Melanoma

What is melanoma ?

Melanoma is a disease in which malignant (cancer) cells form in melanocytes (cells that color the skin). Melanoma occurs when the pigment-producing cells that give colour to the skin become cancerous. Melanoma can occur anywhere on the skin.

What is metastatic melanoma?

The term “metastatic melanoma” is used to refer to melanoma (a type of skin cancer) that has spread from the skin to other areas of the body.

What are the symptoms of melanoma?

• Unusual growth
• Unusual moles or a change in an existing mole
• Bigger mole diameter
• Darkening of the skin
• Mole color changes
• Skin mole with an irregular border

What are the 5 warning signs of melanoma?

The “ABCDE” rule is helpful in remembering the warning signs of melanoma:

• Asymmetry: The shape of one-half of the mole does not match the other.
• Border: The edges are ragged, notched, uneven, or blurred.
• Color: Shades of black, brown, and tan may be present.
• Diameter: The area is more than five millimeters in size (about the size of a pencil eraser)
• Evolving: Changing in any way including bleeding, itching, or appearance

Is melanoma considered a tumor?

Melanoma is a cancer that begins in the melanocytes. Other names for this cancer include malignant melanoma and cutaneous melanoma. Most melanoma cells still make melanin, so melanoma tumors are usually brown or black. However, some melanomas do not make melanin and can appear pink, tan, or even white.

Where does melanoma usually appear on the body?

• For people with mole anywhere on the body has the potential to develop into melanoma, which is why regular monitoring of these growths is important.
• Usually, in fair-skinned women, melanoma appears most frequently on the lower legs or arms. In fair-skinned men, melanoma appears more frequently on the trunk or the head and neck area.
• In individuals with darker skin, melanoma tends to appear more often on the palms, the soles of the feet, and the skin under the nails.

What are the stages of melanoma?

Melanomas are assigned an anatomic level or “Clark’s level” I to IV as a description of tumor depth into the skin.

In addition, staging of cancer may include the following descriptions:

• Stage I and stage II: Melanoma is confined to the site where the cancer occurred and has not spread to the lymph nodes or internal organs.
• Stage III: Melanoma has spread to the lymph nodes.
• Stage IV: Melanoma has spread to distant organs (metastasis).

What happens if melanoma is not caught early?

When melanoma is diagnosed in the early stages, most people respond well to treatment. But when not caught early, it spreads easily to other parts of the body.

Since I have melanoma, do members of my family need to be tested?

There are genetic variants – gene mutations – that make some individuals prone to developing melanoma. These mutations occur in the genes CDKN2A and CDK4, which code for proteins regulating cell division. Individuals with these mutations have a strong family history of melanoma and carry a 60 to 90 percent lifetime risk of developing the disease.

Can melanoma be treated successfully?

Metastases that cause symptoms but cannot be removed may be treated with radiation, immunotherapy, targeted therapy, or chemotherapy. The treatment of widespread melanomas has changed in recent years as newer forms of immunotherapy and targeted drugs have shown promising results and are more effective than chemotherapy.

Is chemotherapy used to treat melanoma?

Chemotherapy doesn’t work as well against melanoma as it does for some other types of cancer. Doctors are more likely to use newer drugs called targeted cancer drugs or immunotherapy to treat melanoma.

Dacarbazine (DTIC; available as a generic drug) is the only FDA-approved chemotherapy for melanoma. Temozolomide (Temodar) is essentially an oral version of dacarbazine, and it is used for the treatment of stage IV melanoma. Both DTIC and temozolomide have been shown to shrink melanoma for about 12% to 15% of patients.

Can melanoma be cured with immunotherapy?

Immunotherapy is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. Several types of immunotherapy can be used to treat melanoma. The higher percentage of patients treated with nivolumab and ipilimumab are in clinical trials.

What are the risk factors?

