Melanoma is a rare and dangerous form of skin cancer. It can occur anywhere on the skin and also in the eyes. Unlike the other skin cancers that are usually localized, melanoma invades surrounding structures and can spread to any part of the body. This condition is more common in women and is becoming more prevalent. Exposure to ultraviolet light is a known risk factor in predisposing to disease development but the exact cause remains unknown. Early recognition and treatment can be curative.
Melanoma is a type of skin cancer originating from the pigment producing cells known as melanocytes. The skin has an upper layer called the epidermis, that contains the melanocytes, and an inner layer called the dermis. Production of the pigment melanin from melanocytes gives our skin its natural color. Skin becomes tanned when exposed to sunlight because there is increased production of melanin. Melanoma occurring on the skin is called cutaneous and when it occurs in the eye it is called intraocular melanoma. The coloration of the melanoma is usually black or brown but can vary between shades of pink and purple and may resemble a mole.
The initial presentation is either an abnormal growth on the skin or a change in an existing mole. A melanoma can develop anywhere on the skin but are more common in the parts of the body that have more exposure to the sun. They can occur in anyone so it is important to check your skin for any signs of growth or change.
A normal mole is symmetrical in shape, has distinct borders and is uniform in color. Causes for suspicion in otherwise healthy skin include the following. A mole with an asymmetrical shape. If you were to draw a line down the middle of it and both halves were not mirror images of each other then it would be considered asymmetrical. The border should be sharp and clearly demarcated from the surrounding skin. However if the edges are blurry and abnormally formed, it is a cause for concern. Other signs include uneven coloration and a large size. Check for any kind of change in already existing moles including growth or itching.
Melanomas can occur at sites where individuals may not normally think to check and are thus termed hidden melanomas. These can be on the soles of the feet or under a fingernail.
Exposure to ultraviolet radiation for prolonged periods of time causes damage to the DNA of skin cells. When this damage goes uncorrected it can trigger mutations that cause the cells to rapidly proliferate giving rise to a cancer. Harmful UV rays are not only from sun exposure, but also from tanning beds. Individuals who get sunburned and those with significant family histories are at higher risk of developing melanoma. Since this cancer can develop in areas not exposed to the sun it is unclear what exactly the underlying cause may be. Other important risk factors include having fair or light colored skin that burns easily and does not tan well.
This requires a thorough skin examination by a dermatologist. The most accurate way to make a definitive diagnosis is from a biopsy. This is a procedure in which all or a portion of the abnormal skin growth is removed and sent for laboratory examination. There are several types of biopsy procedures used when diagnosing melanoma. These include a punch biopsy in which a round piece of skin with the growth is removed, an excisional biopsy that removes the growth but also a small portion of the normal surrounding skin, and an incisional biopsy in which only the most abnormal part of the growth is removed. The results of the biopsy will verify whether or not an individual has melanoma and also what stage it is at. The different stages of the disease are described according to the size, location and spread of the cancer.
The treatment options vary depending on the stage of the cancer. When diagnosed in the early stages the melanoma is localized to the epidermis and it can be removed in its entirety. Such surgical procedures are curative and no other forms of treatment may be required. However if the melanoma has spread to other parts of the body then surgical removal of the skin growth is not the only step in management. The patient is given chemotherapy and targeted drug treatments that help fight the cancer. Also radiation is given to the affected area.
The most important step in prevention of melanoma is decreasing exposure to harmful ultraviolet radiation. Try to avoid being outdoors from the 10 am to 3 pm when the sun is most intense. If you are going outside always wear sunscreen, even if it is cloudy. The recommended sunscreen is broadband SPF 30, at the very least. It should be applied half an hour prior to sun exposure and then reapplied every two hours. In cases where an individual is perspiring a lot or swimming, application should be more frequent. Wear clothing that covers your arms and legs. Broad brimmed sun hats and UV protectant sunglasses are also important preventative measures. Avoid getting sun burned and tanning since both are harmful.
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