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understanding-melanoma-symptoms-causes-and-treatment

Understanding Melanoma: Symptoms, Causes, and Treatment

The cells (melanocytes) that make melanin, the pigment responsible for your skin's color, grow into melanoma, the most dangerous kind of skin cancer. Additionally, melanoma can develop in your eyes and, very rarely, within your body, including in your throat or nose.

 

The actual reason why all melanomas occur is unknown, although being exposed to ultraviolet (UV) radiation from sunlight, tanning beds, or tanning lamps increases your chance of getting the disease. You can lower your chance of developing melanoma by limiting your exposure to UV light.

 

Melanoma risk appears to be rising among those under 40, particularly women. The detection and treatment of malignant alterations prior to the progression of the disease can be made possible by being aware of the warning symptoms of skin cancer. With early detection, melanoma can be successfully treated.

 

Types:

 

There are 4 main types of melanoma skin cancer –

 

1. Superficial spreading:

 

The most prevalent type of melanoma skin cancer is superficial spreading melanoma. About 70% of all melanoma skin cancers are caused by it.

Radial growth is a term used to describe how superficial spreading melanoma spreads over the skin's surface. But it might also begin to penetrate the skin (called vertical growth). It frequently has an irregular border and is flat and thin (less than 1 mm thick). It can be various tints of red, blue, brown, black, grey, and white, among other colors. Moles can occasionally give rise to superficial spreading melanoma that the skin already has. Typically, arms, legs, and the trunk of the body (the core region of the body) are affected by superficially spreading melanoma. Men typically experience it on their backs and women on their legs.

 

2. Nodular:

 

The second most typical type of melanoma skin cancer is nodular melanoma. 15% to 20% of all melanoma skin cancers are caused by nodular melanoma. Compared to other melanoma skin cancer types, it develops and spreads faster. It is a protruding growth that is elevated above the skin (polypoid). The growth could resemble a mushroom and have a stalk or stem (pedunculated). Typically, it is black, although it can occasionally be red, pink, or the same shade as your skin. Typically, nodular melanoma appears on the face, chest, or back. On skin that has not been exposed to the sun, it can be discovered.

 

3. Lentigo maligna:

 

Most frequently, lentiginous malignant melanoma affects elderly individuals. 10% to 15% of all melanoma skin cancers are caused by it. Typically, lentigo maligna melanoma presents as a large, flattened tan or brown area with an irregular border. It has several shades of brown or black and tends to get darker as it develops. Lentigo maligna, an early stage of development occurring exclusively in the top or outer layer of the skin, is a type of in situ tumor that frequently serves as its origin (epidermis). Before beginning to develop down into the skin, lentigo maligna melanoma often spreads outward across the skin's surface for several years. Areas of skin that are frequently exposed to the sun without protection are typically where lentigo malignant melanoma occurs, such as the face, ears, and arms.

 

4. Acral lentiginous:

 

The majority of cases of acral lentiginous melanoma are found in individuals with dark complexions, such as those of African, Asian, or Hispanic ancestry. It has nothing to do with being in the sun. Small, flat patches of discolored skin that are frequently dark brown or black occur as the outward sign of acral lentiginous melanoma. Before it begins to develop down into the skin, it often grows over the skin's surface and outward for a considerable amount of time. Acral lentiginous melanoma typically appears under the nails, on the palms of the hands, or on the bottoms of the feet. Because it is challenging to notice abnormal patches on the soles of the feet and under the nails, acral lentiginous melanoma is sometimes difficult to diagnose.

 

Some rare types of melanoma do not start in the skin. The following types of melanoma are rare:

 

  1. Mucosal lentiginous melanoma grows on the thin, moist lining of some organs or other parts of the body (mucosa or mucous membrane), such as the nasal passages, mouth, throat (pharynx), rectum, anal canal and vagina.
  2. Desmoplastic melanoma grows in the thick, inner layer of skin (dermis) or the layer of connective tissue that surrounds the mucosa (submucosa).
  3. Desmoplastic melanoma often grows on the head, neck, upper back or areas of the body with mucosa.

 

Symptoms:

 

You can get melanomas anywhere on your body. Your back, legs, arms, and face are the places where they often appear because of sun exposure.

The palms of your hands, the bottoms of your feet, and the undersides of your fingernails are examples of places where melanomas can develop that don't get a lot of sun exposure. People with darker skin are more likely to have these concealed melanomas.

