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What Are The 4 Types Of Melanoma

After Skin Cancer Treatment

These are the four main types of skin cancer

Most skin cancer is cured surgically in the dermatologist’s office. Of skin cancers that do recur, most do so within three years. Therefore, follow up with your dermatologist as recommended. Make an appointment immediately if you suspect a problem.

If you have advanced malignant melanoma, your oncologist may want to see you every few months. These visits may include total body skin exams, regional lymph node checks, and periodic chest X-rays and body scans. Over time, the intervals between follow-up appointments will increase. Eventually these checks may be done only once a year.

What Causes Amelanotic Melanoma

Amelanotic melanomas are rare. According to 2014 research published in JAMA Dermatology, amelanotic melanomas make up about 2 percent to 20 percent of all melanomas. Though their appearance makes them harder to detect, the causes of amelanotic melanomas are the same as their more recognizable counterparts. Most often, genetic changes to the cells in moles cause them to turn into cancerous cells, or melanoma.

All of your cells contain DNA, a chemical that controls how your genes work. When DNA mutations cause your genes to function abnormally, cells may grow uncontrolled, becoming cancerous. The most common cause of these cellular changes is exposure to ultraviolet rays;from the sun or a tanning bed, though it may take years after UV exposure for these mutations to occur.

Rare, inherited genetic mutations may also play a role in causing melanoma. Inherited melanomas are caused by changes to tumor suppressor genes, impairing their ability to control cellular growth and ultimately contributing to cancer. People with a condition called xeroderma pigmentosum have an inherited mutation in the genes that repair damaged cellular DNA after UV exposure. These genes dont work properly in those with XP, making them more susceptible to melanoma.

Melanomas With Unknown Primary

In rare cases, melanoma is found to have spread to lymph nodes or organs, but the original tumor site is unknown. When this type of melanoma occurs, it is called melanoma of unknown primary . Only about 3% of melanomas are MUP.

Current hypotheses suggest that most of these melanomas originate on the skin and arise from:

  • Melanomas of the skin that were incompletely removed
  • ;Regressed melanomas: When your bodys immune system may have destroyed a portion of the cancerous cells in a cutaneous melanoma but not before some melanoma cells were able to get into lymph nodes or blood vessels
  • ;Pigmented cells that traveled to the lymph nodes and were transformed into melanoma.

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Amelanotic Melanoma Risk Factors

Though these risk factors dont mean someone will develop melanoma, they are linked with increased risk of all forms of the cancer, including amelanotic melanoma.

Exposure to UV rays: Damage to DNA in your skin cells, from exposure to UV rays , is the No. 1 risk factor for all types of melanoma. Both natural sunlight and artificial tanning lamps increase the risk of developing this type of skin cancer. Getting many sunburns during childhood also has been associated with the development of melanoma on the chest, back and legs.

Moles: If you have a lot of moles or have atypical moles, youre at greater risk of developing melanoma. Additionally, patients with the inherited condition dysplastic nevus syndrome are at a high risk of developing melanoma during their lifetime.

Fair skin: People who have light-colored, freckled skin and blond or red hair with blue or green eyes are at a greater risk of developing melanoma. This is especially true if your skin tends to burn as opposed to tanning when exposed to UV rays.

Race: Melanoma is 20 times more likely for white people than it is for black people, according to the American Society of Clinical Oncology .

Family and personal history: If your close relatives have a history of melanoma, youre at increased risk. If youve previously had melanoma or another type of skin cancer, the chance of developing it again is also greater.

Risk Factors For Metastatic Melanomas

Malignant Melanoma

You cannot get metastatic melanoma without first having melanoma, though the primary melanoma may be so small its undetectable. Major risk factors for melanomas include:

  • Light skin, light-colored hair or light-colored eyes
  • Skin prone to burning easily
  • Multiple blistering sunburns as a child
  • Family history of melanoma
  • Frequent exposure to sun or ultraviolet radiation;
  • Certain genetic mutations
  • Exposure to environmental factors, such as radiation or vinyl chloride

Other factors have been connected with increased metastasis. In a 2018 study in the Anais Brasileiros de Dermatologia and a 2019 study in the Journal of the National Cancer Institute, the following factors were associated with higher levels of metastasis:

  • Male gender
  • Primary tumor thickness of more than 4 mm
  • Nodular melanoma, which is a specific subtype that a care team would identify
  • Ulceration of the primary tumor

Read Also: What Are The Early Stages Of Melanoma

Medical Treatment For Skin Cancer

Surgical removal is the mainstay of skin cancer treatment for both basal cell and squamous cell carcinomas. For more information, see Surgery.People who cannot undergo surgery may be treated by external radiation therapy. Radiation therapy is the use of a small beam of radiation targeted at the skin lesion. The radiation kills the abnormal cells and destroys the lesion. Radiation therapy can cause irritation or burning of the surrounding normal skin. It can also cause fatigue. These side effects are temporary. In addition, topical chemotherapy creams have been FDA approved for the treatment of certain low-risk nonmelanoma skin cancers. Patients with advanced or many basal cell carcinomas are sometimes prescribed oral pills to block the growth of these cancers. Side effects include muscle spasms, hair loss, taste changes, weight loss and fatigue.

