Melanoma is a malignant skin tumor. The disease occupies a special place among skin neoplasms, as it has a high tendency to metastasizing (spreading of tumor cells) and low effectiveness of therapy, especially at the advanced stages. About 35% of melanomas appear on the site of pigmented nevi (birthmarks), the rest – on the unchanged skin. Risk factors include increased insolation and presence of hereditary predisposition.
Malignant formation arises from epidermal melanocytes, which synthesize melanin (pigment), therefore, the tumor is colored. With the germination of the basal plate of the skin, the formation quickly spreads to various parts of the body through the lymphatic vessels. Melanomas develops mainly on the skin, but can also spread to the mucous membranes of the oral cavity, genital area, rectal area, and conjunctiva.
In 2016, about 76,380 new cases of melanoma were recorded in the United States, which caused about 10,130 deaths. Lifetime risk ranges from 1% to 2%. Over the past 8 years, the prevalence rate has remained stable (previously it increased faster compared to the other malignant tumors). Melanoma accounts for <5% of the total skin cancer cases diagnosed in the United States, but causes the most deaths from skin cancer. On average, in the United States, one person is diagnosed with melanoma every hour.
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How to detect melanoma
In practice, specialists face a variety of skin pigmentations. Any pigmented formation should be considered as a possible melanoma and monitored carefully. Most often, melanoma develops in men in the back, and in women in the lower leg. These localizations require special attention.
Signs of skin melanoma can be detected during the visual examination. Most often, the tumor has a size of 6 mm to 3 cm, an asymmetric shape (round or triangular). The color of the formation is usually intensely brown or gray-black, but pink or light brown color is noted in 15-16% of cases.
There are signs that patients may notice by themselves:
- Asymmetry of the neoplasm.
- Color inhomogeneity.
- Persistent headaches.
- Weight loss for no apparent reason.
- Gray skin color.
- Enlarged lymph nodes.
Stages of melanoma
According to the degree of spreading, 4 clinical stages of the melanoma development are distinguished:
- The first stage of melanoma: a tumor 2 mm in diameter, not extending beyond the skin layer or mucous membrane, without metastases.
- The second stage of melanoma: a tumor exceeding 2 mm in the largest size, without metastases to the lymph nodes, bones or organs.
- The third stage of melanoma: a tumor of any size with metastases in the nearest (regional) lymph nodes.
- And the last stage of melanoma: any tumor with distant metastases (in organs, bones).
How to avoid the development of melanoma?
The negative effects of ultraviolet rays are well-known. They are also the main factor stimulating the melanoma development. The ultraviolet has a damaging effect on DNA and activates oxygen molecules, which also damage DNA. Ultraviolet radiation reduces the antitumor protection of the skin.
A tan after winter non-sunny months is very harmful. The total dose of radiation that the child has received during the first five years of life is of great importance. Risk group also includes people who regularly visit the solarium, especially under the age of 35 years.
In addition to solar irradiation, risk factors include:
- Congenital nevi.
- Acquired nevi.
- Atypical nevus (giant moles with uneven edges or different colors).
- Burns received in childhood after exposure to the sun.
- Family cases of melanoma.
- Inadequate immune system functioning.
Treatment of melanoma
The choice of treatment for melanoma depends on the stage of the disease. At the initial stage of the disease, treatment is limited to surgical removal of the tumor. When the tumor spreads in the skin or regional lymph nodes, in addition to surgical treatment, immunotherapy is also used. At the last stage of melanoma, diverse treatment methods are combined depending on the number of nevi and their location. Unfortunately, in the presence of metastases, there is no completely curable treatment method. The goal of the treatment in this case is to prolong life and reduce complaints caused by the tumor.