Although melanoma is not the most common type of skin cancer, it is the most serious. Melanoma occurs when melanocytes, the cells that produce melanin, mutate and grow uncontrollably. If not detected and treated early, melanoma can spread to other parts of the body. Melanomas often occur on the chest, back, and legs. However, they can appear on other body parts often exposed to the sun, including the face and eyes. At Vibrant Dermatology & Skinbar MD in Dedham, Massachusetts, we offer effective melanoma treatment.
Should You Consider Melanoma Treatment?
When detected early, melanoma is easily treated. Therefore, it is important to be always on the lookout for any changes in your skin. Early diagnosis and treatment can prevent cancer from spreading to the other parts of the body.
According to recent health reports, melanoma is becoming increasingly common among people under the age of 40, and especially women. Knowing the symptoms of melanoma and other skin cancers can help with early detection and treatment.
Symptoms of Melanoma
Although melanomas can appear anywhere in the body, they are more likely to develop on areas that are often exposed to the sun, such as the back, arms, legs, and face. In rare cases, melanomas can develop in other parts that do not see much sunlight, such as your fingernail beds, the palm of your hands and soles of your feet. People of color are more vulnerable to these hidden melanomas.
You should be concerned if you develop a new mole, notice some changes in an existing mole, or if you develop a new pigmented or unusual-looking growth on your skin. Melanoma can also occur on a normal-appearing skin. You should also see a doctor if you develop:
- A skin sore that is not healing
- A sore or spot that is tender, itchy, or painful
- A sore or spot that is bleeding
- A spot or lump that is smooth, waxy, shiny, or pale
- A firm, red lump that looks crusty or ulcerated
- A flat red spot that is scaly, dry, or rough
Initial Diagnosis
To differentiate between harmless moles and cancerous moles, we use the ABCDE examination.
Asymmetric (A)
Harmless moles are usually round and symmetrical, whereas cancerous moles are likely to have two very different-looking halves.
Border (B)
Cancerous moles are likely to have notched, irregular or scalloped borders.
Color (C)
Cancerous moles have many colors and uneven shades. They could be brown, black, or tan. Some have a blue or white pigmentation.
Diameter (D)
Cancerous moles tend to have a diameter that is larger than 1/4 inch.
Evolving (E)
If an existing mole starts to change its size, color, or shape, it could be a sign of melanoma.
Types of Melanoma
Superficial Spreading Melanoma
Superficial spreading melanoma is the most common type of melanoma. People with freckles and pale skin are more likely to develop superficial spreading melanoma compared to people with darker skin. Superficial spreading melanomas usually grow outwards rather than downwards, making them easily treatable.
However, if they grow downwards into deeper layers of the skin, they can spread to other cells in the body. You see a doctor if you notice a mole is getting bigger, especially if it has an irregular border.
Nodular Melanoma
Nodular melanoma is a faster-developing and the second most common type of melanoma. If left untreated, it can quickly grow downwards into the deeper layers of skin. Nodular melanomas usually appear on the chest, back, head, or neck. They often appear in a reddish or blue-black color on previously healthy skin. It is common for nodular melanomas to bleed or ooze.
Lentigo Maligna Melanoma
Lentigo maligna melanomas are less common and less dangerous. They develop slowly over several years in parts of the body that see much sun, such as the face. Lentigo maligna melanomas are flat and grow slowly sideways in the outermost layer of the skin. They look like a Hutchinson’s freckle, or lentigo maligna, but are usually darker and larger than a normal freckle.
When left untreated, they grow downwards into deeper layers of the skin, forming lumps. Older people, especially those who have been exposed to sunlight for long periods, are at an increased risk of developing this type of melanoma.
Acral Lentiginous Melanoma
Acral lentiginous melanoma is a rare, hidden melanoma. It usually develops on the soles of the feet and palms of the hands. Sometimes they grow around a nail, especially the big toenail or thumbnail. People with darker skin are more susceptible to this type of melanoma compared to other types.
Causes of Melanoma
Melanoma occurs when melanocytes, the cells that produce melanin, start to grow abnormally. Typically, healthy new cells push old cells to the surface of the skin. Once the old cells reach the surface of the skin, they die and eventually fall off. Sometimes new cells develop DNA damage, causing them to grow uncontrollably and eventually forming a mass of cancerous cells.
The cause behind this DNA damage and how this leads to melanoma is not clear yet. However, health experts believe melanoma is caused by a combination of factors, including genetic and environmental factors. They also believe that long-term exposure to ultraviolet (UV) radiation from the sun and from tanning beds and lamps is the primary cause of melanoma. However, we cannot blame UV light for melanomas that occur in places that do not see much sunlight, indicating other factors can increase your risk of developing melanoma.
