Many Melanomas Dont Require Immediate Treatment
Many people have this concept that all melanomas are extremely rapidly growing cancers, says Dr. Marghoob. They think that waiting even one day after the diagnosis of melanoma can be fatal.
While some subtypes of melanoma do grow extremely fast, says Dr. Marghoob, most early melanomas dont require immediate treatment, allowing ample time to detect, treat, and cure them. Dr. Marghoob advises checking your skin on a monthly basis. If you notice a changing spot on your skin, dont delay in getting it checked out by a dermatologist, he says. And if your doctor does think you may have a melanoma, know that for most people its not necessary to rush to treatment. Most people can take the time they need to meet with doctors and understand their options.
Tests That Might Be Done
Biopsy: In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have skin cancer and what kind it is. There are many types of skin biopsies. Ask your doctor what kind you will need. Each type has pros and cons. The choice of which type to use depends on your own case.
Lab tests of biopsy samples: If melanoma is found, lab tests might be done on the cancer cells to see if they have certain gene changes. This might affect your treatment options.
Chest x-ray: This test may be done to see if the melanoma has spread to your lungs.
Ultrasound: This test uses sound waves and their echoes to make pictures of the inside of your body. Ultrasound might be used to look at lymph nodes near the tumor to see if the cancer has spread there.
CT or CAT scan: This test uses x-rays to make detailed pictures of your insides. A CT scan may be used to see if nearby lymph nodes are swollen or if organs like the lungs or liver have spots that might be from the spread of melanoma. If any spots are found, a CT scan might be used to guide a needle into the spots to do a biopsy.
MRI scan: This test uses radio waves and strong magnets instead of x-rays to make detailed pictures of your insides. It’s very good for looking at the brain and spinal cord. This test can help show if the cancer has spread.
What Is Superficial Spreading Melanoma
Superficial spreading melanoma is a form of melanoma in which the malignant cells tend to stay within the epidermis for a prolonged period . At first, superficial spreading melanoma grows horizontally in the skin this is known as the radial growth phase, presenting as a slowly-enlarging flat area of discoloured skin.
An unknown proportion of superficial spreading melanoma become invasive, that is, the melanoma cells cross the basement membrane between the epidermis and dermis and malignant melanocytes enter the dermis. A rapidly-growing nodular melanoma can arise within superficial spreading melanoma and proliferate deeply within the skin.
Management of melanoma is evolving. For up to date recommendations, refer to Australian Cancer Council Clinical practice guidelines for the diagnosis and management of melanoma.
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What Kind Of Treatment Will I Need
There are many ways to treat melanoma. The main types of treatment are:
Most early stage melanomas can be treated with surgery alone. More advanced cancers need other treatments.
The treatment plan thats best for you will depend on:
- The stage of the cancer
- The results of lab tests on the cancer cells
- The chance that a type of treatment will cure the melanoma or help in some way
- Your age
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
Symptoms If Cancer Has Spread To The Bone
You might have any of the following symptoms if your cancer has spread to the bones:
- pain from breakdown of the bone the pain is continuous and people often describe it as gnawing
- backache, which gets worse despite resting
- weaker bones they can break more easily
- raised blood calcium , which can cause dehydration, confusion, sickness, tummy pain and constipation
- low levels of blood cells blood cells are made in the bone marrow and can be crowded out by the cancer cells, causing anaemia, increased risk of infection, bruising and bleeding
Cancer in the spinal bones can cause pressure on the spinal cord. If it isn’t treated, it can lead to weakness in your legs, numbness, paralysis and loss of bladder and bowel control . This is called spinal cord compression. It is an emergency so if you have these symptoms, you need to contact your cancer specialist straight away or go to the accident and emergency department.
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Melanoma Vs Normal Mole
Some melanomas are not dark, some are nice and smooth to the naked eye, and a melanoma has to start somewhere, so at some point will have been small. The size of a mole doesn’t really correlate at all to whether it is cancerous.
