What Is A Melanocyte
Melanocytes are skin cells found in the upper layer of skin. They produce a pigment known as melanin, which gives skin its color. There are two types of melanin: eumelanin and pheomelanin. When skin is exposed to ultraviolet radiation from the sun or tanning beds, it causes skin damage that triggers the melanocytes to produce more melanin, but only the eumelanin pigment attempts to protect the skin by causing the skin to darken or tan. Melanoma occurs when DNA damage from burning or tanning due to UV radiation triggers changes in the melanocytes, resulting in uncontrolled cellular growth.
About Melanin
Naturally darker-skinned people have more eumelanin and naturally fair-skinned people have more pheomelanin. While eumelanin has the ability to protect the skin from sun damage, pheomelanin does not. Thats why people with darker skin are at lower risk for developing melanoma than fair-skinned people who, due to lack of eumelanin, are more susceptible to sun damage, burning and skin cancer.
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.
What Are The Survival Rates For Metastatic Melanoma
Survival rates for melanoma, especially for metastatic melanoma, vary widely according to many factors, including the patient’s age, overall health, location of the tumor, particular findings on the examination of the biopsy, and of course the depth and stage of the tumor. Survival statistics are generally based on 5-year survival rates rather than raw cure rates. Much of the success reported for the targeted therapies focuses on disease-free time because in many cases the actual 5-year survival is not affected. It is hoped that combination therapy discussed above will change that.
- For stage 1 , 5-year survival is ⥠90%.
- For stage 2 , 5-year survival is 80%-90%.
- For stage 3 , 5-year survival is around 50%.
- For stage 4 , 5-year survival is 10%-25% depending upon sex and other demographic factors.
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What Is A Sentinel Lymph Node Biopsy
A sentinel lymph node biopsy may be performed during melanoma surgery. This will reduce the number of lymph nodes that need to be removed for biopsy. The procedure involves injecting a blue dye or a small amount of radioactive material near the area where the tumor was. This material flows into the sentinel lymph nodes, the first lymph nodes that the cancer is likely to spread to from the primary tumor.
A surgeon then looks for the dye or uses a scanner to find the sentinel lymph nodes and then removes it for examination by a pathologist. If the sentinel lymph node biopsy is positive for cancer cells, then the rest of the surrounding lymph nodes are usually removed. If the biopsy is negative, the remaining lymph nodes do not need to be removed as the melanoma has not spread to these areas.
For some people, treatment will involve radiation therapy, immunotherapy, targeted drug therapy, chemotherapy or a combination of these. Your treatment will depend upon the type of skin cancer you have, if it has spread, and your health conditions and age.
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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?
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Diagnosis And Staging What It Means For You
How is melanoma diagnosed?
To diagnose melanoma, a dermatologist biopsies the suspicious tissue and sends it to a lab, where a dermatopathologist determines whether cancer cells are present.
After the disease is diagnosed and the type of melanoma is identified, the next step is for your medical team to identify the stage of the disease. This may require additional tests including imaging such as PET scans, CT scans, MRIs and blood tests.
The stage of melanoma is determined by several factors, including how much the cancer has grown, whether the disease has spread and other considerations. Melanoma staging is complex, but crucial. Knowing the stage helps doctors decide how to best treat your disease and predict your chances of recovery.
What Is Melanoma Cancer
Melanoma is a serious type of skin cancer. Most melanoma is treated surgically, and in many cases this surgery is curative. Through numerous clinical trials, the surgery that is required to treat melanoma has become less invasive. A number of these less radical procedures were pioneered at the Saint Johns Cancer Institute Melanoma Program.
100,350people in the U.S. will be diagnosed with melanoma in 2020 and the American Cancer Society estimates that number will continue to increase year after year.
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Basal Cell Carcinoma: The Most Common Skin Cancer
Basal cell carcinoma, which is also called basal cell skin cancer, is the most common form of skin cancer, accounting for about 80 percent of all cases.
Rates of basal cell carcinoma have been increasing. Experts believe this is due to more sun exposure, longer lives, and better skin cancer detection methods.
This type of cancer begins in the skins basal cells, which are found in the outermost layer, the epidermis. They usually develop on areas that are exposed to the sun, like the face, head, and neck.
Basal cell carcinomas may look like:
- A flesh-colored, round growth
- A pinkish patch of skin
- A bleeding or scabbing sore that heals and then comes back
They typically grow slowly and dont spread to other areas of the body. But, if these cancers arent treated, they can expand deeper and penetrate into nerves and bones.
Though its rare, basal cell carcinoma can be life-threatening. Experts believe that about 2,000 people in the United States die each year from basal cell carcinoma or squamous cell carcinoma.
Some risk factors that increase your chances of having a basal cell carcinoma include:
- Being exposed to the sun or indoor tanning
- Having a history of skin cancer
- Being over age 50
- Having chronic infections, skin inflammation, or a weakened immune system
- Being exposed to industrial compounds, radiation, coal tar, or arsenic
- Having an inherited disorder, such as nevoid basal cell carcinoma syndrome or xeroderma pigmentosum
Squamous Cell Carcinoma: Common In Sun
Squamous cell carcinoma, also called squamous cell cancer, is the second most common type of skin cancer. It accounts for about 20 percent of cases.
