Treatment For Superficial Spreading Melanoma
Superficial spreading melanoma is highly curable when diagnosed early. The goals for treatment of superficial spreading melanoma are to:
- cure the cancer
- preserve the appearance of your skin
- prevent the cancer from coming back
The extent and depth of the melanoma guides your care plan. Treatment often involves surgery to remove the melanoma. If the melanoma is more advanced and has spread to other parts of the body, such as the lymph nodes or internal organs, immunotherapy, targeted therapy, chemotherapy, radiation, surgery, or a combination of therapies may be used to shrink the tumor.;
How Is Melanoma Staged
Melanoma stages are assigned using the TNM system.
The stage of the disease indicates how much the cancer has progressed by taking into account the size of the tumor, whether its spread to lymph nodes, and whether its spread to other parts of the body.
A doctor can identify a possible melanoma during a physical exam and confirm the diagnosis with a biopsy, where the tissue is removed to determine if its cancerous.
There are five stages of melanoma. The first stage is called stage 0, or melanoma in situ. The last stage is called stage 4. Survival rates decrease with later stages of melanoma.
Its important to note that survival rates for each stage are just estimates. Each person with melanoma is different, and your outlook can vary based on a number of different factors.
Different Kinds Of Skin Cancer
There are many types of skin cancer. Some are very rare. Your doctor can tell you more about the type you have.
The two most common kinds of skin cancers are:
- Basal cell cancer, which starts in the lowest layer of the skin
- Squamous cell cancer, which starts in the top layer of the skin
Another kind of skin cancer is called melanoma. These cancers start from the color-making cells of the skin . You can read about melanoma in If You Have Melanoma Skin Cancer.
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This Is Why A New Though Tiny Spot Or Speck Should Not Be Ignored Even If It Looks Normal
Ultimately I believe genetics will help determine the behavior of these, but until we have that data we have to look at patterns, explains Dr. Gordon.
In general, survival rate of melanomas depends on depth of the cancer.
This depth is determined by a dermapathologist who examines a biopsy of the suspicious spot, which includes a surrounding margin of skin also taken out, under a microscope.
The rule of thumb is that the height of the melanoma above the surface of the skin is equal to its depth below the skin surface.
Dr. Gordon explains, In general, smaller lesions the thinner they are and the better outcomes people have.
Some melanomas will grow in a spreading pattern on the skin , but some will grow in a deep pattern that are more aggressive .
There is no easy way to decipher the spread of melanoma until it is biopsied and sometimes until further tests are performed.
Dr. Gordons interests include medical dermatology, particularly the treatment and prevention of melanoma and other skin cancers in athletes. For 2016, 2017 and 2018 Texas Monthly Magazine selected her as one of the Texas Super Doctors Rising Stars.;
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.;;
What Are The Clinical Features Of Superficial Spreading Melanoma
Superficial spreading melanoma tends to occur at sites of intermittent, intense sun exposure, especially on the trunk in males and the legs in females .
Superficial spreading melanoma presents as a slowly growing or changing flat patch of discoloured skin. At first, it may resemble a melanocytic naevus;, ephelis;, or;lentigo. It becomes more distinctive in time, often growing over months to years or even decades before it is recognised. Like other flat forms of melanoma, it can be recognised by the ABCDE signs: Asymmetry, Border irregularity, Colour variation, Different, and Evolving. The EGF signs indicate nodular melanoma.
Superficial spreading melanoma clinical features may include:
- Irregular asymmetrical shape
- Irregular border which may be ill-defined and smudgy in places
- Variable pigmentation: colours may include light brown, dark brown, black, blue, grey, pink, and red
- There may be skip areas that are skin coloured, or white scars due to regression
- Different – the odd-mole-out or ‘ugly duckling’ is different from that person’s usual naevi.
- It may be larger in size than most moles: > 6 mm and often 12 centimetres in diameter at diagnosis: however aim for diagnosis when less than 6mm
- Change over days, weeks, months, or years.
A rare variant of superficial spreading melanoma is the verrucous melanoma on the limbs and back of middle-aged and elderly men.
Invasive may be indicated by the following features:
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Questions To Ask The Doctor
- How far has the melanoma spread under my skin?
- Has it spread anywhere else?
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Doctors Want To Give Their Cancer Patients Every Chance But Are They Pushing Off Hard Talks Too Long
His team then gave mice implanted with human melanomas a weeklong regimen of an MCT1 blocker, AstraZenecas investigational AZD3965. Result: The animals had fewer melanoma cells in the blood and fewer metastases.
