Who Gets Childhood Melanoma
Cutaneous melanoma in children is rare, and extremely rare before puberty. It comprises 3% of all paediatric cancers. However, in New Zealand, melanoma is the second most common cancer registration in people aged 024 years.
Risk factors for childhood melanoma include:
Like the adult population, melanoma mainly affects Caucasian children and is associated with sun exposure. There is a slight female preponderance.
What Are Possible Complications Of Skin Cancer In A Child
Possible complications depend on the type and stage of skin cancer. Melanoma is more likely to cause complications. And the more advanced the cancer, the more likely there will be complications.
Complications may result from treatment, such as:
Loss of large areas of skin and underlying tissue
Problems with the area healing
Infection in the area
Return of the skin cancer after treatment
Melanoma may spread to organs throughout the body and cause death.
How Is Melanoma Treated
- Surgery is used to diagnose and treat melanoma.
- A biopsy is done to make the diagnosis. The doctor may need to see if the melanoma has spread to the lymph nodes, which are small structures that help the body filter out harmful substances. A biopsy of the lymph nodes is called a sentinel node biopsy.
- If the tissue is found to be melanoma, the entire mole or affected area is removed.
- If the cancer has spread, more surgery may be needed to remove as much of it as possible.
When possible, surgery is done to remove the melanoma and any affected lymph nodes. Some melanomas can be removed easily and need only minor surgery, while others may need a more extensive surgery.
Surgery is not an option for all children with melanoma. Instead, they may be treated with chemotherapy, immunotherapy or targeted therapy.
- Chemotherapy uses powerful medicines to kill cancer cells or stop them from growing and making more cancer cells. Chemo is usually used if the disease has spread to the lymph nodes or to other organs.
- Chemo may be injected into the bloodstream, so that it can travel throughout the body.
- Some chemo may be given by mouth.
- Combination therapy uses more than one type of chemo at a time.
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What Are The Survival Rates For Melanoma
When melanoma is found and treated early, it is highly curable, with a five-year survival rate of more than 90%.
The five-year survival rate is about 70% when melanoma has spread only to the lymph nodes.
If melanoma has spread beyond the lymph nodes to other parts of the body, the five-year survival rate is about 25% but these numbers have improved. Now about 50% of adult patients treated with combination immunotherapy are expected to be alive four years after diagnosis.
Stay Away From Tobacco
There is no safe form of tobacco. If you smoke cigarettes or use other types of tobacco products, its best to stop. Its also important to stay away from tobacco smoke . Both using tobacco products and being exposed to tobacco smoke can cause cancer as well as many other health problems. If you dont use tobacco products, you can help others by encouraging the people around you to quit. Call us at 1-800-227-2345 for help, or see How to Quit Smoking or Smokeless Tobacco to learn more about quitting.
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How Can I Help My Child Live With Skin Cancer
If your child has skin cancer, you can help him or her during treatment in these ways:
Your child may have trouble eating. A dietitian or nutritionist may be able to help.
Your child may be very tired. He or she will need to learn to balance rest and activity.
Get emotional support for your child. Counselors and support groups can help.
Keep all follow-up appointments.
Keep your child out of the sun.
After treatment, check your child’s skin every month or as often as advised.
Who Is At Risk For Skin Cancer
Although anyone can get skin cancer, the risk is greatest in people who have fair or freckled skin that burns easily, light eyes and blond or red hair. Darker-skinned individuals are also susceptible to all types of skin cancer, although their risk is lower.
In addition to complexion, other risk factors include having a family history or personal history of skin cancer, having an outdoor job, and living in a sunny climate. A history of severe sunburns and an abundance of large and irregularly shaped moles are risk factors unique to melanoma.
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How Can You Help Prevent Your Child From Getting Skin Cancer
Dr. Woolery-Lloyd says that sunscreen can make a huge difference in your childs chances of developing skin cancer. One study showed that children who went on sunny vacations had a greater number of atypical moles, she explains.
And what about newborns and infants? Dr. Hellman shares that your baby should avoid the sun during the first six months, after which you can begin applying sunscreen, but the best prevention is for kids to stay in the shade. Since most skin cancers are a result of cumulative sun damage, the less exposure to sun damage and burns, the better the long-term preventive value, she says.
Dr. Richard Asarch, a board certified Denver dermatologist, also reminds parents that sunscreen needs to be applied daily and not just on sunny days. Even on a cloudy day, up to 80 percent of the suns UV rays can pass through the clouds. Apply an SPF of at least 30 15-20 minutes before sun exposure to allow a protective film to develop. Asarch continues, Re-apply every two hours or after excessive sweating or swimming. Use enough sunscreen to generously coat all exposed skin.
