survival rates, treatment options, etc.


Melanoma is a cancer of the pigment-producing cells in the skin known as melanocytes. Although it is less common than other forms of skin cancer, it is the most dangerous. If not detected early, it can quickly spread to other organs.

Early treatment is essential. Five-year survival rates are excellent at 99.6% when treatment is initiated when melanoma is discovered and confined to the primary tumor on the skin. However, if it has spread (metastasized) to distant parts of the body, the survival rate drops to about 35.1%.

Prevention is also important, especially if you have fair skin, blond or red hair, and light eyes, as you are at increased risk for melanoma.

In this article, find melanoma moles and understand the stages of this cancer, early and late treatment options, prevention tips, and what to expect for melanoma patients.

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What is a melanoma mole?

It is not uncommon to have normal moles known as . nevus (peculiar nevus), on the skin. In an adult he has as many as 40 such moles. These are aggregates of melanocytes that may appear at birth or in early childhood, or develop throughout life. A normal mole is about the width of a pencil eraser and tends to be smaller than a quarter inch (6 millimeters).

Atypical moles are larger than nevus and may be a mixture of brown and pink. Normal and atypical moles are not cancerous, but they can change and, in rare cases, turn into melanoma. If you have many moles or larger-than-average moles, you are at a higher risk of developing melanoma.

In melanoma, instead of the cancerous melanocytes just staying in place, these cells can spread and start invading other organs. The sooner the melanoma can be removed, the better.

Melanoma can occur anywhere, including under the nails and even in the eyes. In women, cancer most often occurs in the lower extremities and back. In men, it usually occurs on the back, head, and neck. (Note that this article uses gendered terminology from each of the health authorities cited.)

To determine if you may have melanoma and not a nevus or atypical mole, look for the following signs based on what is known as the “ABCDE” rule:

  • asymmetric: It’s not uniform all over and one side of the mole doesn’t look the same as the other.
  • border with irregular features: If you look at the mole, the surroundings may not be smooth, but jagged or uneven. Also, the pigment may appear to penetrate the adjacent skin.
  • different shades of color: This may include tan, brown, black, and even blue, white, pink, and gray areas.
  • diameter: Melanomas can be small, but they are usually larger than 6 millimeters (mm) or 1/4 inch wide. Moles, on the other hand, are often smaller than 5 mm, and dysplastic nevus can be larger than 5 mm. However, if you notice any of these growing, they may be turning into melanoma.
  • Evolve: If you notice that your mole or spot has changed in any way over the weeks or months, it’s important to get it checked.

Early melanoma.

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stages of melanoma

To determine the best treatment for melanoma, it is important for a healthcare provider to first determine the stage of melanoma. The American Joint Committee on Cancer system is the most commonly used staging system, and he relies on three key pieces of information to determine staging.

The first is how deep the tumor has grown into the skin and whether the area is ulcerated (a tear in the skin).

The second considers melanoma thickness, known as the Breslow measurement. The thinner the melanoma, the more likely it is that it has not spread. Tumors less than 1 mm thick are least likely to spread. However, as the tumor thickens, the chance of metastasis increases.

The condition of the skin over the melanoma also makes a difference. If it ulcerates and is no longer intact, the prognosis is poor.

It is also important to determine whether the cancer has spread and, if so, how far it has spread.

Your oncologist (oncologist) may describe the stage of your melanoma as: This is important in order to create the best treatment plan for you.

  • stage 0: At this stage, the melanoma is completely confined to the outermost skin layer known as the epidermis and has not spread to other parts of the body.
  • stage 1: The melanoma is less than 2 mm thick and may or may not ulcerate the skin but has not spread to other parts of the body.
  • stage 2: At this stage, the tumor is 1 mm to 4 mm, or slightly larger, and has not spread to other parts of the body. The skin may or may not be ulcerated.
  • stage 3: Usually nearby lymph nodes are affected. However, in some stage 3 cases, the tumor has passed through the skin but has not yet reached the lymph nodes. If the lymph nodes are involved, melanoma is further staged by extent of spread and extent of growth, classified as stages 3a, 3b, 3c, and 3d.
  • stage 4: The melanoma has spread beyond the regional lymph nodes to distant lymph nodes or other organs such as the brain, liver, or lungs.

Nodular melanoma.

https://dermnetnz.org/topics/nodular-melanoma-images/?stage=Live


Small and early-stage melanoma treatment

If melanoma is found early (stage 0, 1, or 2), recommended treatments are:

  • Remove the melanoma and surrounding noncancerous skin margins to ensure all cells are removed.
  • Extract nearby lymph nodes affected by cancer
  • remove other melanoma spots found elsewhere

If necessary, the area from which the melanoma was removed can be replaced with a skin graft from another part of the body. For prominent areas such as the face, a plastic surgeon may operate to minimize scarring.

Other Melanoma Treatment Options

If melanoma has spread beyond the skin, treatment may also include:

immunotherapy

In melanoma, the cancer often suppresses the immune response to the cancer. However, with the help of drugs, the immune system can target and destroy melanoma cells. Immunotherapy is usually reserved for more advanced or late-stage melanoma.

