What Is Malignant Melanoma Skin Cancer

Can Changing My Diet Help Prevent Melanoma

The American Cancer Society advocates eating a plant-based diet over an animal-based diet as part of a healthy plan to avoid all cancers. Growing evidence suggests that plants pack a powerful punch in any fight against cancer because they’re nutritious, cholesterol-free and fiber-rich.

Theres no doubt that a healthy diet can protect your immune system. Having a strong immune system is important to help your body fight disease. Some research has shown that a Mediterranean diet is a healthy choice that may help prevent the development of cancer. Talk to your healthcare provider about the role food plays in lowering your cancer risks.

Some skin and immune-system healthy foods to consider include:

• Daily tea drinking: The polyphenols in tea help strengthen your immune system. Green tea contains more polyphenols than black tea.
• High vegetable consumption: Eating carrots, cruciferous and leafy vegetables is linked to the prevention of cutaneous melanoma.
• Weekly fish intake: Study participants who ate fish weekly seemed to avoid developing the disease when compared to those who did not eat fish weekly.

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.

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.

Continued

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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Enhancing Healthcare Team Outcomes

Skin cancers are frequently seen by primary care providers, nurse practitioners, internists, and pharmacists this is why an interprofessional team approach is needed. While many skin lesions are benign, it is important always to consider melanoma- as it is potentially deadly if the diagnosis gets missed. If there is suspicion of melanoma, the patient should obtain a referral to the dermatologist/oncologist and pathologist for further workup, irrespective of which of the other healthcare providers first became suspicious. Surgery includes wide local excision with sentinel lymph node biopsy, elective node dissection, or both. These surgical procedures are the definitive treatment for early-stage melanoma.

When performing the wide local excision, first consider the surgical margins. If the primary closure is not feasible, skin grafting or tissue transfers may be needed. Medical management is reserved for adjuvant therapy of patients with advanced melanoma here again, the pharmacist can monitor medications and consult with the dermatologist. Dermatology nursing staff will assist at all stages of case management, and provide patient counsel and monitor the condition, reporting to the treating clinician as necessary. For localized lesions, the prognosis is with surgery, but advanced melanoma has a grim prognosis, but the interprofessional team approach to care will optimize the patient’s prospects for a better outcome.

What Happens At Follow

Follow-up after a melanoma diagnosis is required to:

• detect recurrence early
• diagnose a new primary melanoma at the first possible opportunity. A second invasive melanoma occurs in 510% of melanoma patients and a new melanoma in situ is diagnosed in more than 20% of melanoma patients.

The Australian and New Zealand Guidelines for the Management of Melanoma make the following recommendations for follow-up for patients with invasive melanoma.

• Self-skin examination
• Routine skin checks by patient’s preferred health professional
• Follow-up intervals are preferably six-monthly for five years for patients with stage 1 disease, three-monthly or four-monthly for five years for patients with stage 2 or 3 disease, and yearly after that for all patients.
• Individual patients needs should be considered before an appropriate follow-up is offered
• Provide education and support to help the patient adjust to their illness

The follow-up appointments may be undertaken by the patient’s general practitioner and specialist.

Follow-up appointments may include:

• Check of the scar where the primary melanoma was removed -visual inspection and palpation
• Feel for the regional lymph nodes
• General skin examination
• Full physical examination
• In those with many melanocytic naevi or atypical melanocytic naevi, baseline whole-body imaging and sequential macro and dermoscopy images of melanocytic lesions of concern .

In those with more advanced primary disease, follow-up may include:

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How Common Is Familial Melanoma

Most cases of melanoma are sporadic, meaning it occurs by chance. The number of people who have an inherited risk of melanoma is unknown, but the number is thought to be low. It is estimated that about 8% of people with melanoma have a first-degree relative with melanoma and that 1% to 2% of people with melanoma have 2 or more close relatives with melanoma.

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.

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The System Of The Human Body

system is made up of the skin and skin derivatives such as hair, nails, glands and receptors and provides the body with a line of defence against foreign, infectious pathogens . The skin is the most vulnerable organ to injury and disease as it is an external organ and the largest organ of the body, contributing to approximately 15% of the bodys weight . The skin also helps to maintain homeostasis in the body as well as containing the bodys structures, disposing of

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 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.

What Is Familial Malignant Melanoma

Familial malignant melanoma is a term usually referring to families in which 2 or more first-degree relatives, such as a parent, sibling, and/or child, have a type of skin cancer called melanoma. Cancer begins when healthy cells begin to change and grow, out of control forming a mass called a tumor. Overall, about 8% of people newly diagnosed with melanoma have a first-degree relative with melanoma. A much smaller percentage, about 1% to 2%, has 2 or more close relatives with melanoma.

Individuals in melanoma-prone families frequently have moles called dysplastic nevi. Dysplastic nevi are large, flat, irregular, asymmetric, variably pigmented moles. They occur primarily on sun-exposed skin, but they also occur in areas that are not exposed to the sun. The moles must be monitored very carefully for any change in size, shape, and color to watch for cancer. In the United States, the average age when melanoma is diagnosed in people with familial melanoma is in the 30s the average age when melanoma is diagnosed in the general population is in the 50s.

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I’ve Been Diagnosed With Melanomawhat Happens Next

Doctors use the TNM system developed by the American Joint Committee on Cancer to begin the staging process. Its a classification based on three key factors:

T stands for the extent of the original tumor, its thickness or how deep it has grown and whether it has ulcerated.

What Is Breslow depth?

Breslow depth is a measurement from the surface of the skin to the deepest component of the melanoma.