Signs And Symptoms Of Melanoma
The warning signs of skin melanoma are often called the A B C D Es of melanoma and include:
- A for asymmetry: The two halves of the mole do not match.
- B for border irregularity: The borders of the mole are fuzzy and irregular rather than sharp.
- C is for color variegation: In addition to brown or black, other colors are present.
- D is for diameter: The size of the mole is bigger than the size of the eraser on your pencil .
- E is for evolving: The mole has changed in size, shape or color.
These signs may not always be seen in pediatric melanoma. Other signs include a mole that is bleeding, itches, or has developed a break in the skin. A lump near the mole or in the lymph glands close to the mole should also be looked at by a doctor.
There are no blood tests that can screen or diagnose melanoma. This is why it is important that you report any of the above warning signs to your childs physician promptly. Survival rates are high when melanoma is diagnosed and treated early.
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Sun Exposure & Vitamin D
Some sunlight is good for you and is needed for bone health. It has been suggested by some vitamin D researchers that approximately 5 to 30 minutes of sun exposure at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D. Individuals with limited sun exposure need to include good sources of vitamin D in their diet or take a supplement to achieve recommended levels of intake.
UCSF Benioff Children’s Hospitals medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your child’s doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child’s provider.
What Are The Different Types Of Skin Cancer
There are three main types of skin cancer, including:
Basal cell carcinoma
Basal cell carcinoma accounts for the majority of all diagnosed skin cancers. This is a highly treatable cancer and grows very slowly. Basal cell carcinoma usually appears as a small, shiny bump or nodule on the skin, mainly those areas exposed to the sun, such as the head, neck, arms, hands, and face. It more commonly occurs among people with light-colored eyes, hair, and complexion.
Squamous cell carcinoma
Squamous cell carcinoma, although more aggressive than basal cell carcinoma, still is highly treatable. It accounts for a much smaller percentage of all skin cancers. Squamous cell carcinoma may appear as nodules or red, scaly patches of skin, and may be found on the face, ears, lips, and mouth. Squamous cell carcinoma can spread to other parts of the body, although this is rare. This type of skin cancer is usually found in fair-skinned people.
Malignant melanoma accounts for the smallest percentage of all skin cancers but represents the most deaths from skin cancer. Malignant melanoma starts in the melanocyte cells that produce pigment in the skin. Malignant melanoma sometimes begins as a mole that then turns cancerous. This cancer may spread quickly to other parts of the body. Malignant melanoma most often appears on fair-skinned men and women, but people with all skin types may be affected.
Distinguishing benign moles from melanoma
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Can Melanoma Be Cured
Melanoma that’s caught early, when it’s still on the surface of the skin, can be cured.
Untreated melanoma can grow downward into the skin until it reaches the blood vessels and lymphatic system. This lets it travel to distant organs, like the lungs or the brain. That’s why early detection is so important.
Pediatric Melanoma: Occurrence Is Rare Yet Most Common Type Of Skin Cancer In Children
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It is estimated that there are approximately 400 new cases of melanomas diagnosed annually in the U.S. among those aged younger than 19 years. Melanoma is the most common type of skin cancer that occurs in children, according to St. Jude Childrens Research Hospital, as approximately 7% of all cancers diagnosed in children aged between 15 years and 19 years are melanomas. On a brighter note, the majority of melanomas are diagnosed early on and are highly curable.
HemOnc Today asked Alberto Pappo, MD, director of the solid tumor division at St. Jude Childrens Research Hospital, about the risk for melanoma in children, the different types that occur and the different treatment options that exist for the pediatric population of melanoma patients.
Question:How common is melanoma in children? What are the most recent statistics suggesting?
Answer: Melanoma can occur in children and we do not know exactly why this happens. It depends on how melanoma is defined. The term melanoma in pediatrics has been applied very broadly to a variety of different diseases. One is the typical melanoma that we normally find in adults. There is another type of melanoma in pediatrics called spitzoid melanoma. This type of melanoma has a different natural history and treatment recommendation than that of the regular conventional melanoma that we see in adults.
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What Causes Melanoma In Children
It is not known why children get melanoma early in life. Most adult melanomas can be linked to ultraviolet exposure from the suns rays. UV damage is most commonly seen in sunburns. Melanin can help protect the skin from this damage.
People with more melanin and darker skin are less likely to develop melanoma. People who tan poorly and sunburn easilysuch as those with fair skin, light hair and blue eyeshave less melanin and are more likely to develop melanoma.
