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What Everyone Needs To Know About Melanoma
According to the American Academy of Dermatology, malignant melanoma (MM) is the third most common type of skin cancer, but accounts for 90% of all deaths related to skin cancer. It arises from the melanocytic (pigment producing) cells of the epidermis. Melanomas of all sizes have the ability to metastasize and become fatal.
The incidence of the disease is increasing worldwide. More than 135,000 cases are diagnosed each year, and nearly 10,000 people die from melanoma in the United States annually.
Caucasian men 50 years or older are at greater risk, however more young people are also getting the disease, including teenagers. It is now the most common cancer among people 25-29 years old.
Patient populations with higher incidences of melanoma include:
- Fair-skinned individuals (Fitzpatrick skin types I-II)
- High number of melanocytic nevi
- Large congenital melanocytic nevi
- History of abnormal moles
- Family history in a first degree relative – mother, father, siblings
There are multiple subtypes of melanoma including:
- Superficial spreading melanoma
- Nodular melanoma
- Lentigo maligna melanoma (arising from a sun freckle)
- Acral melanoma (on hands and feet)
- Less than 5% constitute the remaining subtypes of amelanotic (colorless), desmoplastic and polypoid melanoma
Important indicators of a patient’s overall outcome with melanoma depend on several factors, some of which are whether there are lymph nodes in the area that can be felt, the patient is male, and if the melanoma is located on the head, neck and torso.
Ninety percent of cases are diagnosed as primary skin tumors with no evidence that the disease has spread to other places in the body. When it spreads to other areas of the body a patient’s chance of survival are decreased.
The most common early signs of MM include:
- A growing mole on the skin.
- An unusual looking mole or a mole that does not look like any other mole on your skin (the ugly duckling).
- Non-uniform mole (has an odd shape, uneven or uncertain border, different colors).
In the early stages, melanoma may not cause any symptoms but sometimes may cause itching, bleeding, and pain. It may even look like a bruise that won’t heal.
A biopsy of the skin is necessary for a diagnosis. This biopsy will provide information regarding how deep the melanoma is, which determines what treatment is necessary. Depending on how deep it is, a biopsy of the lymph nodes near the area of concern may be necessary. Other diagnostic testing, including bloodwork, X-rays and a specialized form of CT scan, may be necessary to better determine if it has spread to other areas of the body.
Surgical removal is typically the gold standard first line treatment. Other treatments including injectable medications and, less frequently, radiation may be used if it has spread to other organs of the body.
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