Tumor thickness: Known as Breslow thickness or Breslow depth, this is a significant factor in predicting how far a melanoma has advanced. In general, a thinner Breslow depth indicates a smaller chance that the tumor has spread and a better outlook for treatment success. The thicker the melanoma measures, the greater its chance of spreading.

Tumor ulceration: Ulceration is a breakdown of the skin on top of the melanoma. Melanomas with ulceration are more serious because they have a greater risk of spreading, so they are staged higher than tumors without ulceration.

N indicates whether or not the cancer has already spread to nearby lymph nodes. The N category also includes in-transit tumors that have spread beyond the primary tumor toward the local lymph nodes but have not yet reached the lymph nodes.

M represents spread or metastasis to distant lymph nodes or skin sites and organs such as the lungs or brain.

After TNM categories are identified, the overall stage number is assigned. A lower stage number means less progression of the disease.

What Are The Four Main Types Of Melanoma Of The Skin

Superficial spreading melanoma

What you should know: This is the most common form of melanoma.

How and where it grows: It can arise in an existing mole or appear as a new lesion. When it begins in a mole that is already on the skin, it tends to grow on the surface of the skin for some time before penetrating more deeply. While it can be found nearly anywhere on the body, it is most likely to appear on the torso in men, the legs in women and the upper back in both.

What it looks like: It may appear as a flat or slightly raised and discolored, asymmetrical patch with uneven borders. Colors include shades of tan, brown, black, red/pink, blue or white. It can also lack pigment and appear as a pink or skin-tone lesion .

Lentigo maligna

What you should know: This form of melanoma often develops in older people. When this cancer becomes invasive or spreads beyond the original site, the disease is known as lentigo maligna melanoma.

How and where it grows: This form of melanoma is similar to the superficial spreading type, growing close to the skin surface at first. The tumor typically arises on sun-damaged skin on the face, ears, arms or upper torso.

What it looks like: It may look like a flat or slightly raised, blotchy patch with uneven borders. Color is usually blue-black, but can vary from tan to brown or dark brown.

Acral lentiginous melanoma

What you should know: This is the most common form of melanoma found in people of color, including individuals of African ancestry.

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The Abcdes Of Melanoma

To help people find a possible melanoma on their skin, dermatologists created the ABCDEs of melanoma:

If you find a spot on your skin that has any of the ABCDEs of melanoma, see a board-certified dermatologist for a skin exam.

The following pictures can help you see how the ABCDEs of melanoma can appear on the skin.

Understanding What Is Malignant Melanoma

Malignant melanoma is a lethal form of cancer that arises from the skins pigment-producing melanocytes cells. If you are wondering what is malignant melanoma? Then the answer is that it is malignant cancer that forms on an existing mole or materializes on the skins surface.

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It can also arise on the eye . Malignant melanoma of vulva and vagina has even been documented. Fair-haired and red-headed people are at greatest risk. Dark-skinned individuals rarely suffer from it.

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Deterrence And Patient Education

Patients need to receive counsel to engage in preventative activities, especially once they have been treated for melanoma. These actions include:

• Avoid midday sun
• Use sunscreen at all times of the year
• Don protective clothing to cover skin
• Avoid tanning beds
• Be familiar with their skin so they can promptly spot changes – this includes areas that may not receive much sun exposure

Ways To Prevent Skin Cancer

Most cases of skin cancer are preventable. You can reduce your risk of getting skin cancer by following these safety tips:

• Cover up. When the UV Index is 3 or higher, protect your skin as much as possible. Wear light-coloured, long-sleeved shirts, pants, and a wide-brimmed hat made from breathable fabric. When you buy sunglasses, make sure they provide protection against both UVA and UVB rays.
• Limit your time in the sun. Keep out of the sun and heat between 11 a.m. and 3 p.m. The UV index in Canada can be 3 or higher during those times. When your shadow is shorter than you, the sun is very strong. Look for places with lots of shade, like a park with big trees, partial roofs, awnings, umbrellas or gazebo tents. Always take an umbrella to the beach.

• Use sunscreen. Put sunscreen on when the UV index is 3 or higher. Use sunscreen labelled broad spectrum and water resistant with an SPF of at least 30.
• Avoid using tanning equipment. There is no such thing as a healthy tan. Using tanning equipment damages your skin and increases your risk of developing melanoma, the deadliest form of skin cancer.

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Melanomas Are Divided Into Four Types Depending On Their Location Shape And How They Grow Into Dermis:

Superficial, spreading or flat: Grows superficially at the first to form an irregular pattern on the skin with an uneven colour.

Nodular: Lumpy and often blue-black in colour. May grow faster and spread downwards.

Acral lentigous: Occurs mostly on the palms of the hand, soles of the feet or nailbeds.

Lentigo maligna: Flat irregular large brown spot. Usually occurs on the faces of elderly people.

Melanoma can also start in the mucous membraces of the mouth, anus and vagina, in the eye or other places in the body where melanocytes are found.

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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What Is The Treatment For Melanoma

Following confirmation of the diagnosis, wide local excision is carried out at the site of the primary melanoma. The extent of surgery depends on the thickness of the melanoma and its site. Margins recommended in New Zealand are shown below.

• Melanoma in situ: 5 10 mm
• Melanoma < 1 mm: 10 mm
• Melanoma 12 mm: 10 20 mm
• Melanoma > 2 mm: 20 mm

Clinical Practice Guidelines for the diagnosis and management of melanoma updated in 2017, recommend, where possible:

• Melanoma in situ: 5 mm, and wider margins if appropriate
• Melanoma < 1 mm: 10 mm
• Melanoma 12 mm: 10 20 mm
• Melanoma 24 mm: 10 20 mm
• Melanoma > 4 mm: 20 mm