Other factors that may increase the chance of developing melanoma include:
- Fair skin, light hair and freckles
- Several large moles or many small moles
- A history of blistering sunburns or sunbathing
- A history of using tanning beds
- Exposure to X-rays
- A family history of melanoma
Certain genetic conditions increase a child’s risk of developing melanoma. These include:
- Xeroderma pigmentosum
How Is Skin Cancer Diagnosed In A Child
The healthcare provider will examine your child’s skin. Tell the healthcare provider:
When you first noticed the skin problem
If it oozes fluid or bleeds, or gets crusty
If its changed in size, color, or shape
If your child has pain or itching
Tell the healthcare provider if your child has had skin cancer in the past, and if other your family members have had skin cancer.
Your child’s healthcare provider will likely take a small piece of tissue from a mole or other skin mark that may look like cancer. The tissue is sent to a lab. A doctor called a pathologist looks at the tissue under a microscope. He or she may do other tests to see if cancer cells are in the sample. The biopsy results will likely be ready in a few days or a week. Your child’s healthcare provider will tell you the results. He or she will talk with you about other tests that may be needed if cancer is found.
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Uncommon But Not Impossible
While skin cancer is the most common cancer in the world, very few cases develop in children. Its less common than in adults, says Anne Marie McNeill, MD, a board-certified dermatologist practicing in Newport Beach, California. But it can and does occur. There are only about 300 to 420 new cases per year in our country, but the incidence is increasing.
Dr. McNeill points out that melanoma, one of the most dangerous forms of skin cancer, is the second most common cancer in people aged 15 to 29, and that children are at a higher risk for melanoma than other skin cancers. Risk factors for childhood melanoma include genetic predisposition and family history, so melanoma-prone families should take special care. Each person with a first-degree relative diagnosed with melanoma has a 50 percent greater chance of developing the disease than people who do not have a family history of the disease.
Additional risk factors include fair skin and a high level of ultraviolet radiation exposure specifically, intense sun exposure early in life . Its important to keep in mind that this exposure, especially if it causes a blistering sunburn in a young child, is a risk factor for melanoma later in life. So, even if your son or daughter doesnt develop skin cancer during childhood, the damage done during those early years may take a toll.
Skin Cancer In Children: What To Look For
In adults, melanomas tend to appear as darker spots, but in children, melanomas are frequently whitish, yellowish, or red. As with adults, any changes on the skin, especially changes to moles, should be brought to the attention of a doctor. The general recommendations of the ABCDES of what to look for in skin checks apply to children and adults:
- A Asymmetrical shape, like moles that are irregular or not symmetrical
- B Border, moles that have an unclear or unusual border
- C Color, especially the presence of more than one color in a mole
- D Diameter, moles that are larger than 6 mm
- E Evolution, which involves any changes to a mole over time3
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How Can You Prevent Skin Cancer In Kids
Taking measures to prevent skin cancer in childhood can also lower the risk later on.
Here are some habits to implement:
- Have kids wear sunscreen with an SPF of at least 30 every day .
- Avoid being in the sun when its the strongest .
- Encourage kids to wear hats and protective clothing.
- Educate teens about the dangers of tanning salons.
- Model good sun protection behaviors yourself.
What Causes Skin Cancer In A Child
Exposure to sunlight is the main factor for skin cancer. Skin cancer is more common in people with light skin, light-colored eyes, and blond or red hair. Other risk factors include:
Age. Your risk goes up as you get older.
Family history of skin cancer
Having skin cancer in the past
Time spent in the sun
Using tanning beds or lamps
History of sunburns
Having atypical moles . These large, oddly shaped moles run in families.
Radiation therapy in the past
Taking a medicine that suppresses the immune system
Certain rare, inherited conditions such as basal cell nevus syndrome or xeroderma pigmentosum
Actinic keratoses or Bowen disease. These are rough or scaly red or brown patches on the skin.
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How Is Skin Cancer In Children Treated
Skin cancer in children and adults is categorized by stages 0 through 4. The more advanced a cancer is, the higher its stage. Treatment options depend on the stage and location of the cancer.
Stage 0 or 1 melanoma can usually be treated successfully with wide excision, an operation that removes the mole and the healthy skin just around its margins.
At stage 0, a melanoma may instead be treatable with imiquimod cream , a prescription ointment that helps cancerous and noncancerous skin growths disappear.
Stage 2 melanoma requires wide excision, and may also involve a lymph node biopsy. A stage 2 melanoma may have invaded the lymph system, so a biopsy may be appropriate. Talk with your childs doctor about whether a biopsy makes sense at this stage.
Stage 3 melanoma requires surgery to remove the tumor and surgery on the lymph nodes to which the cancer spread. Radiation therapy may also be necessary.
Stage 4 melanoma can be very difficult to treat. This stage means the cancer has spread to distant lymph nodes and possibly other parts of the body. Surgery, chemotherapy, and immunotherapy may all be involved.