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Melanoma - Types, Causes, Symptoms, Risk Factors, Diagnosis and Treatment

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Melanoma is a skin cancer that can aggravate with sun exposure. Read this article to know more.

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Kartikay Aggarwal

Published At April 4, 2022
Reviewed AtFebruary 3, 2023

Overview:

One of the serious types of skin cancer is melanoma. The treatment options for melanoma might not be successful all the time. Mere exposure to the sun can increase the risk of melanoma. It is essential for an individual to track the moles that are growing in the body. However, a precise diagnosis can give way for wide treatment options.

What Is Melanoma?

Melanoma is a type of malignant cancer that develops in the skin. This cancer is known to develop from the cells called melanocytes. Melanocytes are cells that produce melanin. Melanin refers to the dark-colored pigment that gives color to the skin. In addition to the color, melanin also provides protection against ultraviolet rays. Melanocytes also have a vital role in immunity.

What Are the Causes of Melanoma?

Any abnormality in the production of melanocytes can cause melanoma. Any disturbance to the DNA can cause damage to the cells and result in the growth of new abnormal cells. In addition to these, ultraviolet radiation and genetic factors are the main causes of the occurrence of melanoma.

What Are the Symptoms of Melanoma?

The signs and symptoms associated with melanoma are,

  • Development of new and unusual pigmentation in the skin.

  • A mole that can change its existing size and shape.

  • Ulceration and bleeding.

  • A red spot that is flat, rough, and dry.

  • Soreness in the skin.

  • Painful and itchy lesions.

  • Formation of crust in the involved site.

  • Delayed wound healing.

Spreading of melanoma can cause nausea, vomiting, loss of appetite, and fatigue.

What Are the Types of Melanoma?

There are four notable types of melanoma. They are:

  • Superficial Spreading Melanoma: Among all types of melanomas, this is the most common type. It can occur on the lumps and trunk. Initially, cancer tends to grow very slowly, and in later stages, it grows rapidly across the surface of the skin.

  • Nodular Melanoma: Nodular melanoma is the second most common type of melanoma. This can occur in the head, neck, and trunk region. This variant tends to grow more rapidly than other types. The lesions that are caused by nodular melanoma might appear bluish-black or red.

  • Lentigo Maligna Melanoma: It is a rare type of melanoma, and lentigo maligna melanoma has a tendency to occur only in adults. The main reason for the occurrence of this condition is excessive exposure to sunlight. In the initial stages, it might look like small stains and later develop into a dangerous condition.

  • Acral Lentiginous Melanoma: This melanoma is the rarest variant. The lesions caused by the condition can occur on the soles of the feet, palms of the hands, and the nails' interior parts. One of the latest advantages of people with dark skin is that they have a very rare possibility of getting melanoma. But, acral lentiginous melanoma can affect dark-skinned people also.

What Are the Different Stages of Melanoma?

There are totally five stages in melanoma. They are:

  • Stage 0: In this stage, the cancer is present only in the outer layer of the skin. In medical terms, this stage is referred to as melanoma in situ.

  • Stage 1: In stage 1, the thickness of the cancer is about two millimeters. There is no involvement of the lymph nodes. By the end of this stage, cancer would not have spread to any other region. In some patients, the skin might be ulcerated.

  • Stage 2: In stage 2, melanoma has an average thickness of 1 mm to 4 mm. The increase in thickness is the greatest difference between stage 1 and stage 2. There is no involvement of lymph nodes noted in this stage.

  • Stage 3: In stage 3, melanoma has spread to the nearby lymph nodes. The lymphatic channels are affected. In some cases, more than one lymph node is affected. The lesion might be bigger than 4 mm. It is also known to be ulcerated.

  • Stage 4: By the end of stage 4, melanoma's cancerous nature would have become severe. A spread of cancer to the distant organs and the lymph nodes is noted. There is also the involvement of the liver, lungs, and brain.

What Is an Ugly Duckling?

An ugly duckling is a sign that indicates melanoma. This recognition method is based on the concept that the normal moles present in the body might be similar to one another. In the case of melanoma, they might appear ugly when compared to the nearby moles or lesions. The lesions that are uglier might be smaller or larger than the nearby moles. In some cases, it might also look darker or lighter than the surrounding region. If a lesion does not have any surrounding wounds, then they are considered an isolated lesion. These isolated lesions are known as ugly ducklings.

What Are the Risk Factors of Melanoma?

There are several risk factors associated with melanoma. They are:

  • Skin Complexion: The color of the skin greatly influences the condition of melanoma. People who have dark skin tend to have a higher level of melanin. If the individual is fair-skinned, then they have poor protection from the harmful ultraviolet rays. This is due to the reduced melanin in the cells.

