What is melanoma? First of all, this is the most dangerous kind of skin cancer. It develops in the cells (melanocytes) responsible for the production of melanin - a pigment that gives the skin a certain shade. In some cases, melanoma can appear in the eyes and even in the internal organs - for example, in the intestine, esophagus or urinary tract.
The exact causes of the tumor remain unknown, but it has been proved that exposure to ultraviolet radiation during prolonged exposure to the sun or in a solarium contributes to the development of skin cancer. Accordingly, the risk is reduced by limiting the time spent in direct sunlight or other sources of ultraviolet radiation.
Cancer is often diagnosed in clean and apparently healthy areas. Melanoma of the skin does not always develop from a mole.
Photo: the initial stage of cancer.
According to statistics, most often skin melanoma is diagnosed in people over 40 years old, mainly in women. Knowing the primary signs of cancer promotes early detection of the disease and timely treatment. Melanoma can be completely eliminated provided that early diagnosis and prevention of the spread of pathology are possible.
Symptoms
This type of cancer affects any area of the skin. Usually affected are parts of the body that are most exposed to sunlight: back, legs, arms and face.
It should be remembered that melanoma can occur in the most unforeseen places, for example, on the soles of the feet, palms, and the nail bed. Such latent tumors are more often diagnosed in people with dark or dark skin.
The first signs of the disease include:
- Changes in existing moles;
- The appearance of a pigmented or unusual-looking neoplasm on the skin.
Normal moles
Healthy moles usually have a uniform color - reddish, brown or black. They have clear boundaries that separate them from the rest of the skin. The shape is oval or round, and the size, as a rule, does not exceed six millimeters in diameter (like a round eraser on the tip of a pencil).
Most people on the body have from 10 to 45 nevi, and many appear only by the age of 50. True, normal moles can change externally over time, and some even disappear with age.
Atypical age spots
Behind unusual moles can be hiding melanoma (photo), the initial stage of which rarely causes patients to suspect.
The classic primary diagnosis of this disease is abbreviated as "ABCDE" and means:
- A: asymmetric form. Particular attention should be paid to strange-shaped moles. As a rule, if you mentally divide them in half, the resulting halves will be very different from each other.
- B: uneven borders. A tumor is characterized by a curve, a jagged or wavy contour.
- C: changes in color. Neoplasms that combine several colors or are characterized by an uneven distribution of shades are dangerous.
- D: diameter. Melanoma can occur from a mole with a diameter of more than six millimeters (photo). The initial stage, as a rule, is characterized precisely by an increase in size.
- E: evolution (transformation). Changes that occur over time should be observed, especially if the mole grows in size or changes color or shape. Transformation may also mean the appearance of new symptoms. So, pathological moles begin to itch or bleed.
Cancerous (malignant) nevuses are very diverse. For some, all of the above symptoms are characteristic, while others show only one or two signs of pathology.
Hidden cancer
Melanoma often develops in areas of the body that are exposed to minimal exposure to sunlight. This is the area between the toes, palms, soles of the feet, scalp, genitals. Such tumors are sometimes called latent because they occur in the least typical places. When cancer is diagnosed in black patients, it almost always turns out to be latent melanoma.
Photo: initial stage of toe melanoma.
Similar tumors can be detected:
- Acral lentiginous melanoma - what is it? This is a rare form of a tumor that develops under the fingernail. It is also found on the soles of the feet and hands, most often in representatives of the black race and other people with a dark skin tone;
- In the oral cavity, digestive tract, urinary tract, or vagina. This type of melanoma affects the mucous membranes. In such cases, it is especially difficult to make an accurate diagnosis, since the symptoms of skin cancer in such areas are no different from the signs of other, much more common diseases.
- In eyes. This malignant melanoma most often affects the choroid of the eyeball - a layer located under the sclera (albumen). The tumor causes visual impairment and is often detected upon examination by an optometrist.
You should consult a doctor as soon as possible if you notice unusual changes in the skin or the appearance of atypical neoplasms.
