Melanoma

Melanoma is the deadliest form of skin cancer because of its propensity to spread or metastasize to other parts of the body. It is the most common cancer among young women in their late 20s, and it is rising at a faster rate than any other cancer. If the melanoma is found early it can be cured, but a late diagnosis has a poor prognosis.

The four types of melanoma include:
• Lentigo maligna melanoma, which is flat and irregular and takes years to grow
• Nodular melanoma, characterized by rapidly growing brown to black raised bumps in the skin
• Superficial spreading melanoma, the most common type of melanoma, which is flat, asymmetric and varies in color
• Acral lentiginous melanoma, typically found on hands, feet and nails that is the most common melanoma in Asians and African-Americans

Risk factors include:
• Fair skin
• History of sunburns, especially in childhood or adolescence
• Personal or family history of melanoma or atypical moles
• Blond to red hair
• Blue eyes
• Immunosuppression
• Sun induced freckles
• Congenital moles

Symptoms include:
• A mole that changes in shape, size or color
• A mole that itches or becomes tender with bleeding

Diagnosis is only certain if a biopsy has been taken by a trained health care professional. The biopsy tissue is then sent to a histopathologist for review and definitive diagnosis. It is very important that all biopsy samples are sent for evaluation, because it is absolutely necessary to know the depth of the melanoma for staging purposes. This will dictate the prognosis and the aggressiveness of treatment.

Treatment will definitely include surgical removal of the melanoma with a specific margin around it, and may also include a lymph node biopsy at the same time. After surgery, treatment may include radiation and chemotherapy in case the melanoma spreads to other parts of the body.

The best prognosis occurs:
• If the melanoma has not invaded deep into the skin
• When the lesion is found on the arms or legs instead of the chest or back
• Before the cancer has spread or metastasized to other parts of the body
• In a younger patient

Remission and recurrence varies depending how early the melanoma was surgically removed, and if it has spread to other parts of the body. The Breslow level is a system of charting five-year survival rates based upon the melanoma characteristics. For example, a melanoma less than 1 millimeter and without ulceration (Breslow IA) has a 95 percent chance of five-year survival, whereas once it has spread to distant parts of the body (Breslow IV) there is only a 7 to 19 percent chance of five-year survival.

Therefore, it is very important to do self-exams and seek the care of your health care professional the moment that you have any concerns about a skin lesion.