Melanoma is a malignant formation on the surface of the skin. It is the most dangerous form of skin cancer due to its likelihood of spreading to other parts of the body. A tumor develops when cells called melanocytes become abnormal and multiply in an uncontrolled way. Melanoma is one of the tumors that tend to grow rapidly.
Melanoma in childhood
Is there melanoma in children? Malignant skin tumor in children is very rare and accounts for only 1-3% of all melanomas. However, the number of cases is growing every year by about 2 percent. Especially frequent cases of the disease in children who are in the age category from 15 to 19 years. Malignant melanoma in childhood is a potentially fatal disease. Surgical excision is the main treatment for malignant melanoma.
What does melanoma look like in children? In children and adolescents, melanoma often looks different and can grow faster than in adults. While formations in adults are usually dark in color, in children they are often whitish, yellowish or pink.
Melanoma in adolescents is more similar to melanoma in adults. Most of the formations are pigmented. About 60% have such symptoms as asymmetry, violation of borders, color change, increase in diameter over 6 mm, growth.
Melanoma in children aged 10 years and younger has the criteria described above in 40% of cases. The formation is mainly red, not pigmented.
Classification
There are three main categories of childhood melanoma, including:
- Congenital melanocytic nevus. About 5-10% of nevuses degenerate into melanoma with age. This type of formation looks like a large, pigmented mole or birthmark. Nevus is formed in utero, they are found only at the birth of a child.
- Common melanomas. Rarely diagnosed before puberty. Clinically, this pediatric melanoma has some similarities with adult melanoma,
- Epithelioid Nevus (Spitz Nevus). Melanomas of this type are rounded in shape, uniform in color and nodular in nature. They often do not have the common genetic mutations observed in adult melanoma. Currently, the cause of the appearance of these formations is not known.
According to studies, the location of the primary tumor is an important prognostic factor, with melanomas of the scalp and neck having a poorer prognosis than those that appear elsewhere. Melanomas of the eyes or mucous membranes are rare forms of the disease, but can also occur in children.
Risk Factors and Causes
While melanoma is the least common form of cancer in general, it is the most common type of malignancy in children. The causes of skin melanoma in children are similar to the causes of melanoma in adults. Studies show that exposure to ultraviolet radiation can have a direct impact on the development of the disease.
The following risk factors for developing melanoma are:
- Light skin, blond or red hair, freckles. Blue or green eyes.
- Prolonged sun exposure without the use of sunscreen.
- Some types of moles, which over time can develop into melanoma.
- A history of skin cancer. Risk of relapse.
- Immunodeficiency or immunosuppression. Children with congenital immunodeficiency, as well as patients receiving immunosuppressive therapy in connection with organ transplantation, have an increased risk of developing melanoma.
Currently, the incidence of melanoma tends to increase in children with darker pigmented skin, especially under the age of 13 years.
Symptomatology
Timely detection of potential melanoma includes monitoring the size, shape and color of moles. Often mistaken for warts or mosquito bites, melanoma in children may look completely different than in adults. Therefore, parents should pay attention to the features of the formations on the skin of the child, for example:
- asymmetric mole edges;
- uneven mole edges (torn, blurry);
- nevus of irregular shape;
- large diameter (more than 6 mm);
- uneven color of formation with shades of black, blue-brown or red;
- nevus growth;
- itching and bleeding.
Parents should also be aware that there may be no signs of melanoma in the child. A significant number of pediatric melanomas have clearly defined edges and a light shade. This mismatch of melanoma symptoms in a child can lead to a serious delay in diagnosis. That is why it is so important that parents contact a specialist in a timely manner when suspicious formations appear. At the initial stage, the formation affects only the upper layers of the skin. Hence, with early detection of melanoma, 100% is curable. It is worth remembering that a tumor can appear not only on the skin that is exposed to the sun. Therefore, it is necessary to examine the skin of the head, arms, trunk and legs of the child.
Children who have been diagnosed with melanoma will need to undergo periodic examinations of the skin by a dermatologist. Observation by an oncologist is required. It is also recommended to use methods to prevent skin lesions. In addition, protection from harmful solar radiation is required.
How is infant melanoma diagnosed?
Diagnosis of melanoma in Moscow, St. Petersburg or any other major city can be done in specialized cancer centers or clinics. The examination is carried out through physical examination, taking a biopsy and conducting a histological examination. Also a highly informative diagnostic method is dermatoscopy. The study of formations is carried out using a special device that creates a multiple increase in the surface of the skin.
