Introduction:
Melanoma can be of two types- cutaneous melanoma and non-cutaneous melanoma. Non-cutaneous melanoma occurs in the eyes, inside the nose, and in mucous membranes, which are inside the vagina, mouth, rectum, and anus. Only five percent of skin cancers are melanoma. Cutaneous melanoma has an increased mortality rate. It causes 10000 deaths per year. When diagnosed early, it has an increased survival rate of up to 98 percent.
What Is Cutaneous Melanoma?
Cutaneous melanoma is a type of skin cancer in the melanocytes or pigment-producing skin cells. Melanin is the pigment that gives the skin color. Melanoma is a highly metastasizing cancer that can spread to other organs and lymph nodes. In most cases, the primary site of developing melanoma is usually not found, and it results in the late-stage diagnosis of cancer and difficulty in treatment procedures.
What Are the Causes of Cutaneous Melanoma?
The actual cause of cutaneous melanoma is unknown. Exposure to ultraviolet radiation from the sun, indoor tanning, and abnormal DNA (deoxyribonucleic acid) mutation can cause melanoma. During exposure to natural or artificial sunlight for a longer period (there will be increased production of melanin pigment, which results in tanning), people having a family history of melanoma and people with a fair complexion are at increased risk of developing melanoma. It is seen in people above the age of 40 years.
What Are the Symptoms of Cutaneous Melanoma?
Cutaneous melanoma can be found anywhere on the body. They are often seen in areas like the hand, feet, face, or back because of an increased chance of exposure to the sun. It can be seen as moles, bumps, scaly patches, or open sores. The signs and symptoms which can be seen in cutaneous melanoma are a change in the existing shape, size, and color of the mole or the development of new, unusual pigmented growth on the skin. The signs and symptoms that have to be checked for cutaneous melanoma in an abnormal mole include -
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Asymmetry: The spot is usually asymmetric in cutaneous melanoma. When cut into two halves, both have different shapes. They are irregularly shaped.
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Border: The edges of the spot or the mole are not smooth.
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Color: They have an uneven distribution of colors, which may have brown, black, red, white, or grey.
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Diameter: The diameter will be greater than 6 millimeters.
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Evolving: The spot or the mole is evolving. That is, there will be a change in shape, size, or color. Other signs and symptoms like bleeding or itching on the moles can also be seen.
What Are the Types of Cutaneous Melanoma?
There are several types of cutaneous melanoma -
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Superficial Spreading Melanoma: Superficial spreading melanoma is the most common cutaneous melanoma. Before the invasion to the inside layers of the skin, it starts to grow horizontally across the outer layer.
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Nodular Melanoma: It is the second most common type of cutaneous melanoma. It is an aggressive type of cutaneous melanoma that quickly invades the deeper layers of the skin. It has the appearance of a blue or a black lump on the skin.
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Lentigo Maligna Melanoma: Lentigo maligna is called melanoma in situ. This melanoma can be treated easily. When it starts to invade the skin, it is called lentigo malignant melanoma. They are seen as flat, brown patches seen on the skin. It can be confused with age spots.
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Amelanotic Melanoma: It can be seen as faint pinkish marks on the skin, and it is difficult to detect.
What Are the Stages of Cutaneous Melanoma?
Cutaneous melanoma can be staged according to the extent of the spread of cancer to the tissues.
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Stage 0 - This stage is also called melanoma in situ. Melanoma is present in the dermis or the top layer of the skin.
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Stage 1 - This stage has no evidence of the spread of melanoma. It is low-risk primary melanoma that can be cured with the help of surgery.
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Stage 2 - In this stage, there is no evidence of the spread of melanoma. But after the treatment, there is a higher chance of recurrence of the melanoma.
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Stage 3 - The melanoma starts to spread to adjacent lymph nodes and skin.
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Stage 4 - The melanoma metastasizes to distant lymph nodes, skin, and other organs.
How Is Cutaneous Melanoma Diagnosed?
Several tests can be used in the diagnosis of cutaneous melanoma. They include -
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Biopsy - When a suspicious mole is identified, a small tissue is removed and examined under the microscope for the confirmation of any cancerous involvement and staging of the melanoma.
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Sentinel Lymph Node Biopsy - Sentinel lymph nodes are the first lymph nodes with cancer involvement. Sentinel lymph node biopsy (SLNB) is performed to identify cancer involvement in the lymph nodes by removing cells from the lymph nodes and examining them under the microscope. A negative sentinel lymph node biopsy confirms that the cancer has not yet metastasized to the adjacent lymph nodes and organs. A positive sentinel lymph node biopsy result suggests that cancer has spread to adjacent lymph nodes and organs.
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Computed Tomography (CT) Scan - Using computer technology and high X-ray radiation, a cross-sectional image of the affected region is produced to know if cancer has spread to the internal organs.
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Magnetic Resonance Imaging (MRI) Scan - Using a larger magnetic field and computer technology to create a three-dimensional image of the organs produced to know if the melanoma has spread to the brain and spinal cord.
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Positron Emission Tomography (PET) Scan - Using a radioactive drug to determine the abnormal activities in the body.
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Blood Tests - The level of lactate dehydrogenase is measured by using a blood test.
What Is the Treatment for Cutaneous Melanoma?
The treatment of cutaneous melanoma depends on the stage of the melanoma. Surgery is usually the first treatment strategy in cutaneous melanoma.
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Melanoma Surgery - During the early stages of cutaneous melanoma, surgical therapy increases the probability of curing. Cancer and the normal skin surrounding the cancer are removed under local anesthesia.
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Lymphadenectomy - In cases where melanoma has spread to the adjacent lymph nodes, removal of the lymph nodes near the melanoma is needed to prevent the spread of the melanoma to other areas of the body.
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Metastasectomy - In melanoma metastasized to other organs, the removal of the melanomas is done to prevent the further growth of cancer.
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Targeted Cancer Therapy - Targeted therapy focuses on a specific site to kill the cancerous cells leaving healthy cells undisturbed.
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Radiation Therapy - High radiation kills the cancerous cell and shrinks the tumors.
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Immunotherapy - By stimulating our immune system to fight against cancerous cells.
Conclusion:
Cutaneous melanoma is a rare skin cancer, but it has an increased mortality rate. So early, stage diagnosis is essential for the complete cure of melanoma. It can be prevented by avoiding excess sun and sunburns. Avoid the usage of tanning beds. During sun exposure, use a broad-spectrum sunscreen with an SPF (skin protector factor) of 30 or more, which should be used every two hours.
