Melanoma

Most people have heard of melanoma and most people are quite scared of it. Melanoma is a form of skin cancer that often will begin with a simple dark spot or mole on the skin. How well you will do is very dependent upon how early you are able to detect it and in most cases if you can get in there early a simple surgery is all that is required. This article looks at the latest information and research around melanoma and teaches you how to recognise and deal with this scary and common condition.

What is it?

As mentioned above a melanoma is a form of skin cancer that begins in some cells in your skin known as melanocytes. These cells are responsible for making a dark pigment in your skin that we call melanin. This is the chemical that helps you to get a tan when you have been in the sun. Melanoma is known in medicine as a malignant melanoma; however it is easier for our purposes to shorten it to melanoma. You simply must pick up in this condition in the early stages before it spreads to the rest of your body. Melanoma is by far the most serious of the skin cancers as it grows quickly and does not take long to spread to other parts of your body. This is also a type of cancer that affects younger people more commonly than older people. In fact older people are more likely to obtain a skin cancer known as a squamous cell carcinoma. No one is really sure what causes the melanoma, however it is known that too much exposure to the UV rays from the sun and tan beds can definitely cause the melanocytes to change. When these cells change they can begin to form in an unusual and abnormal way and then turn cancerous. Some people do not get moles that turn into cancer and others do, however we are not sure why this is. There are certainly those who are more likely to get melanoma than others and these are usually people with lots of moles (over 50), having moles with jagged edges, relatives who have had melanoma, freckles, bad sunburn as a child, blue or green eyes, fair skin and hair, or going to tanning booths.

Are there any warning signs?

Indeed there are and two of the main things to look out for are new moles forming that are dark and appear on your skin as well as changes in the moles that you already have. You must visit your doctor if you notice that a mole on your body has changed in size, shape, color, or if it bleeds, itches, feels different, or hurts. If you have been to your doctor and they suspect that it could be a melanoma then you will most likely be referred to a dermatologist who specialises in skin. If they think that you have a melanoma then they will most likely cut it out and then send it off to the lab to get it tested. This may be the only form of treatment that you need, however in some cases they do not remove all of the cancer and you may need to have more skin removed.

Treatments!

Surgery is the method that is used in order to treat these skin cancers. This will usually be done with local anesthetic that will numb the area surrounding the melanoma, so that you will not feel a thing. Your surgeon will then cut out the melanoma as well as some of the normal looking skin surrounding it to ensure that all of the cancer is removed so that it will not come back. More skin is taken if your melanoma is deep into the skin. Many people have thin melanomas that are very small and doctors will not need to remove as much skin. Thicker melanomas will require more skin to be removed; however your doctor will discuss this with you before the operation. The incision or wound will be closed with sutures in order to leave as small of a scar as possible. In some cases so much skin has to be removed that you may require some skin from other places in your body in order to fill in the space, this is called a graft.

There is a newer form of surgery known as Mohs micrographic surgery and you may be offered this if you have a slow growing melanoma, or if the melanoma is on your neck or face. This surgery focuses on removing all of the cancer cells whilst at the same time attempting to save as much skin as possible. After the surgeon has taken an initial melanoma out they will then take a very small piece of skin from around the tumour and look at it under a microscope to see if there are any cancer cells left there. If there are still cancer cells there then they will remove another piece and check it again. The operation will stop when they find that there are only normal cells in the layer of skin that they have removed. There is no evidence yet that tells us if this is better than standard surgery for melanoma.

In some cases your doctor may think that the cancer has spread and in this case you will need further testing. The doctor will check your lymph nodes surrounding the melanoma and see if they show any signs of being infected with cancer. If this is the case then they will be sent away to the lab for testing. If they seem normal then the doctor will probably not want to remove them right away, however they might take a sample and make sure that they are cancer free. If they are not cancer free then you may need an operation to remove the cancerous lymph glands and you may even require treatment with radiotherapy, chemotherapy, or drugs that enhance the immune system.

What can I do?

We do not know exactly what causes melanoma, however sun seems to play a big part. You should avoid strong sunlight and when you have to be in it you should use sunscreen and wear protective clothing.

Outcome?

Finding a melanoma early is a good thing and there is a very good chance that you will be completely cured. We cannot say whether or not your melanoma will ever come back, however the thinner and smaller your melanoma is the better your chance is of not seeing it again. If you have suffered from a melanoma then you are more likely to get another one than those who have never had one before. You should check your skin very often to ensure that you would notice anything unusual if it was to pop up. If you are concerned in any way then you should talk to your doctor who will be able to tell you what to do.


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