Inhibiting MCT1 doesnt have much effect on the primary tumor or on established metastases, Morrison said. But for cells in between, it can prevent metastasis and, at least in the mice, extend survival.
Although AstraZenecas MCT1 inhibitor is being tested in an early-stage clinical trial, the participants have solid tumors that have already metastasized. Morrison thinks thats too late: Oxidative stress kills cancer cells in the bloodstream, not once theyve reached their destination. If blocking MCT1 and thereby exposing tumor cells to oxidative stress in the bloodstream has any benefit, he said, it will be around stage 3, when cancer cells have reached the bloodstream and lymph nodes but not beyond.
Our prediction is that blocking MCT1 wont have much activity against stage 4 melanoma, but if used as an adjuvant therapy in stage 3, it might decrease the percentage of patients who progress to stage 4, Morrison said.
His discovery might extend beyond melanoma. Lung and pancreatic tumor cells also use MCT1 to grab lactate from the bloodstream, presumably enabling those cancers, too, to metastasize.
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Risk Of Further Melanomas
Most people treated for early melanoma do not have further trouble with the disease. However, when there is a chance that the melanoma may have spread to other parts of your body, you will need regular check-ups.;Your doctor will decide how often you will need check-ups everyone is different. They will become less frequent if you have no further problems.;After treatment for melanoma it is important to limit exposure to the sun’s UV radiation.;As biological family members usually share similar traits, your family members may also have an increased risk of developing melanoma and other skin cancers. They can reduce their risk by spending less time in the sun and using a combination of sun protection measures during sun protection times.;It is important to monitor your skin regularly and if you notice any changes in your skin, or enlarged lymph glands near to where you had the cancer, see your specialist as soon as possible.;
Why Its Important To Catch Cancer Early
For some cancers that are screened for on a regular basis, survival rates tend to be high. Thats because theyre often diagnosed early on, before symptoms develop.
But catching some cancers early is difficult. There are no regular screening guidelines for some cancers, and symptoms may not show up until the cancer is in its advanced stages.
To help protect yourself from these cancers:
- Be sure to keep up with your regular blood work and annual physicals.
- Report any new symptoms to your doctor, even if they seem minor.
- Talk with your doctor about testing if you have a family history of a particular type of cancer.
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How Does The Doctor Know I Have Melanoma
A new spot on your skin or a spot thats changing in size, shape, or color may be a warning sign of melanoma. If you have any of these changes, have your skin checked by a doctor.
The doctor will ask you questions about when the spot on your skin first showed up and if it has changed in size or the way it looks. The rest of your skin will be checked. During the exam your doctor will check the size, shape, color and texture of any skin changes. If signs are pointing to melanoma, more tests will be done.
Stop Tumors In Their Tracks
Every melanoma has the potential to become deadly, but the difference between an in situ melanoma and one that has begun to metastasize cannot be overstated. There is a drastic change in the survival rate for the various stages of tumors, highlighting the importance of detecting and treating melanomas before they have a chance to progress. Its impossible to predict exactly how fast a melanoma will move from stage to stage, so you should be taking action as soon as possible.
To be sure youre spotting any potential skin cancers early, The Skin Cancer Foundation recommends monthly skin checks, and scheduling an annual total-body skin-exam with a dermatologist. These skin exams can help you take note of any new or changing lesions that have the potential to be cancerous, and have them biopsied and taken care of before they can escalate.
Trust your instincts and dont take no for an answer, Leland says. Insist that a doctor biopsy anything you believe is suspicious.
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Most Melanoma Does Not Start In A Preexisting Mole
Melanoma can develop in a preexisting mole, says Dr. Marghoob, but nearly 70% of skin melanomas do not. Rather, they occur in normal skin. Moles themselves are not cancerous, and it is extremely rare for a mole to transform into a melanoma, says Dr. Marghoob. That said, he adds, having many moles helps identify people who are at an increased risk for developing melanoma somewhere on their skin.
Since most melanoma develops on normal skin, Dr. Marghoob stresses the importance of protecting the entire surface of the body, including areas with many moles and areas without any moles. Some people use sunblock only where they have moles because they think the moles themselves are dangerous, adds Dr. Marghoob. Stay safe by applying broad-spectrum sunblock with an SPF of at least 30, wearing sun-protective clothing, or using a combination of the two approaches.
Spreading To The Organs
After the cancer has spread to the lymph nodes, the lymph nodes and/or blood vessels help the cancer move to other areas of the body, like the organs. Which organ it will spread to first, varies depending on where the cancer started, the type and the person, but the liver, lungs, and brain are common sites for metastases.