In advanced cases of melanoma, immune therapies, vaccines, or chemotherapy may be used. These treatments are typically offered as clinical trials. Clinical trials are studies of new therapies to see if they can be tolerated and work better than existing therapies.

Merkel Cell Carcinoma: A Rare Skin Cancer On The Rise

Merkel cell carcinoma is a rare type of skin cancer that affects about 2,000 people in the United States each year.

Though its an uncommon skin cancer, cases of Merkel cell carcinoma have increased rapidly in the last couple of decades.

This type of cancer starts when cells in the skin, called Merkel cells, start to grow out of control.

Merkel cell carcinomas typically grow quickly and can be difficult to treat if they spread.

They can start anywhere on the body, but Merkel cell carcinomas commonly affect areas exposed to the sun, such as the face, neck, and arms.

They may look like pink, red, or purple lumps that are firm when you touch them. Sometimes, they can open up as ulcers or sores.

Risk factors include:

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What Is A Spot That Never Goes Away

A symptom of both basal and squamous cell skin cancer is a spot that looks like a pimple and doesnt clear up for at least several weeks. The spot may also look like a pimple that disappears and reappears in the same spot. These bumps arent pus-filled like pimples, but may bleed easily and crust over and itch.

Treatment Of Metastatic Melanoma

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Metastatic melanomas can be difficult to treat. The five-year survival rate for people diagnosed with melanoma that has spread to nearby lymph nodes is 66 percent, according to the American Cancer Society. When cancer has spread to distant parts of the body, there may also be other metastases too small to detect by scans. For people diagnosed with stage 4 melanoma, or melanoma that has spread to distant parts of the body, the five-year survival rate is 27 percent.

For stage 3 and 4 melanomas, the following treatments may be used:

Multiple therapies can be used at any given time, and your care plan is a dynamic process. You and your care team should discuss all the options and decide on a treatment plan. Each treatment has different side effects, and its important to feel fully informed of all the associated risks. Other medications and options may help manage the symptoms of your cancer treatment, so you can live the highest quality of life possible throughout the course of your treatment and disease.

Expert

Superficial Spreading Malignant Melanoma

This is the most common type of invasive malignant melanoma comprising approximately 70% of all tumors. It starts in the basal layer and spreads horizontally for months to years before it invades into the dermis. It appears as a flat or barely raised pigmented lesion with irregular borders, like ink leaching out into paper and variable color. It is found most commonly on the trunks of men, the legs of women, and the upper backs of both sexes. It is diagnosed most frequently between the ages of 30 and 50 years. 50% occur in pre-existing moles and appear as a darkening or change in color of part of a mole. The other 50% arise as new moles on normal-appearing skin.

More About Melanocytes And Melanin

Melanocytes normally make a pigment called melanin.

  • Normal melanocytes make melanin, which protects the skin from ultraviolet radiation from the sun by absorbing it.
  • Melanin is a brown-coloured pigment that determines our skin, eye and hair colour.
  • Melanocytes do not make much melanin in people with fair skin, who are more likely to get melanoma.
  • Melanocytes make more melanin in people with dark skin, who are thus less likely to get melanoma.
  • Moles, also called melanocyticnaevi, are due to nests of harmless melanocytes in the skin.
  • People with lots of moles are prone to melanoma.

Some different skin types are shown below.

Skin types

Skin burns. Does not tan Skin burns easily. Tans poorly Skin sometimes burns. Tans easily Light brown skin. Rarely burns

Other Types Of Skin Cancer

Unusual types of skin cancer include;Merkel cell tumors.;Merkel cell carcinoma starts when cells in the skin, also called Merkel cells, start to grow uncontrollably. This type of cancer can grow quickly and can be hard to treat if it spreads beyond the skin.

Dermatofibrosarcoma protuberans is another rare skin cancer that begins in the middle layer of skin, known as the dermis. This type of cancer tends to grow slowly and seldom spreads to other parts of the body.

Four Main Types Of Skin Melanoma

Skin Cancer Stage 4 Melanoma

There are four main types of skin melanoma.

  • Superficial spreading melanoma is the most common type of melanoma. It starts off by growing along the top layer of the skin. Eventually, it can penetrate deeper into the skin. Learn more about superficial spreading melanoma.
  • Nodular melanoma is the second most common type of melanoma. It can be aggressive because it usually grows quickly. Its most common feature is a bump or node that rises above the skins surface and that is firm to the touch. Learn more about nodular melanoma.;
  • Lentigo maligna melanoma tends to develop on the face, scalp, or neck. It usually affects older people with very sun-damaged skin. Learn more about lentigo maligna melanoma.;
  • Acral lentiginous melanoma is a rare condition that affects people of all races and backgrounds. It is the most common form of melanoma in people of African and Asian descent. It can develop on the palms of the hands and soles of the feet as well as under the toenails and fingernails. Learn more about acral lentiginous melanoma.;
  • Diagnosis Of Metastatic Melanoma

    Your care team may use several tests to diagnose metastatic melanoma.

