Melanoma is skin cancer. It appears that cells called melanocytes begin to grow out of control. These cells produce a pigment called ‘melanin,’ which is responsible for skin, hair, and the iris of the eyes. When exposed the skin to the sun, the melanocytes produce more melanin as a defense against the action of ultraviolet (UV) rays. Melanin works as a photoprotector, preventing solar radiation from damaging the structures or tissues of the body.
Although most melanomas start on the skin, they can also appear on other body surfaces (such as the lining of the mouth, rectum, vagina, or the choroid layer inside the eyes). Those that develop on the skin are called cutaneous melanomas.
Melanomas, especially in their early stages of development, appear very similar to mole (nevus). However, they are usually more irregular, darker, and more likely to grow. They can develop from existing moles, but in most cases, they are new lesions, called de novo. It estimates that melanoma arises de novo in 75% of cases, and in 25%, it originates from a pre-existing nevus.
To dispel any doubts about the malignant nature of a pigmented lesion, suspicious nevi are removed and analyzed in the pathology laboratory. If they confirm the diagnosis of melanoma, they will start treatment for Melanoma, which will be different depending on whether it is a localized tumor or an advanced or metastatic melanoma.
Metastases begin when a small group of cells from the transportation of the original tumor to another area. And it stops in an organ that grows and produces a tumor similar to the original.
The frequency of melanoma is significantly lower than that of other skin cancers. Still, it is a much more aggressive tumor with a higher risk of metastasis. Consequently, we have a very high mortality rate when not diagnosing it early.
In a decade, global cases of melanoma have increased by almost 50%, reaching 287,000 annually worldwide, according to data from specialists.
People were diagnosed with around 5,000 cases of melanoma annually. According to the specialist, the incidence is about 10-15 cases per 100,000 inhabitants per year.
Professional confirms that this cancer continues to increase every year, and not only the most superficial melanoma but also the thick one, which has a worse prognosis and is growing in the elderly population.
Europeans notice it as ‘the ninth most common cancer’ in Europe, and its effects will be more on women than men.
Causes For Melanoma
Although several factors cause it, one of the most relevant is being in the sun excessively during childhood. We can locate it anywhere on the body. Still, it can also appear in parts of the body where there is no exposure to the sun. Any person may suffer from this type of cancer. However, several factors increase the risk and determine groups of people with a greater probability of developing it. Among them, it is worth highlighting:
- Have light skin or hair (if it is red-haired).
- If the presence of atypical nevi (moles whose appearance is different from those considered normal).
- If the presence of a total number of nevi, which is greater than 40.
- Presence of congenital nevi.
- People have a family history of atypical nevi, melanoma, or both.
- People have suffered one or more severe sunburns, especially in childhood or adolescence, as the effect of solar radiation is cumulative.
- Having been exposed to ultraviolet rays (UVB, UVA) for many hours, even if the skin is completely tanned.
As with other tumors, the risk increases with age, but it is also a tumor of young adults.
Symptoms Of Melanoma
In general, melanomas do not hurt and only sometimes cause itching or a different sensation in the skin. For this reason, appearance is the most important sign to pay attention to it.
According to the specialists, the ABCD system is a useful guide to identify those moles or skin spots that a dermatologist should see to determine whether or not they are melanomas. These four letters correspond to the following characteristics:
Melanoma lesions are often irregular in shape (asymmetric); Benign moles – not cancerous – are usually round (symmetrical).
These conditions often have uneven or irregular borders (notched or notched); benign moles have smooth borders.
Lesions are many shades of brown or black, and we see a single brown spot in benign moles.
They are normally more than 6 millimeters in diameter. Moles that are not dangerous measure less.
Prevention For Melanoma
Prevention is better than treatment for any disease even also Melanoma too. Please note that ‘the sun’ is the main ‘risk factor’ for developing melanoma. Therefore, it is advisable to adopt a series of basic measures when exposed to sunlight. People who have already had melanoma should carefully follow the general guidelines to protect themselves from radiation since they are at higher risk of developing new tumors. In addition, they must undergo regular dermatological check-ups.
To protect your skin, keep the following tips in mind:
Apply Sunscreen Before Exposure
It is better to apply sunscreen before exposure to the sun and renew it through frequent application, especially if you are staying on the beach or in the pool after each swim.
Avoid The Hours Of Greatest intensity
Exposure to the sun should be progressive and avoided between 12:00 and 16:00.
Please note not to expose children under three years of age to direct sunlight. Protect them with a high-protection photoprotector during weak sunlight to preserve their solar capital for as long as possible. It is also advisable to wear solar t-shirts on the beach and pool. Remember that the skin retains the memory of all the radiation received during childhood. Please note that if there is a higher ‘radiation dose,’ there will be a greater risk of developing ‘cancer’ in adults.
Better Use Protection In Outdoor Activities
Outdoor activities can also cause burns. Use sun protection on walks both on foot and by bicycle, when you play sports, or you are in gardens or terraces, etc.
Do Not Lower Your Guard
Do not lower your guard against factors that reduce the sensation of heat. Do not trust the circumstances that involve an additional risk or false security: altitude, cloud cover, reflective surfaces (snow, sand, grass, water), fresh wind.
Protect Yourself With Sunglasses, A Hat, And Dry Clothes
Wear a hat and sunglasses with approved lenses capable of filtering UVA and UVB rays. Also, protect children with a dry and opaque shirt: a wet shirt allows UV rays to pass through.
Dry Yourself Well After Each Bath
Water droplets have magnifying effects. They favor sunburn and reduce sunscreens’ significance even if they are resistant to water.