Initial melanoma symptoms and indications frequently include

  1. Modification to an existing mole
  2. The appearance of a new, pigmented growth or other uncharacteristic feature on your skin

 

Moles are not typically the first sign of melanoma. It can even happen on skin that seems normal otherwise.

 

To differentiate a melanoma from a normal mole, follow the ABCDE guidelines:

  1. A stands for asymmetrical shape. Look for moles with asymmetrical features, such as two parts with distinct appearances.
  2. B stands for irregular border. Seen on melanomas are moles with uneven, notched, or scalloped borders.
  3. C stands for changes in colour. Keep an eye out for growths with a variety of hues or a lopsided distribution of colours.
  4. D stands for diameter. In a mole that is larger than 1/4 inch, look for fresh growth (about 6 millimetres).
  5. E stands for evolving. Watch for alterations over time, such as a mole that expands or changes in size, colour, or form. Additionally, moles might change over time and produce new irritation or bleeding.

 

Stages and Differential Diagnoses:

 

If you have a mole or other suspicious-looking spot, your doctor may remove it and examine it under a microscope to see whether it contains cancer cells. This procedure is known as a biopsy.

The next step is to ascertain if the melanoma has spread when your doctor receives the skin biopsy findings demonstrating the presence of melanoma cells. Staging describes this process. When melanoma is identified, it will be classified according to a number of criteria, including how far it has spread and how it appears under a microscope. The key variable in determining outcomes is tumor thickness.

 

Melanomas can be divided into the following stages:

  1. Stage 0 (Melanoma in situ): Only the top layer of skin has melanoma (the epidermis).
  2. Stage I: Primary melanoma at low risk with no signs of metastasis. Surgery may typically cure this stage.
  3. Stage II: This stage has features of increased recurrence risk, but there is no proof of metastasis.
  4. Stage III: The melanoma has begun spreading to nearby lymph nodes or skin.
  5. Stage IV: The melanoma has metastasized to distant lymph nodes or the skin or has spread to internal organs.

 

There are several tests your doctor can use to stage your melanoma. Your doctor may use these tests:

  1. Sentinel Lymph Node Biopsy: A biopsy of sentinel lymph nodes may be required in patients with melanomas that are deeper than 0.8 mm, those with ulceration in tumors of any size, or other less frequent but potentially troubling symptoms. This is done to find out if the melanoma has spread. Compared to those who are physically examined for melanoma in lymph nodes, those who receive a diagnosis through a sentinel lymph node biopsy have a greater chance of survival.
  2. Computed Tomography (CT) scan: a CT scan can help detect internal organ melanoma.
  3. Magnetic Resonance Imaging (MRI) scan: An MRI scan can help detect brain or spinal cord tumors.
  4. Positron Emission Tomography (PET) scan: A PET scan can examine lymph nodes and other areas of your body that are far from the original skin site where the melanoma was discovered.
  5. Blood work: Before starting therapy, lactate dehydrogenase (LDH) levels can be measured using blood testing. Blood cell counts and blood chemistry measurements are among the other assays.

 

Treatment:

 

The treatment procedure for melanoma will be determined by the stage of cancer and your overall health condition.

 

Melanoma is typically treated by surgery. Other forms of melanoma treatments include:

  1. Melanoma Surgery: In the early stages, surgery offers a great chance of a complete cure for your melanoma.
  2. Lymphadenectomy: When melanoma has spread, the lymph nodes at the main diagnosis site may need to be removed. This can help to keep the infection from spreading to other parts of your body.
  3. Metastasectomy: This procedure is performed to remove tiny melanoma fragments from organs.
  4. Targeted cancer therapy: Drugs are administered to target specific cancer cells in this treatment option. This "targeted" technique destroys cancer cells while leaving healthy ones unharmed.
  5. Radiation Therapy: It uses high-energy radiation to kill cancer cells and shrink tumors.
  6. Immunotherapy: Immunotherapy encourages your immune system to aid in the fight against cancer.

 

Conclusion:

 

A melanoma diagnosis might be frightening. Being vigilant about your skin and moles for changes, as well as visiting your doctor for skin inspections on a regular basis, can give you the best chance of detecting melanoma early, when it is most curable.

 

 

Dr. Alok Gupta
Cancer Care
Meet The Doctor
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