Melanoma is a skin cancer that begins in melanocytes. Melanocytes are skin cells that make pigment. Most melanomas appear as new moles; some start from a mole already present. Melanoma starts in the mole, spreads nearby and then deeper into the skin, into veins and lymph nodes, and finally into the liver, brain, lungs, and bones.
The number of new cases in the United States increased greatly in the last 25 years. If found early, about 85% of melanomas are curable.
The cause is too much ultraviolet radiation from the sun, which hurts the skin. Higher risk is related to severe sunburns, lightcolored skin, blue eyes, blond hair, getting freckles, using tanning salons, and having many abnormal moles or family members with melanoma. People with dark skin can also get melanoma.
Initially there are no symptoms. When the melanoma spreads, symptoms include ABCDE changes in a mole, swollen glands (lymph nodes), shortness of breath, bone pain (when melanoma spreads to bones), and headache, seizures, and visual problems (when melanoma spreads to brain). Skin signs of melanoma are (A) asymmetry (the shape of one half doesn’t match the other), (B) irregular border, (C) uneven color, (D) increasing diameter (change in size), and (E) evolving (mole is changing in size, shape, or color). These are known as ABCDE changes.
The health care provider makes a diagnosis by doing a biopsy (removing a piece of the mole and studying it with a microscope). The biopsy must be done for staging the cancer (how thick it is and how deep it goes in the skin). Also, to see whether the cancer spread (metastasized), the health care provider looks for swollen lymph nodes during an examination and orders blood tests and x-rays.
Treatment depends on the stage of the cancer and whether it spread to other organs. Early detection is critical for a cure, because advanced melanoma generally cannot be cured.
Surgery is done for all stages. For early stages, a surgeon cuts a wide margin of skin to make sure that all cancer is removed. If the melanoma has spread to other organs, surgery, radiation, chemotherapy, and immunotherapy help symptoms but usually don’t cure it.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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