  • Weakened Immune System– The immune system helps fight various cancers, such as skin cancer. Having a weakened immune system, either due to various diseases or medical treatments, like organ transplants, may increase a person’s risk of melanoma.

  • Gender – While men, in general, are at a greater risk of melanoma than women, this varies with age. The risk of this disease is greater in women, versus men, before the age of 45, while it is greater for men after the age of 45.

Symptoms
Your skin is a helpful place to look for any signs or symptoms of melanoma. Look for new spots on the skin or for any spots that change in size, shape or color. If you see a spot on your skin that doesn’t look like any of the other spots you have, that’s a good warning sign and you should have it checked by your doctor.

Besides the appearance of any unusual moles or markings, be mindful of any changes in the feel of certain spots, such as itching. Here are some common warning signs:

  • Having a sore that does not heal.

  • Experiencing swelling or redness beyond a spot’s border.

  • Changes in the surface of a mole, where it oozes, bleeds or becomes scaly. Also if a bump or nodule appears.

Always show your doctor any areas of concern and be sure to have any areas that are difficult for you to see examined.

Skin Cancer Screening
Melanoma can often be detected early. The earlier it can be diagnosed, the better chance of success for treatment. There are several things people can do to improve the chances of early detection.

Regular Skin Cancer Screening at Home – Examine your skin once a month for any new moles or changes in existing moles. Having a familiarity with the pattern of your existing moles, freckles and other marks will help you notice any new changes.

Examinations by a Dermatologist – Routine examinations by a health care professional is especially important for those people who may be at a higher risk of melanoma, either because of a family history of it or having many moles.

Besides incorporating in-home skin cancer screenings, as well as annual screenings with a physician, there are plenty of other things you can do to protect your skin year-round. Here are 5 Ways to Help Reduce Your Skin Cancer Risk.

Diagnosing Melanoma
Should any signs of abnormal areas on the skin occur, your doctor will want to do exams and tests to determine whether it’s melanoma, some other type of skin cancer, or another type of skin condition. There are several steps that may be involved in the diagnosing melanoma, some of these may include the following:

  • Physical Exam– During the physical exam, your doctor will go over family medical history, as well as ask questions pertaining to possible risk factors, when changes in the skin took place and if any symptoms, such as itching or bleeding, occurred. This examination may also involve checking the patient’s neck, groin or underarm area to feel for any signs of enlarged lymph nodes. If your primary physician suspects melanoma or another form of skin cancer, you may be referred to a dermatologist.

  • Taking a Biopsy – If a doctor believes a spot may be melanoma, or possibly another type of skin cancer, they will remove a sample of skin, a biopsy, from the suspicious area to be sent to a lab for review under a microscope. Depending upon the case, there are various types of biopsies that can be performed.

  • Imaging Tests – In order to get a better picture whether the melanoma has spread, various imaging tests may be used, such as CT MRI or PET scans. These tests are usually not done for people with early stage melanoma.

  • Blood Tests – While blood tests are not used to diagnose melanoma, some blood tests may be collected before or during treatment, especially if the melanoma is advanced.

Treating Melanoma
Cancer treatment options for melanoma will vary based upon the stage and location of the melanoma, as well as other factors. Early stage melanoma may often be effectively treated with just surgery, while advanced melanomas may require other treatments. Sometimes the patient’s health care team may recommend a combination of several types of treatments.

  • Immunotherapy – This treatment involves assisting and stimulating the patient’s immune system so that it can recognize the cancer cells and effectively destroy them. There are currently several types of FDA approved immunotherapies for melanoma, such as Keytruda(Pembrolizumab).

  • Targeted Therapy-Unlike standard chemotherapy which may attack healthy cells, while going after cancer cells, targeted therapy seeks to “target” the cancer cells with various cancer drugs, while seeking to avoid damaging the patient’s non-cancerous cells.

  • Surgery – This treatment is generally the option for many types of melanomas, especially for those at an early stage.

  • Radiation – Radiation therapy emits high-energy rays, much like an x-ray, to kill cancer cells. As a treatment for melanoma, radiation may be given after surgery, such as in the area where lymph nodes were removed, or when there is a recurrence of melanoma after the surgery. Radiation therapy may also be used to relieve any symptoms caused by the spread of the melanoma, such as to the brain or bones.

  • Chemotherapy– Generally administered via an injection via a portacath into the vein or taken orally as a pill, chemotherapy treatment uses drugs to kill the cancer cells. While chemo may be used to treat more advanced forms of melanoma, it is generally not used as often as a first treatment, since the availability of newer treatments like immunotherapy and targeted cancer drugs.

Clinical Trials
Sometimes it is possible for a patient to participate in a clinical trial study involving a promising new melanoma treatment. Participating in a clinical trial may be the only way for some patients to get access to a newer treatment. Clinical trials are also a good way for doctors to find new, better options to treat particular types of cancers. In order to be considered for participation into a particular study, patients will need to match specific criteria of eligibility.

Learn more about clinical trials available with Oncology Associates.

Melanoma is a curable disease. The earlier it is diagnosed and treated the better the success for treating it. It’s important to be aware of the symptoms and risk factors and to also become mindful of screening for it on a regular basis.