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What is malignant melanoma?

Melanoma skin cancer starts in the melonocyte cells of the skin. The skin protects our body from heat, injury, infection, water loss and sunlight. Its outermost layer is called the epidermis, which consists of flat, scaly squamous cells. Squamous cells contain a protein (keratin) that makes the skin strong, but flexible. Basal cells and melonocytes (the cells that give the skin its colour) lie deeper in the epidermis. Beneath the epidermis is the dermis which contains nerves, blood vessels, lymphatic vessels, sweat glands, oil glands and hair follicles.

Melanocytes produce a pigment called melanin that gives the skin its colur and protect it from sun damage. When skin is exposed to the sun, it produces more pigment and tans. Melanocytes often cluster together and form moles (nevi). Most moles are benign, but some may go on to become malignant melanomas.

Its characteristic signs are:

• Differential pigmentation (spectrum of brown, black and pink)
• Irregular border
• Progressive central depigmentation
• Usually flat and may be greater than 1cm in diameter at diagnosis

Melanomas are divided into four types, depending on their location, shape and how they grow into dermis:

Superficial, spreading or flat: Grows superficially at the first to form an irregular pattern on the skin with an uneven colour.

Nodular: Lumpy and often blue-black in colour. May grow faster and spread downwards.

Acral lentigous: Occurs mostly on the palms of the hand, soles of the feet or nailbeds.

Lentigo maligna: Flat irregular large brown spot. Usually occurs on the faces of elderly people.

Melanoma can also start in the mucous membraces of the mouth, anus and vagina, in the eye or other places in the body where melanocytes are found.


What Causes Melanoma?

The most important factor that appears to increase the risk of developing melanoma is your skin’s sensitivity to the sun’s ultraviolet rays. Most skin cancers start on areas that are only exposed to the sun from time to time, such as your back, neck and the backs of your legs.

Other factors that appear to increase the risk of developing malignant melanoma are:

• Lots of moles, particularly atypical moles (dysplastic nevi)
• Family history of melanoma on more than one relative
• Blond or red hair
• Fair or freckled complexion
• Severe sunburn during childhood

People who have been treated for one melanoma are at high risk of developing more. Some people develop skin cancer without any of these risk factors.

How is Melanoma Diagnosed?

Your doctor may have suspected melanoma after talking with you about your health and completing a physical examination. Or perhaps you noticed a new mole or change in a mole you already had.

A skin biopsy is usually necessary to confirm a melanoma diagnosis. In this procedure, the mole is removed and checked under a microscope. A skin biopsy requires a local anesthetic.

What is staging?

Once a diagnosis of cancer has been made, it is important to know the stage of your cancer. The stage helps determine which treatment will work best for you. The stage of a cancer depends on its size and the extent to which it has spread to other parts of the body. Complete staging may only be possible after surgery or additional tests and it may be necessary to remove some of the lymph nodes near the cancer.

Sometimes the stage of a cancer is described as a number – Stage 0, 1, 2, 3 or 4 – followed by a letter. The higher numbers are used for cancers that have spread. Ask your doctor to tell you the stage of your cancer and to explain what the numbers and letters mean in your case.



What treatments will I have?

No two cancers are the same. Your doctors will consider the type and stage of your cancer, the scientific evidence that the treatment works for your type of cancer, and any other health issues you have. How thick a melanoma is (Breslows thickness) is the most important factor in deciding on the best treatment. You will be encouraged to help make the final treatment choices.

Cancer patients often have a combination of treatments. Your treatment may include:

Surgery: An operation to remove part or allof the tumour and some surrounding tissue. A decision to have surgery depends on where the tumour is and how close it is to vital organs. Many different surgical techniques are used to remove a melanoma with the least possible scarring. To reduce the chance of it coming back, some healthy skin tissue around the melanoma is often removed as well if the tumour is large, a skin graft may be needed.

Biological therapy: Special proteins or substances (similar to vaccines) are given to fight cancer cells or help boost the immune systems’s ability to fight cancer. Melanomas often respond well to biological therapy.

Chemotherapy: The use of drugs or medications that interfere with the ability of cancer cells to grow and spread Healthy cells can be affected during treatment, so you may experience side effects like nausea, vomiting, loss of appetite, fatigue, hair loss and an increased risk of infection.

Most people handle chemotherapy fairly well, and the side effects can usually be reduced or controlled. Chemotherapy is not used very often to treat melanoma, but it can be helpful in some cases.

Radiation therapy: (radiotherapy): High energy x-rays are used to destroy cancer cells. Side effects may occur as a result of some damage to tissue near the tumour, but these can usually be controlled. In external radiation therapy, the rays a are carefully aimed at the tunour avoiding surrounding healthy tissue. Radiation therapy is not used very often to treat melanoma, but it can be helpful if a melanoma comes back or is causing discomfort.

What are clinical trials: Clinical trials are scientific studies to test new ways of preventing treating or managing cancer. Clinical trial treatment trials investigate new approaches to treat cancer, such as new drugs of combinations of existing treatments. They are closely monitored to make sure that they are safe and effective for the participants. Ask your doctor if there is a clinical trial suitable for you as a treatment option. You may benefit and so may future cancer patients.

What else do I need to know?

It is important to have regular visits with your doctor to monitor your progress even after your treatment is finished. You will be seen every three months or so at first, and then less often. Your doctor will also recommend regular visits to check your general health, but will want to make an appointment right away if you notice anything unusual or worrying. Learn how to examine your skin, know what to look for and do it regularly. How do I help myself?

Try to stay positive. Staying positive is about figuring out how to deal with cancer in the best way that you can – and everyone will do this their own way. It doesn’t mean that you must seem be happy or cheerful all the time, or avoid talking or thinking about the difficulties of having cancer. But it can mean looking after yourself by finding relaxing, enjoyable activities that refresh you mentally, spiritually or physically.

Article By:- eHealthhut Webmaster
www.ehealthhut.com
2009-05-27