What is melanoma?
Melanoma is one type of skin cancer that is based on melanin-containing pigment cells or melanocytes. A melanoma can arise from benign moles (nevi naevocellulares), though the chances of this happening by very small birthmark. Furthermore, the emergence of troubled (dysplastic / atypical) moles or "spontaneously" from normal skin where no mole was noted before. They can be included in a small percentage of patients would also arise elsewhere, for example in the mucosa, the rectum, the meninges, or even into an eye.
Feature
Benign moles are flat or slightly raised, brown or black spots that vary in size, shape and color. However, its shape and pigmentation always regular, as opposed to a troubled mole, that various shades of brown to black, and in some cases may exhibit a reddish discoloration.
When an ordinary or restless mole becomes larger, color, color composition or shape changes, itches, sticks or hurts, bleeds or crusts exhibits are advised to consult a doctor.
A melanoma is usually irregularly shaped than a birthmark and asymmetric, the pigmentation is often irregular. Besides black and brown can also red, purple, blue, gray and white appearance. Over time, go melanomas protrude slightly above the skin, and they become larger. The total thickness of a melanoma (Breslow's depth) is one of the most important predictive characteristics of the chances of survival of the patient. Often the difference between a benign mole and melanoma to just under the microscope (after removal), and even then not always certain. When in doubt, the doctor will opt for removal, with a certain safety margin of a few mm around the mole. If, after investigation that the deviation was indeed malignant than there will be a re-operation in the short term. It will be around the place where the abnormality was still another tissue to be removed, but now with a considerably wider margin (0.5 - 2 cm, depending on the Breslow's depth of the melanoma). In specific cases are also advised lymfklieroperatie.
Self-examination
In melanomas, it is of great importance that the deviation is detected and treated as early as possible. Timely detection of this form of skin cancer usually heal well with a relatively small operation. If the tumor is discovered at a later stage be expanded operations including lymfklieroperaties sometimes necessary with any additional radiation. If, despite metastases occur, the prognosis is bleak. Therefore it is recommended to monitor monthly any suspicious moles or other skin spots on change in time so a doctor can be consulted.
Risk factors
Risk factors for getting melanoma: heredity, having more than 50 ordinary moles or at least three troubled. People with pale skin, freckles or blond / red hair have a slightly increased risk. These risks are all fixed and can not be influenced. The only known modifiable factor is exposure to sunlight and tanning bed use. These mainly involves preventing combustion.
Melanoma treatment
The most commonly used treatments for melanoma include:
- operation of the melanoma, and sometimes the lymph nodes (surgery)
- chemotherapy with dacarbazine (cell division inhibitor drug)
- targeted treatment with BRAF inhibitor in melanoma sensitive there for his
- ipilimumab, an anti-CTLA4 drug that increases the chance of an autoimmune response against the melanoma
- experimental treatments (new interventions or unregistered medicines which still is not sure what the chances of success and what are the side effects)
- radiation (radiotherapy)
Metastases
Once cancer metastases is generally spoken incurable, and that goes for melanoma. The 5-year survival rate (the number of patients that 5 years after diagnosis of metastases is alive) is less than 10%. The average life expectancy is only 6 to 12 months. Treatment will be palliative, aimed at prolonging life and quality of life. In some cases, a patient is still alive for several years, depending on the natural behavior of the melanoma in that patient, and the response to treatment. Metastases to the skin and lungs have a better prognosis than metastases to the brains, bones or liver.
Prospects
Thanks to the attention there for many years in various campaigns and in the media is devoted to melanoma, this form of skin cancer is detected at an increasingly earlier stage. People with suspicious symptoms go to the doctor sooner than was previously the case. This makes the prospects of people with melanoma are significantly improved over the last 30 years. In the majority of patients today comes after removing the melanoma not return. This is more to allow more timely discovery write than to major advances in treatment. Melanoma remains the foulest and most notorious form of skin cancer.