  • Sunburn: The presence of severe sunburns that persists for a longer period can increase melanoma risk.

  • Ultraviolet Light: Excessive exposure to ultraviolet radiation either from the sunlight or tanning lights can increase melanoma risk in an individual.

  • Geographic Location: People who are known to live near the earth's equator region tend to receive sunlight directly. This can increase the amount of ultraviolet radiation that is received.

  • Family History: An individual who has a close family member affected by melanoma has an increased risk.

  • Poor Immunity: People who have poor immune power suffer a greater risk of skin cancer.

How Is Melanoma Diagnosed?

Diagnosis requires the following procedures.

  • Clinical Examination: The doctor will clinically examine the lesion. The medical history of the patient will be noted.

  • Biopsy: Biopsy is the procedure in which the small tissue is removed as a sample. The suspected skin tissue is sent to the laboratory for diagnosis. The punch biopsy is the most recommended method for melanoma. In the punch biopsy, a circular blade is used. It is pressed onto the skin surface. In some cases, an excisional biopsy is also recommended. In this procedure, a scalpel is used to remove the entire portion of the lesion.

  • ABCDE Examination: ABCDE examination is a characteristic method of determining melanoma.

    • Asymmetric: The moles that are noncancerous tend to be symmetrical and round in shape. If the mole or lesion is cancerous, then it can look different.

    • Border: If the borders are ragged, blurred, and notched, then it might indicate the presence of cancer.

    • Color: If the lesion has multiple uneven colors, it might indicate the condition of melanoma.

    • Diameter: A sudden increase in the size of the lesion can indicate melanoma.

    • Evolving: The ability of the condition to evolve into a more vigorous one might indicate skin cancer.

What Are the Treatment Options for Melanoma?

Surgical options are known to be helpful for melanoma. In the surgical procedure, the lesion is removed along with the smaller part of the normal tissue. If the melanoma involves a larger area of the skin, then the placement of graft might be necessary after the removal. In the later stage of melanoma, radiation therapy is the most commonly employed method. Chemotherapy can also be given to destroy the cancer cells that are present in the skin. The doctor will plan the combination of chemotherapy with radiation therapy. The other two treatment options for skin cancers are immunotherapy and targeted drug therapy. Immunotherapy focuses on enhancing the immune power in an individual. In targeted drug therapy, the drugs are administered to kill the specific cancer cells.

How Can You Prevent Melanoma?

By following the below tips, you can prevent melanoma.

  • Avoid excessive exposure to sunlight.

  • You can use creams that contain sun protection factors (SPF). Sun cream lotions that contain titanium dioxide or zinc oxide are recommended. You are asked to apply these lotions 30 or 60 minutes before going outdoors.

  • If you are planning to swim in a pool, then reapplying the sun lotions is recommended. In heavy sweating conditions also, the individual is recommended to apply this lotion once again. Children should be asked to stay indoors if the weather is too hot.

  • Wearing long-sleeved clothing can increase your level of protection.

Conclusion:

Melanoma is a type of skin cancer that can be dangerous when it spreads. So the earlier the condition is diagnosed and treated, the chances for recovery are better because most kinds of skin cancers can be cured if they are treated before they start to spread.

For more help, contact icliniq.com.

Frequently Asked Questions

1.

How Long Melanoma May Not Present Symptoms?

It is always necessary to look for any abnormal changes in your skin, especially on the moles. The changes in the size, shape, and color of the mole mark the initial sign of melanoma. The time of symptom development depends on the type of melanoma. Specific melanoma grows slowly and does not produce any skin changes in the initial stage. Whereas a few other types increase and spread to other organs. It includes:
- Nodular melanoma grows more quickly than other types. It causes bluish-black lesions on the head, neck, trunk, etc.
- Superficial spreading melanoma may grow slowly initially, but its growth increases at later stages.

2.

What Are the Characteristics of Melanoma in General?

Melanoma is a type of skin cancer that develops from melanocytes (melanin-producing cells). It is believed to occur due to excessive exposure to ultraviolet radiation. It mainly develops over the back, face, arms, and legs. The characteristic features include:
- It causes abnormal changes to an already existing mole or may occur as a new change in the skin.
- Irregularly shaped mole.
- Irregularly bordered mole.
- Changes in the mole color.
- New growth in the skin.
- Itchy or bleeding lesion.

3.

Does Melanoma Spread Quickly?

Yes, melanoma tends to spread quickly. The untreated melanoma overgrows and spreads to other parts of the body to cause life-threatening complications. Approximately it may spread within six weeks. Especially the nodular type of melanoma is more common, and it grows quicker than other types. These lesions appear o the trunk, head, and neck and maybe black or red. It might spread to adjacent lymph nodes and other organs like the lungs and brain if left untreated.

4.

