Overview Of Malignant Melanoma
Malignant melanoma is the most dangerous type of skin cancer. It is also the rarest. It is the leading cause of death from skin disease.
Commonly Associated With
Lentigo maligna melanoma; Melanoma in situ; Superficial spreading melanoma; Nodular melanoma; Acral lentiginous melanoma
Causes Of Malignant Melanoma
Malignant melanoma is caused by changes (mutations) in skin cells called melanocytes. These cells make a skin color pigment called melanin. Melanin is responsible for skin and hair color.
Melanoma can appear on normal skin. Sometimes it can develop from moles. Moles that are present at birth may develop into melanomas. Larger moles that are present at birth may be at higher risk of developing melanoma.
There are four major types of malignant melanoma:
Superficial spreading melanoma is the most common type. It is usually flat and irregular in shape and color, with different shades of black and brown. It is most common in fair skin people.
Nodular melanoma usually starts as a raised area that is dark blackish-blue or bluish-red. Some do not have any color (amelanotic melanoma).
Lentigo maligna melanoma usually occurs in older people. It is most common in sun-damaged skin on the face, neck, and arms. The abnormal skin areas are usually large, flat, and tan with areas of brown.
Acral lentiginous melanoma is the least common form. It usually occurs on the palms, soles, or under the nails.
The risk of developing melanoma increases with age. However, more and more young people are developing it.
You are more likely to develop malignant melanoma if you:
- Have fair skin, blue or green eyes, or red or blond hair
- Live in sunny climates or at high altitudes
- Spent a lot of time in high levels of strong sunlight because of a job or other activities
- Have had one or more blistering sunburns during childhood
- Use tanning devices, such as tanning beds
Other risk factors include:
- Having close relatives with melanoma
- Certain types of moles (atypical or dysplastic) or many birthmarks
- Weakened immune system due to disease or medicines
Symptoms Of Malignant Melanoma
A mole, sore, lump, or growth on the skin can be a sign of melanoma or other skin cancer. A sore or growth that bleeds, or changes in color can also be a sign of skin cancer.
The ABCDE system can help you remember possible symptoms of melanoma:
Asymmetry: One-half of the abnormal area is different from the other half.
Borders: The edges of the growth are irregular.
Color: Color changes from one area to another, with shades of tan, brown, or black, and sometimes white, red, or blue. A mixture of colors may appear within one sore.
Diameter: The spot is usually (but not always) larger than 5 mm in diameter — about the size of a pencil eraser.
Evolution: The mole keeps changing appearance.
Another way to look for possible melanoma is the “ugly duckling sign.” This means the melanoma does not look like any of the other spots on the body. It stands out like the ugly duckling in the children’s story.
Exams & Tests For Malignant Melanoma
Your health care provider will check your skin and look at the size, shape, color, and texture of any suspicious areas with a dermatoscope.
If your provider thinks you might have skin cancer, a piece of skin from the growth will be removed. This is called a skin biopsy. The sample is sent to a lab for examination under a microscope.
A sentinel lymph node (SLN) biopsy may be done in some people with melanoma to see if cancer has spread to nearby lymph nodes.
Once malignant melanoma has been diagnosed, CT scans or other types of x-rays may be done to see if cancer has spread.
Treatment Of Malignant Melanoma
Surgery is almost always needed to treat melanoma. The skin cancer and some surrounding area will be removed. How much skin is removed depends on how deep the melanoma has grown.
If cancer has spread to nearby lymph nodes, these lymph nodes may also be removed. After surgery, depending on the risk of the disease returning, you may receive chemotherapy or immunotherapy.
Treatment is more difficult when the melanoma has spread to other organs. Treatment involves shrinking the skin cancer and treating cancer in other areas of the body.
You may receive:
- Chemotherapy: Medicines are used to kill cancer cells directly.
- Immunotherapy: These include drugs such as interferon to help your immune system fight cancer or other drugs that boost your immune system’s ability to find cancer cells and kill them. They may be used along with chemotherapy and surgery.
- Radiation treatments: These may be used to kill cancer cells.
- Surgery: Surgery may be done to remove cancer that has spread to other parts of the body. This is done to relieve pain or discomfort associated with growing cancer.
- Topical medicines: It boosts the immune system in local areas.
If you have melanoma that is hard to treat, you might consider enrolling in a clinical trial. Ask your doctor for more information. Researchers continue to study new treatments.