Factors that may increase your risk of melanoma include:

• Fair skin. Having less pigment (melanin) in your skin means you have less protection from damaging ultraviolet (UV) radiation. If you have blond or red hair, light-colored eyes, and freckles or sunburns easily, you’re more likely to develop melanoma compared to someone with a darker complexion. However, melanoma can develop in people with darker complexions, including Hispanic people and black people.
• A history of sunburn. One or more severe, blistering sunburns can increase your risk of melanoma.
• Excessive ultraviolet (UV) light exposure. Exposure to UV radiation, which comes from the sun and tanning lights and beds, can increase the risk of skin cancer, including melanoma.
• Living closer to the equator or at a higher elevation. People living closer to the earth’s equator, where the sun’s rays are more direct, experience higher amounts of UV radiation than those living farther north or south. In addition, if you live at a high elevation, you’re exposed to more UV radiation.
• Having many moles or unusual moles. Having more than 50 ordinary moles on your body indicates an increased risk of melanoma. Also, having an unusual type of mole increases the risk of melanoma. Known medically as dysplastic nevi, these tend to be larger than normal moles and have irregular borders and a mixture of colors.
• A family history of melanoma. If a close relative, such as a parent, child, or sibling has melanoma, you have a greater chance of developing a melanoma too.
• Weakened immune system. People with weakened immune systems have an increased risk of melanoma and other skin cancers. Your immune system may be impaired if you take medicine to suppress the immune system, such as after an organ transplant, or if you have a disease that impairs the immune system, such as AIDS.

How long can you live with melanoma?

• The overall average 5-year survival rate for all patients with melanoma is 92%. This means 92 of every 100 people diagnosed with melanoma will be alive in 5 years. In the very early stages, the 5-year survival rate is 99%. Once melanoma has spread to the lymph nodes the 5-year survival rate is 63%.

Does diet or lifestyle make any difference?

There is no specific diet or lifestyle that patients with melanoma should adhere to. However, in general, it is a good idea to eat a healthy diet and stay in good physical shape.

How you can reduce or prevent your risk of melanoma and other types of skin cancer?

• Avoid the sun during the middle of the day. For many people in North America, the sun’s rays are strongest between about 10 a.m. and 4 p.m. Schedule outdoor activities for other times of the day, even in winter or when the sky is cloudy.

You absorb UV radiation year-round, and clouds offer little protection from damaging rays. Avoiding the sun at its strongest helps you avoid the sunburns and suntans that cause skin damage and increase your risk of developing skin cancer. Sun exposure accumulated over time also may cause skin cancer.

• Wear sunscreen year-round. Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.
• Wear protective clothing. Cover your skin with dark, tightly woven clothing that covers your arms and legs, and a broad-brimmed hat, which provides more protection than a baseball cap or visor.

Some companies also sell protective clothing. A dermatologist can recommend an appropriate brand. Don’t forget sunglasses. Look for those that block both types of UV radiation — UVA and UVB rays.

• Avoid tanning lamps and beds. Tanning lamps and beds emit UV rays and can increase your risk of skin cancer.
• Become familiar with your skin so that you’ll notice changes. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps, and birthmarks. With the help of mirrors, check your face, neck, ears, and scalp.

Examine your chest. trunk, and the tops and undersides of your arms and hands. Examine both the front and back of your legs and your feet, including the soles and the spaces between your toes. Also check your genital area and between your buttocks.

Is melanoma curable?

Like many other cancers, melanoma is potentially curable when caught at an early stage.

• Once you have/had melanoma, you are at a higher risk than the general population of developing a new primary melanoma, as well as a recurrence of the original melanoma.
• This is why it is important for you to have regular check-ups that include lifelong surveillance from your healthcare providers.

Should I participate in a clinical trial?

• These clinical trials may offer participants new treatment options that may have otherwise been unavailable to them, especially after exhausting conventional treatments.
• If you are interested in participating in a clinical trial, ask your doctor whether you are eligible, and discuss any concerns or questions you may have, to help you determine whether it’s a good fit for you.