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?
What Causes A New Mole To Appear
A new mole appears when melanocytes, the pigment producing cells in a persons skin, proliferate, or duplicate, producing the characteristic moles they see on the surface. Melanocytes contain a pigment that gives moles their distinctive coloring.
Moles can be benign or cancerous. Cancerous moles, such as melanomas, develop as a result of genetic mutations. The exact cause of benign moles remains unknown.
Possible causes of a new mole include:
- exposure to ultraviolet radiation
Moles fall into different subtypes based on their attributes. Types of moles include:
Pathology Report In Nodular Melanoma
The pathologist’s report should include a macroscopic description of the specimen and melanoma and a microscopic description.
- Diagnosis of primary melanoma
- Mitotic rate a measure of how fast the cells are proliferating
- Whether or not there is ulceration
The report may also include comments about the cell type and its growth pattern, invasion of blood vessels or nerves, inflammatory response, regression, and whether there is an associated naevus .
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Look Out For An Ugly Duckling
The Ugly Duckling is another warning sign of melanoma. This recognition strategy is based on the concept that most normal moles on your body resemble one another, while melanomas stand out like ugly ducklings in comparison. This highlights the importance of not just checking for irregularities, but also comparing any suspicious spot to surrounding moles to determine whether it looks different from its neighbors. These ugly duckling lesions or outlier lesions can be larger, smaller, lighter or darker, compared to surrounding moles. Also, isolated lesions without any surrounding moles for comparison are considered ugly ducklings.
Are There Different Kinds Of Skin Cancer
There are many types of skin cancer. Your doctor can tell you more about the type of skin cancer you have.
Basal cell and squamous cell skin cancers are much more common than melanoma and dont often spread to other parts of the body. Melanoma is more deadly because it is more likely to spread to other parts of the body.
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Melanoma Can Be Colorless
While its true that many melanomas are dark brown to black in color, some melanomas have no color and appear as pink spots or bumps. Beware of isolated pink spots, especially if the spot looks different than the other marks on the skin, says Dr. Marghoob. Pay attention to any spot or mark that has an uneven texture, shape, border, or distribution of colors. In addition, any spot that has changed in some way should prompt a visit to your local doctor.
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.
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How Do You Treat Stage 4 Melanoma
The good news is that even stage 4 melanoma can be treated. The sooner the cancer is found, the sooner it can be removed and the higher your chances are for recovery. Stage 4 melanoma also has the most treatment options, but these options depend on:
- where the cancer is
- how advanced the cancer has become
- your age and overall health
How you respond to treatment also affects your treatment options. The five standard treatments for melanoma are:
- surgery: to remove the primary tumor and affected lymph nodes
- chemotherapy: a drug treatment to stop growth of cancer cells
- radiation therapy: the application of high-energy X-rays to inhibit growth and cancer cells
- immunotherapy: treatment to boost your immune system
- targeted therapy: the use of drugs or other substances to attack cancer drugs
Other treatments may also depend on where the cancer has spread to. Your doctor will discuss your options with you to help map out a treatment plan.
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
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Diagnostic Excision Of A Lesion Suspicious Of Nodular Melanoma
If the skin lesion is suspected to be a nodular melanoma, it should be urgently cut out . A small biopsy is best avoided, except in unusually large lesions. An incisional or punch biopsy could be misleading.
The pathological diagnosis of melanoma can be challenging. Nodular melanomas have little or no spread of malignant cells within the epidermis; the melanoma cells are found within the dermis or subcutaneous fat. Extra tests using immunohistochemical stains may be necessary.
Can A Dysplastic Nevus Turn Into Melanoma
Yes, but most dysplastic nevi do not turn into melanoma . Most remain stable over time. Researchers estimate that the chance of melanoma is about ten times greater for someone with more than five dysplastic nevi than for someone who has none, and the more dysplastic nevi a person has, the greater the chance of developing melanoma .
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What About Other Treatments I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
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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How Quickly Can Skin Cancer Grow
When doctors talk about skin cancer, they often reiterate the point that its important to catch any potential issues early in order to have the best chance of recovery. But exactly how quickly can skin cancer grow? Is it safe to wait a week after noticing something strange on your skin? How long should you wait before deciding that a spot is just a spot?
What Is Skin Cancer?
The term skin cancer actually encompasses a collection of different skin cancers, each with its own symptoms and potential growth rate. Some forms of skin cancer are considered to be less aggressive, such as basal cell carcinoma, while others are considered more aggressive, such as squamous cell carcinoma or malignant melanoma. The growth rate will depend on the person and type of skin cancer, explains Dr. Azeen Sadeghian, board certified dermatologist at Sanova Dermatology in Baton Rouge, Louisiana. For example, some forms of skin cancer grow in a matter of weeks and others over months, she continues.
How Do I Spot It?
Dermatologists have come up with an easier way to gauge if your spot is of concern with the ABCs of Skin Cancer!
