MELANOMA

 Basic information

description

Melanoma is a skin cancer that can occur on any skin or mucosal surface of the body. Melanoma can spread to other areas of the body, such as the lymph nodes, liver, lungs, and central nervous system. It can affect any age, usually older adults, and is rare in children. It is the most common cancer in women age 20 to 29, and second to breast cancer in women ages 30 to 34.

FREQUENT SIGNS & SYMPTOMS

• A changing mole is the most common symptom.
• Flat or slightly raised skin lesion. It can be black, brown, blue, red, white, or a mixture of colors. Borders are often irregular. Some may bleed, itch, or cause pain.

causes

Cells (melanocytes) that give skin its brownish color change into melanoma cells. It is unclear why this occurs. Melanomas may appear on normal skin or arise from a mole (nevus) or other abnormal skin area that has changed in appearance. They tend to occur at sites of sun exposure. When the cells grow down into deep skin layers, they invade blood vessels and lymph vessels and are spread to other body areas.

risk increases with

• Moles (more so with large numbers of moles).
• Occupations or activities involving excessive sun exposure, such as farming, athletics, or sunbathing.
• Excess sun exposure and sunburns in childhood (even one severe, blistering sunburn increases risk).
• Having atypical moles (dysplastic nevi).
• Increased age.
• Genetic factors. This is most common in fair-skinned, blond people. It is rare in Black people. It is rare in African-Americans.
• Weak immune system due to illness or drugs.
• Personal or family history of melanoma.
• Sunny or high altitude climates.

PREVENTIVE MEASURES

• Wear sunglasses, broad-rimmed hats, and protective clothing. Always use a sunscreen (15 SPF or higher). Avoid sun exposure between 10 am and 4 pm.
• Examine your skin regularly for changes in pigmented areas (such as moles). Ask a family member to examine your back, scalp, and soles of the feet. Get medical advice about any skin lesion (especially brown or black) that becomes multicolored, develops irregular edges or surfaces, and bleeds or changes in any way.

expected outcomes

Varies greatly. Early melanomas that have not spread are curable with surgical removal. Once the tumor has spread to distant organs, the prognosis is poor. However, symptoms can be relieved or controlled.

possible complications

• Cancer spreads (metastasis) to other places in the body, which can be fatal.
• Melanoma recurs. It can be the same site or new site.

 diagnosis & treatment

general measures

• Your health care provider will do an exam of the affected skin area. Biopsy (removal of a small amount of affected skin for viewing under a microscope) aids in diagnosis. Other tests may be done to see if the cancer has spread (staging).
• Treatment varies and depends on location and size of affected area, stage of the cancer, your health, age, and preferences. Treatment may include surgery (most often), anticancer drugs (chemotherapy) and/or radiation therapy, and biologic therapy.
• Goal of surgery is to remove as much of the skin cancer as possible. Skin graft may be done if large areas of tissue are removed. Lymph nodes may also be removed.
• Chemotherapy uses drugs, and radiation therapy uses radiation to attack the cancer cells. Biologic therapy uses the body's immune system to fight cancer.
• Since there is a risk of melanoma recurring, be sure to have regular follow-up medical exams.
• To learn more: American Cancer Society; (800) ACS-2345; website: www.cancer.org or National Cancer Institute; (800) 4-CANCER; website: www.cancer.gov.

medications

• Anticancer (chemotherapy) drugs may be prescribed.
• Biologic therapy drugs may be prescribed.

activity

No limits except those involving sun exposure.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of melanoma.
• During or after treatment, changes occur in the same or another skin area.

Special Notes: