Today, melanoma is considered the most dangerous and aggressive form of skin cancer. It originates form melanocytes in the epidermis and is possible to occur on a pre-existing nevus (mole) or on a previously healthy skin area (de novo).
More often, it occurs on sun-exposed areas, still, it can be found in non-exposed areas, such as the palms, the soles and the perineum.
Melanoma usually resembles a nevus or freckle but with a different, from the usual, morphology. The color can vary from black, blue, dark brown or gray and in more advanced lesions, it tends to enlarge and become thicker. Symptoms, such as pruritus (itching), bleeding and crusting, may coexist.
Melanoma | Signs
Signs clinically suspected of melanoma are:
- Change of shape, color & size of a lesion
- Asymmetry or border irregularity
- Bleeding or crust formation
- Change of color or many colors within a nevus
- Area diameter greater than six millimeters
- Raised area on a previously flat nevus
- Ulceration and pruritus (itching) may indicate malignant transformation
Due to the aggressiveness and rapid growth of the tumor, it is very important to detect melanoma as soon as possible. For that reason, it is imperative for a qualified dermatologist to examine the nevi (moles) at least once a year and determine whether Dermoscopy and Mole Mapping is required, in order to allow detailed monitoring.
Melanoma | Surgery
If melanoma is suspected, a complete surgical removal of the lesion is required at the earliest reasonable opportunity. Then the lesion must be microscopically examined (histology-biopsy). Laser treatment or other destructive methods (e.g., Diathermy Coagulation & Cryotherapy) should not be used for the treatment of these lesions because they destroy the tissue, leading to loss of valuable information for the diagnosis of the neoplasm, its depth and staging.
In any case, if melanoma is detected in its early stages, it can be cured completely.
Who is most at risk of developing melanoma?
Regular skin examinations are especially important for people who are at high risk of skin cancer. The risk factors for the development of melanoma are:
- People with light skin pigmentation (Phototype Ι)
- Presence of many (>50) or dysplastic – deformed nevi
- Presence of congenital nevus
- History of malignant melanoma in the family
- Many lentigines or freckles on the skin of the face, hands and body
- Intense intermittent exposure to the sun (e.g., in the summer)
- History of sunburn during childhood
- Intense exposure to artificial UV radiation sources (e.g., solarium)
What happens after a patient is tested positive for melanoma?
A positive biopsy is followed by an additional wider surgical excision of the tumor, lymph node examination (sentinel node) and staging of the tumor. In some cases, Radiotherapy and Chemotherapy may be required.
Superficial spreading and nodular melanomas are the most aggressive types of melanoma. Early diagnosis of small superficial lesions can lead to complete cure, while advanced tumors with occurrence of metastases may limit the mean survival time to 6‑9 months.