- A Asymmetry
- B Border Irregular
- C Color
- D Diameter
- E Evolving
Skin Cancer Detection & Treatment
How Do People Find Signs Of Melanoma On Their Own Skin
Performing a skin self-exam as often as recommended by your dermatologist is the best way. While examining your skin, you want to look for the following:
Mole that is changing in any way
Spot that looks different from the rest of the spots on your skin
Growth or spot on your skin that itches, bleeds, or is painful
Band of color beneath or around a nail
Sore that doesnt heal or heals and returns
The ABCDEs of melanoma can help you find changes to a mole, freckle, or other spot on your skin.
How Is Metastasis Detected
If your doctor suspects that your melanoma may have spread, there are several tools available to verify the diagnosis. These include a blood test for lactate dehydrogenase , which increases when melanoma metastasizes, and imaging studies, such as chest X-ray, computed tomography , magnetic resonance imaging , positron emission tomography and ultrasound.
The doctor may also need to take a sample of your lymph nodes, using a procedure called “sentinel lymph node mapping.” If confirmed, there are many treatments available, including chemotherapy, immunotherapy, radiation therapy and surgery.
Taking Care Of Yourself
Hearing that your cancer has spread is scary, but a lot of research is underway to find new treatments. And there are treatments available to try to stop the disease from spreading, so you can live longer.
It’s important to have support and to talk about your fears and feelings, too. Your doctor can help you find a cancer support group.
These tips may help you feel better during melanoma treatment:
- If you lose your appetite, eat small amounts of food every 2 to 3 hours instead of bigger meals. A dietitian can give you other tips on nutrition and eating during your cancer treatment. Ask your doctor for a referral.
- Exercise can help you feel better overall and fight fatigue. But listen to your body, and balance rest and activity.
- Get the kind of emotional support that’s right for you. It could be from family, friends, your cancer support group, or a religious group.
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Who Gets Skin Cancer And Why
Sun exposure is the biggest cause of skin cancer. But it doesn’t explain skin cancers that develop on skin not ordinarily exposed to sunlight. Exposure to environmental hazards, radiation treatment, and even heredity may play a role. Although anyone can get skin cancer, the risk is greatest for people who have:
- Fair skin or light-colored eyes
- An abundance of large and irregularly-shaped moles
- A family history of skin cancer
- A history of excessive sun exposure or blistering sunburns
- Lived at high altitudes or with year-round sunshine
- Received radiation treatments
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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The Warning Signs Of Skin Cancer
Skin cancers — including melanoma, basal cell carcinoma, and squamous cell carcinoma — often start as changes to your skin. They can be new growths or precancerous lesions — changes that are not cancer but could become cancer over time. An estimated 40% to 50% of fair-skinned people who live to be 65 will develop at least one skin cancer. Learn to spot the early warning signs. Skin cancer can be cured if it’s found and treated early.
What Will Happen After Treatment
Youll be glad when treatment is over. For years after treatment, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back.
At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed. After 5 years, they may be done once a year.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as good as you can.
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How Fast Can Melanoma Spread
A second factor that plays an important role in how fast melanoma can spread is the genetic factor. Certain gene abnormalities encourage melanoma to invade the surrounding tissue. This means that certain ways of how cells are composed can affect the speed of the melanoma spreading. This process, though, can vary significantly from one person to another.
If you have been diagnosed with melanoma skin cancer, talk with your doctor about your personal situation and treatment options.
Tools That Can Help You Find Melanoma On Your Skin
To help you find melanoma early, the American Academy of Dermatology developed the following:
Melanoma can look different on a childs skin. Taking this short quiz can help you hone your skills at finding childhood melanoma.
ImagesImages 1,3,4,5,6,7,8,10: Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Image 2: Developed by the American Academy of Dermatology
Image 9: Used with permission of the Journal of the American Academy of Dermatology.
ReferencesBarnhill RL, Mihm MC, et al. Malignant melanoma. In: Nouri K, et al. Skin Cancer. McGraw Hill Medical, China, 2008: 140-167.
Gloster HM Jr, Neal K. Skin cancer in skin of color. J Am Acad Dermatol 2006;55:741-60.
National Comprehensive Cancer Network. NCCN guidelines for patients: Melanoma. 2018. Last accessed February 12, 2019.
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E: Evolving And/or Elevated
“E” stands for;two different features of melanoma:
- Elevation: Moles are often elevated above the skin, often unevenly so with some parts raised and others flat.
- Evolving: A mole that is evolving is also concerning and, in retrospect, many people with melanomas note that a mole had been changing in terms of size, shape, color, or general appearance before they were diagnosed.
When a melanoma develops in an existing mole, the texture may change and become hard, lumpy, or scaly. Although the skin may feel different and itch, ooze, or bleed, a melanoma does not usually cause pain.
How Serious Is My Cancer
If you have melanoma, the doctor will want to find out how far it has spread. This is called staging. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the melanoma through the skin. It also tells if it has spread to other parts of your body.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
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