Once its in the organs, it is known as stage four melanoma.
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Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful.;It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.;
How Does The Doctor Know I Have Skin Cancer
Basal and squamous skin cancer may look like:
- Flat, firm, pale or yellow areas that look a lot like a scar
- Raised reddish patches that might itch
- Rough or scaly red patches, which might crust or bleed
- Small, pink or red, shiny, pearly bumps, which might have blue, brown, or black areas
- Pink growths or lumps with raised edges and a lower center
- Open sores that dont heal, or that heal and then come back
- Wart-like growths
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Red Flag #: Bone Pain Or Fractures
The bones are considered a late-stage site of melanoma metastasestypically, it doesnt spread to the bones until its already spread to another area of the body first. Melanoma can cause pain in the bones where its spread, and some peoplethose with very little body fat covering their bonesmay be able to feel a lump or mass. Metastatic melanoma can also weaken the bones, making them fracture or break very easily. This is most common in the arms, legs, and spine. If you feel any sharp, sudden, or new pains that wont go away, talk to your doctor.
You Of Course May Not Think The Tiny Speck Is Melanoma But Over Time Its Going To Get Bigger Or Spread Superficially
How long does this take to happen, or to put it another way, how fast does this spreading or growth occur?
Melanomas can either have not spread past the skin or already be metastatic by the time you find a 1 mm lesion, says Dr. Jennifer Gordon, who is board certified by the American Board of Dermatology; she practices at Westlake Dermatology located in Austin, Texas.
Dr. Gordon points out, however: A 1 mm lesion would be rare to be already metastatic.
This would be the nodular type of melanoma, which is an uncommon sub-type of this skin malignancy.
I realize this offers little comfort, but it is the unfortunate truth, continues Dr. Gordon. There are multiple types of melanomas, such as:
- Melanoma in-situ
- Nodular melanoma
- Desmoplastic melanoma, etc.
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Prevalence And Risk Factors
The incidence of melanoma is increasing across all ages, including a more than 600% increase in young adults from 1970 to 2009 . Melanoma is the sixth most common cancer in men and women and the second most common cancer in women ages 20 to 29 in the United States.
Based on the most recent US data, there will be about 178,560 new cases of melanoma in 2018: 87,290 in situ and 91,270 invasive. At current rates, 1 in 27 white men and 1 in 42 white women will develop an invasive melanoma over a lifetime. An estimated 9,320 people will die of melanoma in 2018: 5,990 men and 3,330 women. Apart from these statistics, if melanoma is detected and treated before it invades the deeper layers of skin, the 5-year survival rate is 99%.2,3
The primary risk factor for melanoma is exposure to UV radiation . Most melanomas arise in previously normal skin, and only 20% to 30% arise from pre-existing nevi. Although there are several genetic syndromes that predispose individuals to melanoma, these account for less than 15% of melanomas. These syndromes include xeroderma pigmentosa and familial atypical mole-melanoma syndrome .2,3
Spreading To The Lymph Nodes
When a tumor gets too big, it requires more oxygen and nutrients to survive.
This is when the tumor sends out signals that cause new blood vessels to grow into the tumor , bringing the nutrients and oxygen it needs. After angiogenesis occurs, cancer cells are now able to break off and enter the bloodstream.
They can also break off and spread through the lymphatic system . When this happens, the cancer cells can now settle and take root in a new area of the body. Once the cancer cells have spread to the lymph nodes its considered stage three melanoma.
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Warning: Graphic Image Below
If not treated it may eventually cause dramatic disfigurement yet will very rarely metastasize in even the most neglected cases.
Many years of basal cell carcinoma neglect. Apparently this patient didnt know that cancer was eating away at his face.
Squamous cell carcinoma which will likely metastasize if left untreated begins insidiously, appearing first as a faded pink and very flat patchy area on the skin.
A person can go for years without knowing that this usually slow growing skin cancer is progressing.
Many people even in industrialized nations do not check their skin monthly and never get clinical exams and may even be fully aware of a new lesion yet get so used to it that it never dawns on them that its malignant.
There may be the It cant happen to me mindset, along with those who are afraid of what the doctor might find, and those who avoid doctors because they dont have health insurance or because they are cognitively impaired.
Often, people will notice something growing on their face or scalp but chalk it up to older age or benign damage from the sun.
Its possible to have melanoma for several years without knowing it, because some kinds of melanomas grow rather slowly and spread out laterally before they begin burrowing vertically into deeper layers of skin tissue.
Melanoma on the bottom of a foot.