Melanoma is a form of cancer that begins in melanocytes (cells that make
the pigment melanin). It may begin in a mole, but can also begin in other
pigmented tissues, such as in the eye or in the intestines. Melanoma is
the most serious type of cancer of the skin. Melanoma occurs when melanocytes
(produce melanin, the pigment that gives skin it natural color) become
malignant. Most pigment cells are in the skin therefore when melanoma
starts in the skin, the disease is called cutaneous melanoma. Melanoma
may also occur in the eye (ocular melanoma or intraocular melanoma).
Chances of developing melanoma increase with age and can occur on any skin
surface. In men it is often found on the trunk or head and neck and in
women it often develops in the lower legs. If developed in dark-skinned
people it tends to occur under the fingernails or toenails, or on palms
or soles. The exact cause of melanoma is not known although there are
certain risk factors that may contribute to people developing melanoma.
Some of them are dysplastic nevi, many ordinary moles, fair skin, personal
history of melanoma or skin cancer, family history of melanoma, weakened
immune system, severe blistering sunburns, and ultraviolet radiation.
Most time the first sign of melanoma is the change in the size, shape,
color or feel of an existing mole. Most melanomas have a black or blue-black
area and some early stage melanomas may be found when an existing mole
changes slightly for example, when a new black area forms. Other symptoms
like newly formed fine scales and itching in a mole also are common symptoms
of early melanoma. In advanced melanoma, the texture of the mole may change
leaving the mole hard or lumpy. Melanomas may feel different than regular
moles. More advanced moles may itch, ooze, or bleed also, but melanomas
usually don’t cause pain.
A skin examination is often part of a routine checkup by a health care
provider. Upon skin exam if the doctor sees a suspicious spot on the skin
that he thinks is melanoma, the patient will need a biopsy. During a biopsy
the doctor tries to remove all the suspicious looking growth then the
tissue is sent to a pathologist to examine under a microscope to look
for cancer cells. If the diagnosis is melanoma, the doctor then needs
to know the stage of the disease before planning treatment. To stage the
doctor may need to remove nearby lymph nodes to check for cancer cells,
and may also order chest x-ray, blood tests, and scans to help facilitate
this process. If melanoma is diagnosed early and treated when the tumor
is thin and has not deeply invaded the skin a cure is possible. However,
if melanoma is not removed in its early stage, cancer cells may grow downward
from the skin surface and invade healthy tissue. If this happens the disease
often spreads to other parts of the body making the disease difficult
to control.
Melanoma patients are often treated by a team consisting of a dermatologist,
surgeon, medical oncologist, radiation oncologist, and plastic surgeon.
Treatment choices such as surgery, chemotherapy, biological therapy, or
radiation therapy are discussed with the patient after staging is complete.
The doctor and patient work together to develop a plan to best fit the
patient’s needs.
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