Melanoma
General characteristics of the disease
Melanoma is a specific tumor on human skin, the cells of which, malanocytes, produce the pigment melanin. And since it affects the color of the skin, hair and retina of the human eye, one of the main signs of melanoma is the dark color of the tumor.
Melanoma is just one of the types of oncological skin pathologies. It is quite rare compared to other types of skin cancer, basal cell or squamous cell tumors. Melanoma accounts for no more than 15% of all cases of skin oncology.
Most often, the symptoms of skin melanoma are diagnosed on the limbs and trunk of people with East European skin type. Its peculiarity is a pale white color and an increased tendency to burn when tanned. Patients with signs of melanoma most often have red or blonde hair, blue, gray, or green eyes.
A provoking factor for the development of melanoma can be the resulting severe sunburn, the presence of trophic ulcers or scars in the places where the limbs are bent. Melanoma symptoms are more commonly diagnosed in the elderly, in patients with a family history of skin cancer, and in men and women whose skin tends to develop moles. Melanoma is especially dangerous for patients with congenital pigmentary xeroderma, Paget's or Bowen's diseases.
Melanoma is an extremely aggressive and dangerous disease. Timely diagnosis and successful treatment of melanoma is one of the most difficult problems of modern oncology. The disease is diagnosed annually in about 4 people per 100 thousand of the population. Guaranteed healing from the disease is achieved only with a regionally widespread process in the early stages of melanoma.
Skin melanoma symptoms
Melanoma does not necessarily develop at the site of a mole or birthmark (nevus). A dark-colored asymmetric formation can appear on an area with clear skin, devoid of any age spots.
However, most often it is nevi that are almost black, dark gray or dark brown in color that are prone to malignancy (malignancy of the process). An important symptom of skin melanoma is the absence of hair vegetation on the nevus. Initially, it also almost never rises above the surface of the skin. Over time, the age spot begins to change its color, and the first symptom of melanoma is the appearance of skin at the site of the tumor of a pink-red, gray or white hue.
Signs of melanoma in the later stages of development include bleeding, itching, pain, expression, as well as the spread of the process and the appearance of numerous pigmented spots next to the tumor. The average size of a melanoma is from 6 mm in diameter. The behavior of melanoma in terms of growth rate and metastasis is unpredictable.
A sign of superficial melanoma is slow growth for several years. Rapid growth is a feature of nodular skin cancer. Symptoms of this type of melanoma include looseness and a tendency to ulceration of the skin at the site of the tumor.
Malignant lentigo or Hutchinson's freckles are more common in older adults. Another type of melanoma, peripheral lentigo, usually occurs in people with dark skin color and is diagnosed in later stages of melanoma due to localization in places that are difficult to see, for example, on the sole.
Melanoma diagnostics
Any outwardly suspicious neoplasm on the skin requires careful attention to itself. At the first symptoms of skin melanoma, the diagnosis of the disease begins with interviewing the patient about the timing of the appearance and behavior of a suspicious spot. After taking the history and examining the neoplasm, it is the turn of laboratory tests to diagnose melanoma. The first of them is a skin biopsy, a study under a microscope of a scraping of the surface layers of the skin, performed under local anesthesia.
Tumor aspiration biopsy, surgical lymph node biopsy, chest x-ray, CT (computed tomography) and MRI (magnetic resonance imaging) of the whole body are used to diagnose metastatic melanoma. The indications for this type of diagnosis are a confirmed diagnosis of "melanoma" based on the results of local biopsy of the neoplasm and palpable tumor nodes in the lymph nodes.
Melanoma stages
Determining the stage of melanoma is one of the most important prognostic factors in treatment. A sign of stage I and II melanoma is the localization of the tumor in the primary focus. In this case, the positive outcome of melanoma treatment is up to 99%. With metastases to regional lymph nodes - a symptom of stage III melanoma - positive results in the treatment of skin cancer can be achieved only in 50% of cases.
In patients with stage IV melanoma, the prognosis sounds less optimistic, however, fortunately, skin cancer is one of the rare cancers, the signs of which are diagnosed in most cases in stages I and II. Today, more than 40% of patients with symptoms of skin melanoma begin treatment with a tumor thickness less than 0.75 mm. At this stage of melanoma, surgical treatment of skin cancer is successful in 97-99% of cases.
Melanoma treatment
At the initial stage of melanoma, surgical excision of the tumor is mandatory. It can be economical, with the removal of no more than 2 cm of skin from the edge of the melanoma, or wide, with skin resection up to 5 cm around the border of the neoplasm. There is no uniform standard in the surgical treatment of stage I and II melanoma in this regard. Wide excision of melanoma guarantees a more complete removal of the tumor focus, but at the same time it can be the cause of cancer recurrence at the site of the formed scar or transplanted skin flap. The type of surgical treatment for melanoma depends on the type and location of the tumor and the patient's decision.
Part of the combined treatment of melanoma is preoperative radiation therapy. It is prescribed in the presence of ulceration on tumors, bleeding and inflammation in the area of the neoplasm. Local radiation therapy suppresses the biological activity of malignant cells and creates favorable conditions for the surgical treatment of melanoma.
Radiation therapy is rarely used as an independent treatment for melanoma. And in the preoperative period of melanoma treatment, its use has become common practice, since tumor excision can be carried out literally the next day after the end of the course of radiation therapy. The recovery interval between the two treatments for skin melanoma symptoms is usually not maintained.
A controversial issue in the treatment of melanoma is prophylactic lymphadenectomy or removal of regional lymph nodes. On postoperative histological examination, they are affected only in 30% of cases. But since there is no reliable method for determining the state of the lymph nodes before the operation, usually with melanoma of the lower extremities, the puffy lymph nodes are removed. For melanoma of the upper extremities, the axillary lymph nodes are excised.
The results of the use of chemotherapy in the treatment of melanoma with metastases are unsatisfactory, therefore this type of therapy for skin cancer is practically not used.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