The take home message is: see a doctor if you develop a lump or patch on the skin, which you are unsure about, or if a mole grows out of fresh skin and you are worried about it.
A melanoma can develop on any area of skin. The most common place for a melanoma to develop in a woman is on the legs whereas for men it is on the chest or back. Rarely, a melanoma can develop in the iris or back of the eye: this might be noticed by an optician at a routine eye check, but will not cause any problems with your vision.
If some cells break off and spread to other parts of the body, various other symptoms can develop. A common early symptom of spread is for the nearby lymph glands to swell.
The situation is complicated further by the fact that some melanomas can spread to the lymph nodes and then fade and disappear from the skin .
This is all in direct contrast to skin cancer that isn’t melanoma: squamous cell carcinoma and basal cell carcinomas. For these, they are easier to diagnose and have a typical appearance that will be familiar to most family doctors. The role of sun exposure is also much more straightforward for basal cell carcinomas. You can read more about these more common skin cancers in the separate leaflet called Non-melanoma Skin Cancer.
How Common Is Melanoma
Melanoma accounts for only about 1% of all skin cancers, but causes the great majority of skin cancer-related deaths. Its one of the most common cancers in young people under 30, especially in young women.
Melanoma incidence has dramatically increased over the past 30 years. Its widely accepted that increasing levels of ultraviolet exposure are one of the main reasons for this rapid rise in the number of melanoma cases.
Prognosis And Survival For Melanoma Skin Cancer
If you have melanoma skin cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for melanoma skin cancer.
What Are The Signs Of Symptoms Of Metastatic Melanoma
Signs and symptoms depend upon the site of metastasis and the amount of tumor there. Metastases to the brain may first appear as headaches, unusual numbness in the arms and legs, or seizures. Spread to the liver may be first identified by abnormal blood tests of liver function long before the patient has jaundice, a swollen liver, or any other signs of liver failure. Spread to the kidneys may cause pain and blood in the urine. Spread to the lungs may cause shortness of breath, other trouble breathing, chest pain, and continued cough. Spread to bones may cause bone pain or broken bones called pathologic fractures. A very high tumor burden may lead to fatigue, weight loss, weakness and, in rare cases, the release of so much melanin into the circulation that the patient may develop brown or black urine and have their skin turn a diffuse slate-gray color. The appearance of multiple blue-gray nodules in the skin of a melanoma patient may indicate widespread melanoma metastases to remote skin sites.
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What If The Skin Changes Are Rapid Or Dramatic
Guideline # 4: The more rapid and dramatic the change, the less serious the problem.
When changes such as pain, swelling, or even bleeding come on rapidly, within a day or two, they are likely to be caused by minor trauma, often a kind one doesn’t remember . If a spot changes rapidly and then goes back to the way it was within a couple of weeks, or falls off altogether, it is not likely to represent anything serious. Nevertheless, this would be a good time to say once again: Nobody can diagnose him- or herself. If one sees a spot that looks as though it is new or changing, show it to a doctor. If one see a spot that doesn’t look like one’s other spots, it should be evaluated.
How Dangerous Is Melanoma Its All A Matter Of Timing
Skin cancer holds the unfortunate distinction of being the worlds most common cancer. Though its prevalence around the globe is disturbing, there is some good news: When caught early, skin cancers are highly curable.
You might already know that catching a cancer early means a more favorable prognosis. But it can be difficult to comprehend just how big a difference early detection makes with melanoma, the most dangerous form of skin cancer. Melanoma should never be underestimated, but treating a tumor early rather than after it is allowed to progress could be lifesaving.
Leland Fay, 46, understands better than most the seriousness of this distinction. When the Monument, Colorado native was diagnosed with melanoma in 2012, he was given a bleak prognosis due to the advanced stage of the tumor it had already reached stage IV.
Leland hadnt thought much of the little black mole on his head a few months earlier, when a dermatologist froze it off during a routine exam. But the mole resurfaced, bigger than it had been originally. After a biopsy and imaging tests, doctors told Leland it was melanoma, and that it had already spread. He could have as few as six weeks to live.