In the later stages of melanoma, an additional examination for the presence of metastases is necessary. These methods include:
- CT scan,
- Magnetic resonance imaging,
- positron emission tomography,
- blood test for the concentration of lactate dehydrogenase.
Where to get tested for melanoma? Check moles for free on the development of the oncological process can be annually on the "day of diagnosis of melanoma." This kind of action is held every year in major cities of Russia. Detailed information can be found on the website of the same name. With the appearance of symptoms or suspicious formations, waiting for this action, of course, is not necessary. You must contact a specialized agency immediately.
Risk factors for developing melanoma in children
Most cases of melanoma occur in middle-aged and older patients. However, this type of cancer can also occur in young children. The incidence of skin cancer is increasing. Diagnosis of melanoma in children is from 1 to 4% of all cases. According to estimates by the National Cancer Institute, about 500 children undergo such an examination annually. Risk factors for melanoma include:
- cases of melanoma or another type of skin cancer in a family history;
- the presence of congenital skin diseases;
- hypersensitivity to ultraviolet radiation due to the genetic component (for example, fair skin, fair or red hair, freckles);
- sunburn;
- the presence of a large birthmark;
- a large number of benign moles.
In general, skin cancer is the most common type of cancer. Melanoma is rare in children and has atypical features compared to adult melanoma. Sometimes it is not possible to classify education as unambiguous as benign or malignant melanoma.
How to treat?
The choice of tactics for treating melanoma in children is determined after the stage of diagnosis. Along with medical and surgical therapy, prevention is the main way to combat incidence.
There are general methods for treating melanoma:
- Surgery is a complete excision of the formation and affected tissue, including the lymph nodes. The most common treatment for melanoma in children is surgical removal. The surgeon excises the formation and nearby tissues. The thickness of the melanoma determines the amount of material removed. During the operation, local anesthesia is most often used. The size of the scar depends on the size, depth and location of the tumor. Also, in some cases, additional studies may be required: lymphatic mapping and biopsy. These procedures are to check the lymph nodes for the presence of affected cells.
- Chemotherapy. It is used in cases of spread of metastases to the lymph nodes and other organs.
- Radiation therapy. One of the options for treating the disease with damage to the lymph nodes.
- Immunotherapy. Indications for the appointment of such therapy are usually not operable melanoma or advanced stage of the disease. Special antibodies that stimulate the immune system are introduced into the body of the child. This starts the process of destruction of cancer cells.
Prevention Tips
Baby skin is particularly vulnerable to radiation. For this reason, for a walk, you should keep the baby away from sunlight, walk in the shade. Cream for protection can not be used on their delicate skin.
As a child grows older, protecting the skin from sun healing will help prevent the risk of cancer.
How to protect a child over the age of 6 months?
In order to protect the skin of older children, it is necessary to use sunscreens with a high degree of protection. How to properly use such tools is described below.
- Use sunscreen with a degree of protection of SPF from 30 to 50. Reapply every 2-4 hours. In cases where the child is sweating or swimming, the remedy should be used more often.
- Wearing light, covered clothing is an effective way to prevent sunburn.
- Hats and sunglasses also provide sun protection.
- The strongest radiation from the sun begins around 10 am and lasts until 4 pm. You should limit your child’s outdoors at this time.
Preventive action
The negative effects of the sun and, as a result, damage to the skin from ultraviolet rays are a known risk factor for the development of melanoma. Ultraviolet rays can damage DNA, which causes the cells to become cancerous and begin to mutate.
Currently, disease prevention is based on the following principles:
- Limited sun exposure.
- Thorough radiation protection with sunscreen and clothing, including hats.
- If a pregnant woman is diagnosed with melanoma, treatment should be started immediately to prevent transmission of the affected cells to the child.
- Large congenital nevus is recommended to be removed as a preventative measure to exclude the appearance of painful sensations and cosmetic problems in adolescence.
Melanoma. Photo
The picture shows melanoma with smooth edges, a uniform pink color.
The melanoma in the photo below is malignant. The formation has a dark color, uneven edges and an asymmetric shape.
After treatment
A favorable prognosis depends on the stage of the disease, spread beyond the original location on the skin. Even after carrying out all the procedures for the treatment of melanoma, the child still has a risk of the reappearance of the formation. In order to increase the chance of detecting melanoma as early as possible, it is necessary to undergo regular examinations by a doctor, to examine the skin of the child independently every month.
In patients under 11 years of age, melanomas exhibit less aggressive behavior than in adults. The overall five-year survival rate for children and adolescents with melanoma is about 90 percent.