Risk Factors
Fair Skin
People with fair skin have less melanin in their skin, making them more vulnerable to damaging UV radiation. Additionally, people with red or blond hair, freckles, light-colored eyes, and those who sunburn easily are at an increased risk of developing melanoma compared to people with darker skin. However, people of color can also develop melanoma.
Sunburn
Exposing yourself to one or more severe, blistering sunburns can make you more vulnerable to melanoma.
Ultraviolet (UV) Light
Regular exposure to UV radiation from the sun and tanning lamps and beds can increase your risk of developing melanoma and other types of skin cancer.
The Equator and Higher Altitude
People who live close to the equator, where the sun’s rays are more direct, are more exposed to higher amounts of UV radiation than those who live farther north or south. Living in a high altitude area also exposes you to more UV radiation.
Moles
According to medical reports, people with more than 50 normal moles on their bodies are more susceptible to melanoma. Additionally, people with an unusual type of moles are also at an increased risk of developing melanoma. Also known as dysplastic nevi in medical spheres, these abnormal moles are often larger than typical moles, have a mixture of colors and irregular borders.
Family History
If someone in your family, such as a parent, sibling, or child has had melanoma, you are also at an increased risk of developing melanoma.
Weakened Immune System
People with a weakened immune system are more vulnerable to melanoma and other skin cancers. Several things can impair your immune system, including medication, to suppress the immune system after an organ transplant, or diseases that attack and weaken the immune system, such as AIDS.
Diagnosis
Physical Exam
The doctor will examine your skin to check for any signs of melanoma. They will also review your medical history and ask you questions about your overall wellbeing.
Biopsy
A dermatologist will examine a suspicious mole and might recommend removing it for testing. The sample is sent to a lab to check for the presence of cancerous cells. The doctor will likely recommend removing the entire growth when possible. Before a biopsy, the doctor will use local anesthesia to numb the area. There are several types of biopsy procedures, and the doctor will help you choose the most suitable option for you, depending on your situation.
Punch Biopsy
A punch biopsy is performed using a circular blade, pressed into the skin around the mole.
Excisional Biopsy
During an excisional biopsy, a health professional cuts away the entire mole and a small margin of surrounding healthy tissue using a scalpel.
Further Tests
If the results from the initial diagnosis confirm the presence of melanoma, the doctor will carry out further tests to determine the stage of the cancer. To do this, the doctor will:
Determine the Thickness
To determine the thickness of the melanoma, the doctor will examine it under a microscope and measure it using a special tool. The thickness of the melanoma influences treatment plans. Typically, the thicker the tumor, the more serious the condition.
When the melanoma is thinner, surgery to remove the cancerous mole and some healthy tissue around it is often an effective treatment strategy. When the melanoma is thicker, the doctor might order additional tests to determine whether cancer has spread to other parts.
Check if the Melanoma Has Spread
To check whether the melanoma has spread to the lymph nodes, the doctor might recommend a sentinel node biopsy. During a sentinel node biopsy, a dye mixed with a weak radioactive chemical is injected in the area where the cancerous mole was removed. The dye follows the same route a melanoma would follow.
The first lymph node the solution reaches is known as the sentinel lymph node. The doctor locates and removes the sentinel lymph node for examination. If it is cancer-free, it is highly likely the melanoma has not spread beyond the original site of discovery.
Signs of Cancer Beyond the Skin
The doctor might recommend imaging tests for people with more-advanced melanomas to check whether the cancer has spread to other parts of the body. Imaging tests may include MRI scans, CT scans, X-rays, and positron emission tomography (PET) scans.
Melanoma Treatment
Surgery
Since it is easy to access and remove cancerous cells that develop on the skin, surgery is the standard treatment for melanoma. During surgery, the doctor removes the lesion and some healthy tissue around it. Once the surgeon removes the lesion, they send it to a lab to ensure they have removed all of it. A skin graft may be necessary if the melanoma covers a larger area on the skin.
Lymph Node Biopsy
A lymph node biopsy helps to remove cancer that has spread to the lymph nodes.
Radiation Therapy
During radiotherapy, high-powered energy beams, such as X-rays and protons, are used to kill cancerous cells. Radiotherapy is often used to treat advanced melanoma.
Chemotherapy
During chemotherapy, medications are used to target cancerous cells.
Immunotherapy
In this melanoma treatment option, the doctor administers drugs that boost the immune system’s ability to fight the cancer.
Targeted Therapy
This treatment option focuses on identifying and targeting specific weaknesses present within cancer cells.
We Can Help
The key to successful cancer treatment and recovery is early detection and treatment. Always look out for any changes in your skin, especially if you have existing moles. Visit a dermatologist if you notice any of the symptoms we have mentioned above. For melanoma treatment and diagnosis, contact Vibrant Dermatology & Skinbar MD in Dedham, Massachusetts today!