To fully comprehend the significance of timing, it can be helpful to understand exactly what happens to a melanoma when it advances to a later stage, and what it means when a melanoma spreads beyond the original tumor site.
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How Skinvision Can Help You
SkinVision enables you to check your skin spots for signs of skin cancer within 30 seconds. Our algorithm is currently at the level of a specialist dermatologist.In skin spots with a potential health risk, SkinVision provides feedback about the preferred next step to take.
SkinVision also enables you to store photos to keep track of changes over time, helping you to monitor your health in the long term.
The efficient and easy-to-use solution is available for iOS and Android and helps to make skin monitoring a simple routine.
How Dangerous Is Melanoma
Melanoma is usually curable when detected and treated early. Once melanoma has spread deeper into the skin or other parts of the body, it becomes more difficult to treat and can be deadly.
- The estimated five-year survival rate for U.S. patients whose melanoma is detected early is about 99 percent.
- An estimated 7,180 people will die of melanoma in the U.S. in 2021.
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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. A combination of sun protection measures should be used during sun protection times .
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.
What Should People Do If They Have A Dysplastic Nevus
Everyone should protect their skin from the sun and stay away from sunlamps and tanning booths, but for people who have dysplastic nevi, it is even more important to protect the skin and avoid getting a suntan or sunburn.
In addition, many doctors recommend that people with dysplastic nevi check their skin once a month . People should tell their doctor if they see any of the following changes in a dysplastic nevus :
- The color changes.
- It gets smaller or bigger.
- It changes in shape, texture, or height.
- The skin on the surface becomes dry or scaly.
- It becomes hard or feels lumpy.
- It starts to itch.
- It bleeds or oozes.
Another thing that people with dysplastic nevi should do is get their skin examined by a doctor . Sometimes people or their doctors take photographs of dysplastic nevi so changes over time are easier to see . For people with many dysplastic nevi, doctors may conduct a skin exam once or twice a year because of the moderately increased chance of melanoma. For people who also have a family history of melanoma, doctors may suggest a more frequent skin exam, such as every 3 to 6 months .
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Continue Learning About Melanoma
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
What Tests Are Used To Stage Melanoma
There are several tests your doctor can use to stage your melanoma. Your doctor may use these tests:
- Sentinel Lymph Node Biopsy: Patients with melanomas deeper than 0.8 mm, those who have ulceration under the microscope in tumors of any size or other less common concerning features under the microscope, may need a biopsy of sentinel lymph nodes to determine if the melanoma has spread. Patients diagnosed via a sentinel lymph node biopsy have higher survival rates than those diagnosed with melanoma in lymph nodes via physical exam.
- Computed Tomography scan: A CT scan can show if melanoma is in your internal organs.
- Magnetic Resonance Imaging scan: An MRI scan is used to check for melanoma tumors in the brain or spinal cord.
- Positron Emission Tomography scan: A PET scan can check for melanoma in lymph nodes and other parts of your body distant from the original melanoma skin spot.
- Blood work: Blood tests may be used to measure lactate dehydrogenase before treatment. Other tests include blood chemistry levels and blood cell counts.
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The Importance Of The Follow
Attending regular follow-up appointments with a doctor or dermatologist is key to catching any recurring melanomas early before they have a chance to spread or worsen.
A doctor will advise follow-up appointment timing based on the specifics of each individual patient, but the frequency of follow-up appointments are usually based on the stage the melanoma was in when it was treated.
DermNet New Zealand provides an overview:
· Stage I melanoma follow-up visit every year for the next 10 years
· Stage II melanoma depending on the severity of melanoma in this stage, follow-up every 46 months for 23 years and then once every year up to 10 years
· Stage III melanoma every 3 months in the first year, every 4 months in the second year, every 6 months until year 5, and then once a year until year 10
· Stage IV melanoma as for Stage III but with additional visits as required
Taking the proper precautions by staying out of the sun and wearing sunscreen and protective clothing is the other key to help prevent melanoma from returning.
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