Drink Plenty Of Water Frequently
The sun dehydrates the body. Watch the elderly, whose sense of thirst gets attenuated, and children, whose need for water is important, and there we have immature thermoregulation centers.
It Is Better To Avoid ‘Tanning-Sessions Using Lamps With ‘UVA.’
They contribute to the appearance of skin cancer and accelerate skin aging.
Check Your Freckles And Moles
In case you notice the appearance of a new ‘freckle or mole,’ or already existing one, you already have changes in shape, size, or color, consult a dermatologist. The medicals recommend carrying out this self-examination once a month.
Types Of Melanoma
Cutaneous melanoma can develop on any surface of the skin. It appears more frequently on the trunk, from the back to the hip. Also, it occurred even on the head or sometimes on the neck in men. Instead, in women, it develops mainly on the legs or trunk.
There are several types of melanoma: there should not be an exclusion to other parts of the body, as they can also develop on the mucous membranes, under the nails, on the hand palms, or the soles of the feet. It is essential to know that it is not a ‘contagious disease,’ so there is no risk from contact with people who suffer from it.
It affects areas of the skin there has been exposure to the sun for a long time. It appeared on the face, head, neck, and in some cases, on the back of the hand and legs. And it occurs between 60 and 70. At first, we perceive a spot with poorly defined borders. Over time the stain spreads and changes to form a nodule. If it goes away, it comes back in other areas. The color can be variable, with areas of different shades of brown, but it can also be red or black.
It appears in any skin area, although it is located more on the trunk in men and women, more on the legs. It is the most frequent white population: it constitutes about 70% of all melanomas and appears between 40 and 50 years of age. It is a superficial stain with well-defined borders. Its growth is relatively slow, causing an injury that can last from one to several years. Its color is intense but variable: brown, grey, black, or pink. The shape of the edge is irregular.
It affects the soles of the feet and, to a lesser degree, the palms of the hands, the fingers, the genitals, and the mouth. It constitutes 10% of melanomas among the white population and 50% among the black or oriental population. It can appear at any age. A tumor appears on the initial stain a few months later, and the lesions are highly variable. It has more scattered borders, but the colors are similar to superficial spreading melanoma
It is located in any skin area, although usually located on the head and trunk. It is more familiar in men than in women and develops between 50 and 60. We know it as the second most common type of melanoma, accounting for 10% to 15%. Its appearance is that of a lesion in the form of a tumor nodule. The color is variable: black, bluish, brown, reddish. The tumor grows rapidly without noticing a spot. It bleeds often and rises on the skin.
They usually appear on the genital or oral mucosa, digestive tract, or ocular conjunctiva. They develop in the same way as ‘superficial spreading melanomas.
It is very rare and initially presents as an injury. It develops as a tumor with a great capacity for local infiltration and the development of metastases.
It can affect various eye parts, such as the choroid, the ciliary body, or the iris. It is very rare but has a high mortality rate due to the ease with which it spreads. We do not notice its link to sun exposure.
The dermatologist says that currently, we are also talking about molecular subtypes of melanoma. He adds that this molecular classification has implications for treatment.
Depending on the thickness of the tumor and the degree of dissemination of the melanoma. The following stages are differentiated:
They found abnormal cells in the outer layer of the skin without invading other tissues.
The tumor is up to 2 millimeters and does not involve the lymph nodes
The tumor is larger than 2 millimeters and does not involve the lymph nodes.
The tumor already affects the lymph nodes. Satellite tumors may appear around the main lesion.
The tumor affects other organs.
Diagnosis For Melanoma
To determine in which stage they can find the melanoma. They can make the following tests to carry out the most appropriate treatment for Melanoma subsequently:
- Physical examination.
- The lymph node function and sentinel lymph node biopsy inject a radioactive substance into the sentinel lymph node (the first to appear). Its tissue is removed and studied for cancer cells.
- Chest x-ray.
- CT (computed tomography) scan: They take pictures of the inside of the body.
- PET scan (positron emission tomography): used to detect malignant tumor cells by injecting radioactive glucose.
- Magnetic resonance imaging (MRI) with gadolinium: They create images of internal body parts such as the brain using a magnet and radio waves. Gadolinium is a contrast substance that makes cells more visible.
- Blood test.
The rest are carried out except for the physical examination when the skin lesion analysis confirms. It is melanoma and shows that it has characteristics that place it at high risk of metastasis.
In general, when they suspect melanoma, they will remove the tumor completely. Still, they obtain only a small portion or biopsy (removal of a tissue sample) if it is very large. In any of the cases, a pathologist examines ‘the tissue’ with the help of a microscope. They do this to determine how malignant it is.
Treatment For Melanoma
The treatment of melanoma depends on the type and stage of the tumor and other factors such as the patient’s health and age. They can use several types of treatment for Melanoma in combination:
It is the most common treatment and removes the tumor for Melanoma and a part of the healthy tissue around it. The amount of tissue removed depends on the depth and thickness of the melanoma. Sometimes more than one intervention is required. In this way, we can prevent cancer from reproducing if it has invaded nearby areas.
Chemotherapy can treat metastatic melanoma after they give other treatment have. Still, it is no longer often used as initial therapy today because both immunotherapy and targeted drugs are more effective.
We know that drugs block the ‘growth and spread of cancer’ by interfering with specific molecules (molecular targets) involved in its growth, progression, and spread.
There are three immuno-therapy drugs against advanced melanoma. They are antibodies that do not attack the melanoma but rather unblock the cells of the immune system (specifically, the lymphocytes) so that they are the ones that destroy the malignant cells. They also give treatment for Melanoma through an IV.
It uses high-intensity radiation to destroy cancer cells and stop their growth.