Causes
Melanoma occurs due to a violation of the structure of melanocytes. In a healthy person, such cells develop in a strict order: new cells displace old cells to the surface of the skin, where they die and gradually exfoliate. However, sometimes the structure of DNA is disrupted in some cells - they cease to obey the established routine and, over time, form a cluster of cancers.
It is still unknown what exactly damages DNA in skin cells, and why melanoma arises because of this. What is it - a genetic predisposition or a whole complex of factors, including environmental and genetic? Be that as it may, doctors claim that the primary cause of cancer is exposure to sunlight and tanning beds.
However, ultraviolet does not cause all tumors. Evidence of this is the occurrence of pathologies in body parts hidden from the sun (see photo melanoma). So, other circumstances may also be the causes of the disease.
Risk factors
Risk factors include:
- Bright skin. The less pigment (melanin) in the epidermis, the weaker its natural defense against harmful ultraviolet radiation. If you have fair or red hair, freckles, and a tendency to quickly sunbathe in the sun, you are at risk. However, melanoma is also diagnosed in people with dark skin, including representatives of the black race.
- Repeated sunburn with multiple blisters increases the risk of skin cancer.
- Long exposure to ultraviolet radiation. Excessively long exposure to the sun or to the tanning bed threatens skin tumors, including melanoma.
- Living in tropical countries. People living near the Earth's equator, where the sun's rays shine almost in the forward direction, receive higher doses of ultraviolet radiation.
- The presence of multiple or atypical moles. If you have more than 50 normal nevi on your body, you are at risk. The same applies to people with atypical moles. They are not always pathological, and patients often ask dermatologists the same question: why are healthy moles so similar to tumors? Let's see, skin cancer - what is it? There are many melanomas, but in this case, normal accumulations of melanocytes from pathological ones should be distinguished. Unusual neoplasms are called dysplastic nevuses and, as a rule, are characterized by large size, uneven edges and mixed colors.
- Skin melanoma in a family history. If a close relative has melanoma, the risk of developing a similar disease becomes higher.
- Weakened immune system. Skin cancer is more likely to threaten patients with weak immunity - for example, those who have undergone surgery to transplant internal organs.
Screening
Ask your doctor if you need to undergo periodic screening for skin cancer. Such a study is of two types:
- Examination of the skin by a qualified specialist. During the examination, the doctor will analyze the condition of your skin from head to toe.
- Inspection at home. Self inspection - what is it? There can be several melanomas, and examination allows you to remember moles, freckles and other normal spots on the skin, so that you can immediately notice any changes. Self-examination is best done in front of a full-length mirror, while using a small mirror to check hard-to-reach areas. It is necessary to examine the arms and legs from all sides, as well as check the inguinal region, scalp, nails, soles of the feet and the areas between the toes.
Diagnostics
Sometimes it’s enough to diagnose skin cancer by the appearance of a mole, however, a biopsy is still the only way to determine oncology. If such an analysis showed a pathological neoplasm, then melanoma develops. What is this procedure? Its essence is quite simple: the doctor completely or partially removes the suspicious mole, and then a thorough examination of the sample is carried out.
When diagnosing melanoma, the following types of studies are prescribed:
- Trepanobiopsy. During this procedure, the doctor uses a tool with a round blade, which is pressed against the skin around a suspicious mole and removes a rounded fragment of the tumor.
- Excisional biopsy. With this procedure, the entire mole is removed along with a small area of the apparently healthy skin surrounding it.
- Incision biopsy. If this type of study is prescribed, only the most heterogeneous part of the mole or neoplasm is taken for laboratory analysis.
Usually, specialists prefer the first two diagnostic options, since they completely remove the potentially pathological structure. An incisional biopsy is prescribed in cases when complete removal for some reason is impossible or fraught with complications - for example, if a suspicious mole is very large. With a significant diameter, it is likely that the neoplasm is skin melanoma (photo: initial stage).