    If theres evidence of a primary tumor, a biopsy;may be taken. For this, a small section of suspected cancerous skin is removed with a razor, scalpel or small punch tool. The removed tissue is examined under a microscope to determine whether its melanoma.

    Additional tests are needed to determine whether the cancer is metastatic melanoma, or if theres no visible primary tumor. To test for metastatic melanoma, or melanoma that has spread to lymph nodes or distant parts of the body, your care team may perform the following tests.

    • Lymph node mapping and sentinel lymph node biopsy : Your doctor may perform a physical exam of your lymph nodes and check for swelling or physical masses. If no tumors are found , an SLNB may be done. For an SLNB, a radioactive dye is injected to locate the primary tumor. Then, the doctor will remove the lymph nodes that the dye traveled to and check them for melanoma.
    • Computed tomography scan, positron emission tomography scan, magnetic resonance imaging scan;or ultrasound;exam: Each of these scans is a noninvasive way to look inside your body and check for tumors.
    • Blood chemistry studies: Cancer may cause elevated or abnormal levels of certain substances in your blood. A laboratory test can identify if your blood chemistry shows signs of a cancerous tumor.

    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.

    Treatments For Amelanotic Melanoma

    Treatment for all melanomas depends on the staging and is tailored to your symptoms. Your doctor works with you in a process called shared decision-making to determine the best course of treatment depending on your situation and goals.

    One, or a combination, of the following treatments may be recommended:

    Surgery is the most common treatment for melanoma;and typically removes the cancerous tumor as well as a small amount of healthy surrounding tissue, called a margin. Wide excision involves removal of the primary melanoma and may include a skin graft. Lymph node dissection to remove the affected lymph nodes may be done if cancer is found during SLNB testing.

    Radiation therapy, which uses high-dose energy rays to kill cancer cells, may be used as treatment to prevent your melanoma from recurring, to manage symptoms if its spread to your bones, and when the cancer has spread to a large area of lymph nodes or skin that cannot be treated surgically.

    Immunotherapy augments the bodys immune system, boosting your ability to fight the cancer. Treatments include: PD-1 and PD-L1 inhibitors, CTLA-4 inhibitors, Interleukin-2, Interferon and virus therapy.

    Targeted therapy targets the genes, proteins or tissue environment that is causing your cancer to flourish. It helps prevent the growth of cancer cells by blocking the pathways necessary for melanomas to grow. Targeted therapy includes: BRAF inhibitors, MEK inhibitors, KIT inhibitors and tumor-agnostic treatment.

    Expert

    Signs And Symptoms Of Melanoma

    Types of Skin Cancer

    The most common sign of melanoma is the appearance of a new;mole or a change in an existing mole.

    This can happen anywhere on the body, but the;most commonly affected areas are;the back in men and the legs in women.;

    Melanomas are uncommon in areas that are protected from sun exposure, such as the buttocks and the scalp.

    In most cases, melanomas have an irregular shape and are more than 1 colour.

    The mole may also be larger than normal and can sometimes be itchy or bleed.

    Look out for a mole that gradually changes shape, size or colour.

    Superficial spreading melanoma are the most common type of melanoma in the UK.

    They’re more common in people with pale skin and freckles, and much less common in people with darker skin.

    They initially tend to grow outwards rather than downwards, so they do not pose a problem.

    But if they grow downwards into the deeper layers of skin, they can spread to other parts of the body.

    You should see a GP if you have a mole that’s getting bigger, particularly if it has an irregular edge.

    Tests To Check Your Lymph Nodes

    If you are diagnosed with melanoma, your doctor may suggest some tests to check the lymph nodes. Not everyone needs these test. Whether you have them depends on the size of the melanoma and if the lymph nodes look or feel swollen. These tests include:

    • A sentinel lymph node biopsy

      A sentinel lymph node biopsy is a way of checking the lymph nodes closest to the melanoma

    • Ultrasound

      An ultrasound scan;uses sound waves to make up a picture of an area of the body.

    • Fine needle aspiration

      If the ultrasound scan of the lymph nodes is abnormal, the doctor will do a fine needle aspiration.

    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.

    When To Seek Medical Care For Skin Cancer

    Many people, especially those who have fair coloring or have had extensive sun exposure, periodically check their entire body for suspicious moles and lesions.

    Have your primary health care provider or a dermatologist check any moles or spots that concern you.

    See your health care provider to check your skin if you notice any changes in the size, shape, color, or texture of pigmented areas .

    If you have skin cancer, your skin specialist or cancer specialist will talk to you about symptoms of metastatic disease that might require care in a hospital.

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