Melanoma is a type of cancer that involves the melanocytes or pigment cells of the skin. It most often presents as a mole which has changed in size, shape, color or feel.
The incidence of melanoma is increasing . It’s unclear if this is related to increased sun exposure or improved methods of detection and increasing levels of awareness to this cancer.
According to the American Cancer Society this year approximately 48,000 Americans will be diagnosed with melanoma and about 8000 will die from it. Melanoma represents about 4% of all skin cancers but is responsible for 79% of the deaths.
Changes in the size, shape, color or feel of a mole should prompt further investigation by a skin care physician or dermatologist. Benign or harmless moles should appear fairly symmetrical. Many melanomas develop a variable blue or black appearance but other colors can also be present. The edges of a melanoma often are irregular and uneven. Melanomas demonstrate an increase in size and are usually larger than 5-6 mm. in diameter. Ultimately a suspicious finding will require a biopsy for a definitive diagnosis.
Other types of skin cancer which are more easily treated include basal cell and squamous cell.
Prevention of melanoma
- Avoid direct sun exposure especially between the hours of 10AM and 3PM.
- Wear sun protective clothing and sunscreen.
- Be aware that there is an increased risk in those individuals who have a family history of melanoma, are fair-skinned or have a prior history of melanoma.
- Be vigilant in observing any changes in skin moles and if you have any questions check with a dermatologist.
The primary form of treatment is local surgical excision. Mohs surgery is a specialized technique which may determine the local invasion of the melanoma more accurately. CAT scans and MRI scans are imaging studies which are often obtained to check for distant spread of the tumor.
Since melanoma usually spreads through the lymph system a new type of test called lymphoscintigraphy is sometimes used. A small amount of a radioactive substance is injected around the tumor and nearby lymph nodes are then surgically removed to check for tumor spread. If the “sentinal” node shows no tumor then it’s felt that the tumor has not spread to other parts of the body.
Chemotherapy is not highly effective in the treatment of melanoma. Interferon ,a substance which can stimulate an immune response in the body may hold some promise. Vaccine research is also ongoing but not yet available. Obviously the best treatment remains prevention and early detection.