Immunotherapy drugs that may be given include:

  • immune checkpoint inhibitor: They help T cells (white blood cells that are important for the functioning of the immune system) to mount a stronger response to melanoma. Treatments include Keytruda (pembrolizumab), Opdivo (nivolumab), and Yervoy (ipilimumab).
  • Interleukin-2: Interleukin 2, which supports immune system cells that help fight cancer, may be needed to shrink advanced melanoma and prevent its spread.
  • Oncolytic virus therapy: Viruses can cause disease when they enter healthy cells, but they can also be modified and trained to target and destroy cancer cells. One such treatment for melanoma is Imlygic (talimogene laherparepvec), also known as T-VEC.

cancer target therapy

These treatments target the changes that cause cancer cells to start growing. Each case of melanoma is evaluated for features (such as genetic mutations) that these drugs can target. Targeted treatments for melanoma include:

  • BRAF inhibitor: Mutations in the BRAF gene can cause cancer cells to make proteins that trigger melanoma growth, but BRAF inhibitors can interfere with this process. BRAF inhibitors include Zelboraf (vemurafenib), Tafinlar (dabrafenib), and Braftovi (encorafenib).
  • MEK inhibitor: MEK inhibitors target MEK proteins that function in cell signaling pathways with BRAF mutations that can lead to melanoma. MEK inhibitors such as Mekinist (trametinib), Cotellic (cobimetinib), and Mektovi (binimetinib) may be given.
  • KIT inhibitor: Mutations in the KIT gene can cause abnormal melanoma on the palms, soles, or nail beds. KIT inhibitors include Gleevec (imatinib), Tasigna (nilotinib), and Sprycel (dasatinib).

radiotherapy

Radiation therapy bombards melanoma with high-energy particles that damage the DNA of cancer cells and destroy them. Radiation therapy may be given after surgery to destroy any remaining cells. Alternatively, it can be given in combination with immunotherapy to improve outcomes.

Also, if the cancer has spread to other parts of the body, such as the brain, the tumors there may be given high doses of radiation therapy. This is known as stereotactic radiosurgery and is an approach with fewer side effects.

chemical treatment

Chemotherapy drugs are taken by mouth, injected, or injected into the bloodstream to kill melanoma cells. Advanced melanoma may require other newer treatments, such as targeted therapy or immunotherapy, after they have been tried. For melanoma, drugs such as carboplatin, cisplatin, dacarbazine, nab-paclitaxel, paclitaxel, and temozolomide can be used alone or in combination to treat melanoma.

metastasis resection

For patients with stage 4 melanoma who may have partially responded to other cancer treatments such as immunotherapy or targeted therapy, metastasis resection It may give you more control over the disease. This includes surgical removal of metastases (tumors that have spread to areas distant from the primary tumor). This may allow substantial disease control in some patients.

Lymph node resection

Testing may be needed to determine if melanoma has spread beyond the skin. Lymph node resection. In this procedure, a single lymph node or group of lymph nodes near the site of melanoma are removed and dissected to see if cancer can be detected.

If melanoma is found in these lymph nodes, it may determine the type of treatment received and affect the prognosis.

How to prevent melanoma

You can’t always avoid melanoma, but you can minimize your risk. Steps you can take to prevent skin cancer include:

  • stay out of the sun
  • Wear sun-protective clothing such as hats and long-sleeved shirts
  • Apply sunscreen and reapply throughout the day
  • Keep away from sun lamps and tanning beds
  • Monitor mole changes

Can changing my diet prevent melanoma?

Studies have found no clear evidence that any particular food, essential nutrient, or supplement can reduce the risk of melanoma. Those investigated include polyunsaturated fats, selenium, green tea, vitamins A, B, C, D, and E. Avoiding alcohol may reduce risk.

To prevent the development of cancer, the American Cancer Society (ACS) recommends eating mostly plant-based foods, such as foods rich in fresh fruit and leafy green vegetables, while avoiding highly processed foods, meat, and sugary beverages. We recommend that you take a base meal. ACS also recommends reducing or eliminating alcohol.

What is the future outlook for melanoma patients?

Each case of melanoma is different, but it helps us understand how other patients with the same diagnosis are coping. For cancers such as melanoma, how far the cancer has spread affects.

If the melanoma is still localized to the skin, the 5-year survival rate is 99.6%. Survival drops to 73.9% if it spreads to nearby lymph nodes. If the cancer has spread to other areas of the body, the 5-year survival rate drops to 35.1%. But what to do depends on your individual situation.

summary

Melanoma is not the most common form of skin cancer, but it is the most dangerous because it can spread rapidly to distant organs. However, if it is detected early while it is still in the skin, it is more likely to be cured.

Treatment of melanoma depends on the thickness of the tumor and how advanced it is (also called stage). Surgery, targeted therapy, immunotherapy, chemotherapy, and radiation therapy are used, sometimes in combination.

Prevention focuses on avoiding sun and UV exposure and monitoring the skin for suspicious moles.



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