This type of cancer starts in flat cells in the outer part of the epidermis. It commonly crops up on sun-exposed areas, such as the face, ears, neck, lips, and hands. It can also develop on scars or chronic sores.
Squamous cell carcinomas may develop from precancerous skin spots, known as actinic keratosis .
These cancers might look like:
- A firm, red bump
- A flat lesion with a scaly, crusted surface
- A sore that heals and then reopens
People with lighter skin are more at risk for developing squamous cell carcinoma, but the skin cancer can also affect those with darker skin.
Other risk factors include:
- Having light eyes, blond or red hair, or freckles
- Being exposed to the sun or tanning beds
- Having a history of skin cancer
- Having a history of sunburns
- Having a weakened immune system
- Having the genetic disorder xeroderma pigmentosum
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Early Warning Signs Of Melanoma
The key to detecting melanoma early is to know what to look for and where to look for it. This isnt always easy, as melanoma can be a master of disguise. It may look like an age spot, a bruise, a sore, a cyst, a scar or a dark line beneath your nail. You may not feel a melanoma, but there are times that it may itch, hurt or bleed.
The ABCDE method;may help you determine whether an abnormal skin growth may be melanoma:
- A is for asymmetry: Does the mark look different on each half?
- B is for border: Are the edges jagged or irregular?
- C is for color: Is your lesion uneven in color with specks of black, brown and tan?
- D is for diameter: Is your lesion getting larger?
- E is for evolving or elevation: Has your lesion changed in size, shape or texture over the past few weeks or months?
If the answer to any of these questions is yes, or even maybe, see a dermatologist for a proper evaluation. The only way to be sure whether a mole;is melanoma is to visit a doctor.
Other melanoma warning signs may include:
- Sores that dont heal
- Pigment, redness or swelling that spreads outside the border of a spot to the surrounding skin
- Itchiness, tenderness or pain
Risk Factors For Skin Cancer
A person’s risk for skin cancer can be due to many factors. Ultraviolet radiation from the sun is the main cause of skin cancer. Artificial sources of UV radiation like sunlamps and tanning booths can also cause skin cancer. Any amount of UV radiation can be harmful, even if it does not lead to a burn. The risk of developing skin cancer or melanoma is also affected by where a person lives and by the lifetime exposure of UV radiation.
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What Kind Of Treatment Will I Need
There are many ways to treat melanoma. The main types of treatment are:
- Surgery
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
How Is Melanoma Diagnosed
If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.
After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.
Melanomas are grouped into the following stages:
- Stage 0 : The melanoma is only in the top layer of skin .
- Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.
- Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.
- Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
- Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.
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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.
What Causes Melanoma
Melanoma is caused by skin cells that begin to develop abnormally.
Exposure to ultraviolet light from;the sun is thought to cause most melanomas, but there’s evidence to suggest that some may result from sunbed exposure.
The type of sun exposure that causes melanoma is sudden intense exposure. For example, while on holiday, which leads to;sunburn.
Certain things can increase your chance of developing melanoma, such as having:
- lots of moles or freckles
- pale skin that burns easily
- red or blonde hair
Read more about the causes of melanoma.
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What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of melanoma of the skin is 90%, it means that people who have that cancer are, on average, about 90% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.
What You Can Do
Check yourself: No matter your risk, examine your skin;head-to-toe once a month to identify potential skin cancers early. Take note of existing moles or lesions that grow or change. Learn how to check your skin here.
When in doubt, check it out. Because melanoma can be so dangerous once it advances, follow your instincts and visit your doctor if you see a spot that just doesnt seem right.
Keep in mind that while important, monthly self-exams are not enough. See your dermatologist at least once a year;for a professional skin exam.
If youve had a melanoma, follow up regularly with your doctor once treatment is complete. Stick to the schedule your doctor recommends so that you will find any recurrence as early as possible.
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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.;
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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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.
For More Information About Skin Cancer
National Cancer Institute, Cancer Information Service Toll-free: 4-CANCER 422-6237TTY : 332-8615
Skin Cancer Foundation
Media file 1: Skin cancer. Malignant melanoma.
Media file 2: Skin cancer. Basal cell carcinoma.
Media file 3: Skin cancer. Superficial spreading melanoma, left breast. Photo courtesy of Susan M. Swetter, MD, Director of Pigmented Lesion and Cutaneous Melanoma Clinic, Assistant Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System.
Media file 4: Skin cancer. Melanoma on the sole of the foot. Diagnostic punch biopsy site located at the top. Photo courtesy of Susan M. Swetter, MD, Director of Pigmented Lesion and Cutaneous Melanoma Clinic, Assistant Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System.
Media file 5: Skin cancer. Melanoma, right lower cheek. Photo courtesy of Susan M. Swetter, MD, Director of Pigmented Lesion and Cutaneous Melanoma Clinic, Assistant Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System.
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Media file 6: Skin cancer. Large sun-induced squamous cell carcinoma on the forehead and temple. Image courtesy of Dr. Glenn Goldman.
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