Early treatment
If cancer is diagnosed early, treatment usually involves surgery. Small melanoma can be removed during the biopsy procedure - and no additional manipulations are required. Otherwise, not only the tumor is removed, but also part of the healthy skin along with the tissues located beneath it. At an early stage of the disease, other treatment, as a rule, is not prescribed.
Advanced treatment
If malignant melanoma has covered any parts of the body or organs, in addition to the skin, the following methods of treatment are used:
- Surgical removal of affected areas. If the cancer has spread to nearby lymph nodes, most likely you will need to remove them.
- Chemotherapy. For this procedure, specific drugs that destroy cancer cells are used. Medications are administered intravenously, taken orally in the form of tablets, or both methods of administration are combined to provide higher efficacy of their action.
- Radiotherapy. This treatment involves the use of high-power directed energy, such as x-rays. Radiotherapy is usually prescribed after removal of melanoma and lymph nodes. Sometimes it is used to relieve symptoms.
- Biotherapy Biological therapy enhances immunity and helps the body fight pathological processes. Biological products are created from natural body fluids or their analogues produced in the laboratory. Side effects from this treatment are similar to signs of flu and include chills, fatigue, fever, headache and muscle pain.
- Targeted therapy. With this treatment, drugs are used that target specific properties and the specific vulnerability of cancer cells. Only melanoma can be treated with such drugs (the initial stage usually does not require the use of targeted therapy), and not healthy cells. Side effects are very diverse, but most often there is fever, chills, dehydration and skin rashes.
In severe form, the following drugs are prescribed:
- "Vemurafenib";
- Dabrafenib;
- "Trametinib".
However, these drugs are only effective in cases where the cancer is caused by a specific gene mutation. To assess the feasibility of using the above funds, produce a specific analysis of cells taken from the tumor.
Prevention
You can independently reduce the risk of melanoma and other types of skin cancer if you take the following measures:
- Avoid sun exposure in the middle of the day. As a rule, the intensity of natural ultraviolet radiation reaches a peak in the period from 11:00 to 16:00. Plan any outdoor activities in the early morning or evening, even if winter has come and the sky is cloudy. Ultraviolet light is absorbed by the skin year-round, and the clouds provide no protection. People who avoid the sun at the peak of its activity do not receive harmful sunburn or sunburn - both phenomena injure the skin and increase the risk of pathology.
- Apply sunscreen products to your skin all year round. Such creams and lotions do not block the entire flow of dangerous ultraviolet radiation, and even more so of the variety that causes cancer (melanoma and other skin tumors). However, this group of cosmetics plays an important role in the program for the general protection of the skin from negative environmental factors. It is advisable to choose cosmetics with an SPF of at least 15. Apply the cream or lotion in a thick layer and repeat the application every two hours, and with increased sweating or bathing in water, this should be done more often.
- Wear protective clothing. SPF cosmetics do not guarantee complete protection against harmful sunlight. Cover sensitive skin areas with dark-knit clothing. Matter should protect hands and feet. You will also need a hat with wide brim - it is much safer than, for example, a visor cap. Do not forget about sunglasses - they should have a mark on their ability to block both types of ultraviolet radiation (UVA and UVB rays).
- Avoid visiting tanning salons, as after exposure to artificially created ultraviolet radiation, melanoma is often detected (photo). The stages of the disease progress rapidly.
- Examine your skin thoroughly to immediately notice changes. Regularly check the condition of the epidermis for atypical neoplasms or changes in existing moles, freckles, nodules, and birthmarks. Using a mirror, carefully examine the face, neck, ears and scalp, as well as the chest, torso and arms from all sides. Then go on to examine the legs and feet, including the soles and spaces between the toes. It is also necessary to check the inguinal region and the area of skin between the buttocks. Both superficially spreading and nodular melanoma can develop almost everywhere.
The main thing to remember is that the combination of enhanced prevention and timely diagnosis is the only sure step towards healthy skin.