What Are the Features of Vulvar Melanoma?

Cancer that develops from the melanocytes in the vulva refers to vulvar melanoma. The factors that increase the risk of vulvar melanoma are weakened immune systems, smoking, advanced age, and human papillomavirus infection. It causes several changes in the vulva as follows:
- Pain.
- Bleeding or abnormal discharge.
- Itching.
- A lump of black or dark brown, pink or white.

5.

Is Melanoma Common?

Skin cancer is more common than other cancer. However, the melanoma type of skin cancer constitutes only 1 % of skin cancer but is fatal. Women below the age of 30 are more likely to develop melanoma. Increased sun exposure and genetic disturbance leading to abnormal melanocyte production cause melanoma. The following factors increase the risk of acquiring it:
- Decreased immunity.
- Sunburn.
- Family history of melanoma.
- Smoking.

6.

What Is Malignant Melanoma?

Malignant melanoma is a severe skin cancer arising from pigment-producing skin cells (melanocytes). But may also occur from the mouth, throat, brain, etc. They overgrow and spread to other organs. It is found to develop at the age of 57 years. Having fair skin and increased exposure to the sun increases the risk of melanoma. The characteristics signs include:
- Asymmetrical mole.
- Irregular border.
- Change in color.
- Increase in mole size.
- Elevated mole.
- A skin biopsy aids in confirming the diagnosis.

7.

What Causes Melanoma?

The exact cause of this deadly melanoma is unknown. Its occurrence is mainly related to the following:
- Excessive exposure to ultraviolet radiation.
- Increased age.
- Weakened immune system.
- Family history of melanoma.
- Fair skin is more prone to melanoma than dark skin.

8.

How Is Melanoma Treated Effectively?

Melanoma is treated as listed below:
- Surgery - The skin lesion and the involved lymph nodes are surgically removed to prevent further spread.
- Radiation therapy - High energy radiation beam is used to shrink the cancer cells. It is usually employed post-surgery.
- Immunotherapy - Certain immunotherapeutic drugs aid in modifying the immunity to fight against cancer cells.

9.

Does Subungual Melanoma Grow Fast?

Subungal melanoma is a sub-type of melanoma arising from the palms and soles. Subungual melanoma develops from the structures inside the nail. It causes brow-blackish lines on the nail, especially over the thumb or great toenails. The discolored streaks may enlarge in size (more than 3 mm) and lead to cracking and splitting of the nails. The subungual melanoma grows slowly but becomes fatal if it spreads to other organs. Therefore, an initial diagnosis is critical in treating and preventing its spread.

10.

How Do I Know the Early Warning Signs of Melanoma?

Early melanoma signs are essential in treating cancer at the initial stage. The American Academy of Dermatology described the ABCDE rule to find out the warning signs of melanoma, and it includes:
A - Asymmetry.
B - Irregular border.
C - Change in color.
D - Increase in diameter.
E- Evolving or a new change.
Another newly added characteristic feature includes the “Ugly Duckling” sign, which means the lesion appears more ugly than the adjacent mole or lesion.

11.

Who Is at Risk of Getting Melanoma?

The below-listed factors increase the person’s susceptibility to acquiring melanoma.
- Older age.
- Excessive exposure to the sun.
- Fair-skinned.
- Too many moles in the skin may increase the chance of getting melanoma.
- Poor immune system.
- A family history of melanoma.

12.

Can Stress Cause Melanoma?

A rarely occurring skin cancer called melanoma may arise due to various reasons. It has been recently discovered that stress may also trigger the development of skin cancer. Studies show that the stress hormone (norepinephrine) is linked with cancer progression. But, the leading factors include sun exposure, familial history, and weakened immune system. In addition, the genetic and environmental changes and increased stress may induce melanoma in a few individuals.

13.

Does Melanoma Spread to the Lungs?

Melanoma, a severe skin cancer, starts spreading to nearby lymph nodes in stage 3 and distant organs like lungs, liver, and brain in stage 4. The prognosis at stage 4 is very low. It causes the following symptoms:
- Abdominal pain.
- Weight loss.
- Itchy skin.
- Jaundice.
The doctor may suggest chemotherapy and radiotherapy to control the cancer symptoms.

14.

Can I Live Long With Untreated Melanoma?

Melanoma is rare skin cancer, but it grows and spreads rapidly to cause various life-threatening complications. The untreated melanoma may spread to nearby lymph nodes or distant organs like the brain, liver, and lungs. During the initial stages of melanoma, the prognosis and survival rate are considered good. In contrast, the survival rate decreases to 30 % in left untreated individuals. Therefore, it is advisable to visit your dermatologist if you have any changes in your skin or moles.
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Dr. Kartikay Aggarwal
Dr. Kartikay Aggarwal

Dermatology

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