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Malignant melanoma Causes and Risks:
Any change in an existing wart , mole , or other skin lesion , or development of a new growth that ulcerates and does not heal well, could indicate the development of a skin cancer . Skin cancer has a high cure rate if treated early, but neglect can allow the cancer to spread, causing disability or death.
Malignant melanoma is the most deadly form of skin cancer. It is also the least common. However, the incidence has doubled in the United States in the last 20 years. It is the leading cause of death from skin disease. Approximately 35,000 cases of malignant melanoma occurred in the United States in 1990, making it one of the most common forms of cancer that year. Melanoma is the number one cancer in young women under age 35. It can affect any age, with a recent trend toward discovery of the tumor at increasingly younger ages. Men have a higher rate of death from malignant melanoma than women. Deaths from complications of malignant melanoma are increasing at a faster rate than deaths from any other form of cancer except lung cancer .
Malignant melanoma involves cancerous changes to the skin cells that produce the skin's pigment, melanin . About 70% of melanomas appear on normal skin, and 30% occur in nevi ( moles ) or other lesions that have changed in appearance. Rarely, congenital birthmarks such as blue nevi and giant nevi may develop melanomas. The tumor may develop quickly and initially spreads to adjacent skin. It is highly curable in this phase. Later, it spreads downward to deeper skin areas and may spread (metastasize) to the internal structures and organs. This phase has a much lower cure rate.
Superficial spreading melanoma is a form of malignant melanoma that accounts for about 70% of cases of this disorder. It may strike at any age and is most common in Caucasians.
Nodular melanoma accounts for about 15% of cases. It may include ulcerations that never heal. It can develop anywhere on the body, usually between the ages of 20 and 60.
Acral lentiginous melanoma occurs in about 10% of cases of melanoma. It is most common in the elderly and always occurs on the palms, soles, or mucosal surfaces.
Lentigo maligna melanoma occurs in about 5% of cases, usually in the elderly. It is most common in sun damaged skin on the head, neck, and arms.
Sunlight (ultraviolet light) is the chief cause of all skin cancers including melanomas.
Prevention:
Minimize sun exposure. Protect skin from the sun: wear protective clothing such as hats, long sleeved shirts, long skirts or pants. Sunlight is most intense at mid-day, so try to avoid exposure during these hours. Use high quality sunscreens, preferably with SPF (sun protection factor) ratings of at least 15. Apply sunscreen at least one-half hour before exposure, and reapply frequently. Use sunscreen for winter exposure also.
Examine the skin regularly for development of suspicious growths or changes in an existing skin lesion . A new growth that ulcerates or is slow to heal is suspicious. Suspicious changes in existing growths include change in color, size, texture, appearance, or development of pain, inflammation, bleeding or itching . A lesion that is asymmetrical, has irregular or diffuse borders, has multiple colors mixed in one lesion, or is larger than 6 millimeters in diameter is suspicious.
Symptoms:
ALL FORMS - skin lesion or growth
- usually a papule (raised) or macule (raised)
- color varying (brown, black, red or bluish)
- mixture of colors in one lesion
- irregular borders, often asymmetrical
- a change in appearance over time in pigmented skin lesion
- bleeding from a skin growth
SUPERFICIAL SPREADING MELANOMA - skin lesion or growth
- small
- irregular border
- red, white, blue, blue-black color
- located on the trunk, limbs, or other areas
- possible ulceration and lack of healing
NODULAR MELANOMA - skin lesion or growth
- small
- nodules , bumps
- firm
- shiny
- color possibly ranging from pearl to black
- possible ulceration and lack of healing
ACRAL LENTIGINOUS MELANOMA - skin lesion or growth
- dark color
- usually on the palms, soles, tips of fingers or toes, mucous membranes
- possible ulceration and lack of healing
LENTIGO MALIGNA MELANOMA - skin lesion or growth
- irregular borders
- large
- brownish color with darker speckles
- usually on skin that has been overexposed to the sun
Signs and Tests:
The appearance of the skin lesion may indicate malignant melanoma.
A skin biopsy and examination can confirm the diagnosis. An X-ray , CT scan, MRI , or other procedures may be indicated to determine if spreading ( metastasis ) has occurred.
Treatment:
The goal of treatment is to cure the cancer .
Surgical removal of the tumor , with a margin of normal skin also removed, is usually required. Surgical removal of nearby lymph nodes may accompany removal of the tumor. A skin graft may be necessary after the tumor is removed.
Tumor removal may be accompanied or followed by radiation, chemotherapy (anticancer medications), or immunotherapy (medications that stimulate the immune system, such as interferon).
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .
Prognosis:
The depth (thickness) of the tumor is the single most important factor in determining prognosis (expected outcome).
Approximately 77% (men) to 88% (women) of malignant melanomas may be cured if treated early. If deep local spread or metastasis occurs, 5 year survival (the number of people who live for at least 5 years) is about 30%. With distant metastasis, 5 year survival is less than 10%.
Complications:
- spread to deep tissues with damage to structure or function
- metastasis of tumor to other locations within the body
Call Your Healthcare Provider:
Call your health care provider if symptoms indicate that malignant melanoma may be present; if any existing skin lesion changes in color, size, texture, or appearance; or if you develop pain, inflammation, bleeding or itching of an existing skin lesion.
Melanoma is a highly malignant skin cancer which metastasizes (spreads to other tissues) early, while the melanoma bump or papule is very small. The number of melanomas diagnosed annually in the United States is increasing rapidly.
This shows an invasive tumor spreading to the surrounding normal tissue.
This upper abdominal CT scan shows multiple tumors in the liver which have spread (metastasized) from a malignant melanoma in an arm or leg. Note the light circular areas throughout the liver (seen mostly on the left side of the screen).
Urine normally does not contain melanin, the pigment responsible for tanning and skin color. Malignant melanoma may produce excessive melanin that can appear in the urine. On exposure to air, this melanin darkens.
Diffuse melanoma can deposit large amounts of melanin in tissues, producing marked hyperpigmentation.
Malignant lentigo melanoma. Increased risk for melanoma is associated with chronic exposure to sunlight, blistering sunburns, and a family history of skin cancer.
Malignant lentigo melanoma. The incidence of this form of skin cancer is increasing faster than that of any other form of cancer.
Melanomas are sometimes called the patriotic cancer because they may be colored red, whitish, and blue (to blue-black) all in the same lesion. This lesion has multiple colors.
Melanomas are sometimes called the patriotic cancer because they may be colored red, whitish, and blue (to blue-black) all in the same lesion. This lesion has multiple colors.
Note the presence of multiple colors within this melanoma lesion. It is referred to as "patriotic cancer" because it is typically colored red, white, blue/black. This is a common appearance for a melanoma.
Skin cancer, melanoma - flat, dark lesion: Malignant melanoma is occurring more frequently than any other type of cancer in the United States. It is the most dangerous of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole which exhibits any of these changes should be evaluated immediately by your physician.
Malignant melanoma is the most dangerous type of skin cancer. Melanomas beneath the fingernail appear as a black or bluish black discoloration. This type of malignancy spreads (metastasizes) readily.
Increased risk for skin cancer, especially melanoma, is associated with chronic exposure to sunlight, blistering sunburns, and a family history of skin cancer.
Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your physician.
Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your physician.
Malignant melanoma is the most dangerous type of the skin cancers. Typical features of melanomas include irregular borders, multiple colors within the lesion, rapid growth, and susceptibility to easy injury with bleeding. Any mole that exhibits any of these changes should be evaluated immediately by your health care provider.
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