Melanoma (patient information)

For the WikiDoc page for this topic, click here

Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Melanoma is a cancer that starts in the melanocytes. Although much less common than basal cell and squamous cell skin cancers, melanoma causes most skin cancer deaths. Usually, the first sign of melanoma is a change in the size, shape, color or feel of a mole. The ABCD rule can help you tell a normal mole from an abnormal mole. Melanoma can be cured only if it is diagnosed and treated early. When spreads to other parts of the body, the outlook could be very bad.

What are the symptoms of Melanoma?
Usually, the first sign of melanoma is a change in the size, shape, color or feel of a mole. The ABCD rule can help you tell whether the mole is normal or not. Moles that have any of these signs should be checked by your doctor.


 * Asymmetry: It means one half of the mole does not match the other half.


 * Border irregularity: The edges of the mole looks ragged, blurred, or notched.


 * Color: The color over the mole is not the same and may be shades of tan, brown, or black, and sometimes patches of pink, red, blue, or white.


 * Diameter: The mole is larger than about 1/4 inch, although sometimes melanomas can be smaller.


 * The mole is growing or changing in shape or color

Some melanomas do not fit the "rules" above and may be hard to tell if the mole is normal or not. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at highest risk?
Clinical data has suggested that the development of melanoma is related to several factors.


 * Sunlight(solar UV radiation): Too much exposure to sunlight(solar UV radiation) is thought to be the biggest risk factor for most melanomas.


 * Moles: Although as a benign skin tumor, the mole increases the chance of getting melanoma, espcially for people with many moles.


 * Genetic factors: Epidemiological data show that Whites with fair skin, freckles, or red or blond hair have a higher risk of melanoma than other race.


 * Immunosuppressive factors: Clinical surveys suggest patients treated with Immunosuppressive medicines such as transplant patients, have an increased risk of developing melanoma.


 * Previous melanoma: A person with previous history of melanoma has a higher risk of getting another melanoma.


 * Xeroderma pigmentosum (XP): Patients with XP are at higher risk of melanoma because thay can not repair damage caused by sunlight.


 * Age: Epidemiological data suggest that melanoma can be found both in old people and in younger people.


 * Gender: Men have a higher chance of developing melanoma than women.

Diagnosis
Regular self-examinations are key to early detection of melanoma. Any time skin cancer is suspected, go to see a dermatologist.
 * Biopsy: At first dermatologists detect skin cancer through a visual examination of the skin and mucous membranes. Then, if malignancy is suspected, a biopsy will be performed. It is the most important measure for the diagnosis of melanoma.


 * Images tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, ultrasound and chest-x-ray: The goal of these image tests are to help find out the extent of the melanoma and determine the stage of the disease.

When to seek urgent medical care?
Call your dermatologist if symptoms of melanoma develops.

Treatment options
Patients with melanoma have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, immunotherapy, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery: Surgery is the main treatment for most cases of melanoma. It can often cure early stage melanomas. Once the melanoma has spread from the skin to distant organs, the aim of surgery is to remove areas of spread and help patients live longer or have a better quality of life.


 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation. Radiation therapy may be used to treat cancer which has come back and can not be removed by surgery, and distant spread to the brain or the bone.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Usually, chemotherapy is useful in treating cancer that has spread.


 * Immunotherapy: This kind of treatment helps patients's immune system to better attack the cancer. There are many drugs of immunotherapy used for people with advanced melanoma, such as cytokines, interferon-alpha, melanoma vaccines and so on.

Diseases with similar symptoms

 * Benign junctional nevus


 * Cellular blue nevus


 * Basal cell carcinoma


 * Sclerosing angioma


 * Seborrheic keratosis

Where to find medical care for melanoma?
Directions to Hospitals Treating melanoma

Prevention of Melanoma
The best way to lower the risk of melanoma is to avoid too much exposure to the sun and other sources of UV light. Regular self check is also important.
 * Sun protection practices: Slip on a shirt, slop on sunscream, slap on a wide-brimmed hat, stay in the shade, wear sunglasses.


 * Avoid other sources of UV light: Aavoidance of tanning beds and sun lamps.


 * Check for abnormal moles and have them removed: Regular check for your moles and go to see your dermatologist.


 * Genetic counseling and testing: If you have previous melanoma or a family history of melanoma, go to see your dermatologist for genetic counseling and testing.

What to expect (Outlook/Prognosis)?
The prognosis of melanoma depends on the following:


 * The stage of melanoma: Whether cancer is found in the outer layer of skin only, or has spread to the lymph nodes, or to distant places in the body.


 * The location and size of the tumor


 * Whether there was bleeding or ulceration at the primary site


 * The patient’s general health

Resources
Medlineplus

Cancer.org