A Simple Guide to Melonoma

A Simple Guide to Melonoma
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What is Melonoma?
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Melanoma is a progressive neoplastic tumor of melanocytes which are found mainly in the skin and can be present in the eye and the intestine.

It is a rare but dangerous cancer because of its rapid growth.

Who is affected by Melonoma?
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Melonoma is more common in :

1.People with fair skin than in those with darker skin.

2.People with multiple atypical nevi(moles)

3.Persons born with giant congenital melanocytic nevi(moles)

4.People who spend time outdoors under the sun than those staying indoors.

5.People with a family history of melanoma

What is the Cause of Melonoma?
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A. Familial:

Familial cases of melanoma with autosomal dominant genes are more common especially in fair skin people.

B.Sun exposure:

Exposure to the sun is one of the most common causes of melanoma.

Risk factors are:

1.intensity of the sun

2.duration of sun exposure,

3.age when sun exposure takes place

4.degree of skin pigmentation

What are the types of Melanoma?
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Types of primary melanomas:

1.superficial spreading melanoma

2.nodular melanoma

3.acral lentiginous melanoma

4.lentigo maligna melanoma

Melanomas occuring in non-skin areas:

5.clear cell sarcoma (Soft Parts)

6.mucosal melanoma (Intestines)

7.uveal melanoma (Eye)

What are the Symptoms and signs of Melanoma?
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Symptoms & Signs:
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A skin mole which has the following features:

1.Asymmetrical features

2.Border of the mole is irregular.

3.Color: black, blue or brown with occasional reddish and white areas

4.Diameter: Any mole with a diameter of > 5 mm has a higher chance to become melanomas

5.Elevation: The mole is usually raised above the skin.

Any change in the mole appearance may suggest malignancy

Bleeding and ulcerations are late signs.

Loss of skin markings may be present.

There is rarely pain.

How do you make the Diagnosis of Melanoma?
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1.Moles that are irregular in color or shape

2.Excision biopsy of the suspected mole.

3.Lactate dehydrogenase (LDH) tests are used to detect metastases

4.chest X-rays - to exclude spread to lungs

4.CT, MRI, PET scans of body to exclude metastases.

What are the complications of Melanoma?
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Metastases or spread of the melanoma can spread through the lymphatic or blood vessels to:

1.lymph nodes - if detected early and removed, survival rate is better

2.skin and lungs - have a better survival rate

3.brain , bone and liver - have the worst survival rates

What is the treatment of Melonoma?
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Surgery is the only treatment for localized cutaneous melanoma.

The skin lesion must be totally removed with an adequate margin of surrounding skin and tissue.

The biopsy will include the epidermal, dermal, and subcutaneous layers of the skin,in order to determine the depth and any infiltration outside the lesion.

The lymph nodes nearest to the lesion are also removed.

Disseminated melanoma (Cancer has spread to other parts of body) requires chemotherapy.

Radiation therapy is also used after surgery for patients with local melanoma or for patients with un-operable distant metastases.

Immuno-therapy with interleukin-2 or interferon has also been used with encouraging good results.

Gene therapy is a new area where the genes are manipulated to help kill the melanoma cells.

What is the prognosis of Melonoma?
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Prognosis depends on the following factors:
1.tumor thickness

2.depth related to skin

3.type of melanoma,

4.ulceration presence

5.lymphatic spread

6.tumor infiltrating lymphocytes (if present, prognosis is better),

7.location of lesion,

8.distant metastasis

Early diagnosis, biopsy and surgery usually means better prognosis.

Prognosis also depends on the depth and thickness of the melanoma.
The smaller the thickness of the melanoma the better is the prognosis.

Regional node spread and distant metastases usually suggest poor prognosis.

What are preventive measures for Melanoma?
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1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats)

2.Good nutrition and healthy lifestyle boost the immune system and helps prevent malignancy.

3.Patients with family history of skin cancer should be reviewed yearly

4.Israeli scientists from the Oncology Institute of the Hadassa Medical Center in Jerusalem in June 2008 announced the development of a new vaccine which can prevent recurrences and increase survival rates for melanoma patients.