Melanoma And Skin Cancer

Melanoma is a very serious type of skin cancer that can be caused by being exposed to ultraviolet rays. In most cases, these ultraviolet rays usually come from the sun, but they can also come from other artificial sources such as tanning booths (1). Exposure to ultraviolet rays damages your skin, but it usually takes several years before this damage leads to health problems such as melanoma (1). The skin is made up of three layers which are the epidermis, the outer layer of skin, the dermis, which is the middle layer of skin, and the hypodermis, which is the deeper layer of skin which is also made up of fat. Melanocytes are located in the epidermis and produce pigment. Melanoma forms a tumor when melanocytes change and grow rapidly (8).
It
is not as common as other forms of cancers, but it is one of the most dangerous form of skin cancer and causes the most deaths (2). In America, 3 million people are diagnosed with skin cancer each year, and out of these people, 76,000 were diagnosed with Melanoma (1 pdf?). It was estimated that about 76,380 people would be diagnosed with invasive melanoma in 2016. Out of these people, 46,870 were men and the other 29,510 were women. In the United States alone, melanoma kills around 10,130 people every year.
Melanoma looks like a mole and is usually black or brown; however, it can also be other colors such as white, blue, red, purple, or skin-colored (2). This cancer is treatable and curable if it is found early, but if it isn’t, then the cancer can spread throughout the body and be more difficult to cure. (2) In most cases, melanoma only affects the skin, but occasionally it can be found in the eyes or mouth (1)
Melanoma consists of four stages. These stages are based on how severe the melanoma is, such as how large and deep it is, and how much it has spread throughout your body. Stage 0 is noninvasive and is not below the surface of the skin. It is only found in the epidermis, the top layer of skin(3). Stage 1 is invasive, but it is still small and growing at a slow rate. Stage 2 melanoma is considered intermediate. The melanoma is larger and growing at a slightly faster rate. Stages 3 and four are both considered advanced melanoma. In these two stages, the melanoma has spread throughout your body, specifically towards your lymph nodes, making the cancer more severe and more difficult to cure. When the melanoma has spread to your lymph nodes, there are two ways to classify it. The first is called palpable nodes, which is when a physician can feel that there is an enlargement or lump in the lymph node. The second is called nonpalpable lymph nodes, which is when you can not feel a lump or enlargement. A major difference between stages three and stages four is that in stage four, the melanoma cells travel through your bloodstream and lymph vessels. This allows the melanoma to spread throughout your body and even invade your organs. While classifying what stage the melanoma is, there are also substages for each stage that are based off of the thickness of the melanoma (3).
Anyone can get melanoma, but some people are at a higher risk than others.
People who have lots of moles or large moles have the highest risk of getting melanoma. If you have had melanoma in the past or have close blood relatives that have had melanoma, they you are also at a high risk of getting melanoma. This can be because of lifestyle or inheriting a gene mutation. People who have fair skin, sunburn easily, and have red or blonde hair are more likely to get melanoma as well. People with darker skin who don’t get sunburns easily are less likely to get melanoma. There are ways to prevent melanoma and lower your chance of getting it. One way is by reducing your time spent in intense sunlight (1). The second way is by wearing sunglasses and hats to protect your skin from the intense sunlight (1). The last way is to wear broad spectrum sunscreen with a sun protection factor of at least 30 (1). Another risk fact is if you live closer to the equator. This is because the sun rays there are more direct and you have more exposure to ultraviolet rays. (5) Doctors recommend that a person should exam their entire body monthly to make sure that there are not any new blemishes or moles that are changing in shape, size, or color (2). The sooner you find melanoma and consult with a doctor, the easier it is to cure (2). Melanoma is treated by surgical removal, which is performed by cutting it out of your skin. The more invasive the melanoma is, the deeper they will have to cut into your
skin to get all of it. Surgical techniques have improved, however, so surgeons are able to cut less of your skin out and still get all of the cancer removed. The wound heals quickly after surgery and only leaves a small scar.
There are four types of melanoma with Tthe first three types of melanoma start off as noninvasive and only found in the top layers of skin.
In some cases, however, the melanoma can spread and become invasive. The fourth type begins as invasive therefore it is deeper in the skin and could be spread out throughout the body. The first type of melanoma is superficial spreading melanoma. This is the most common type and makes up 70% percent of cases. It is found more in younger people. This type of melanoma starts in the top layer of skin for a while, then it eventually spreads and goes deeper. The signs of superficial spreading melanoma are a flat or slightly raised patch that is asymmetrical and has uneven borders. It can be brown, black, blue, white or red. This type of melanoma can be found anywhere in your body. Some of the most common places it occurs, however, is your torso, legs, or upper back. The second type of melanoma, lentigo maligna, is very similar to superficial spreading melanoma. It appear to be flat and is found in the top layer of skin but eventually becomes invasive. Its colors consist of tan or brown. Lentigo maligna is mostly found in elderly and on the ears, face, upper torso, and arms. This type of melanoma is also the most common form found in Hawaii. Acral lentiginous melanoma is third type of melanoma. It is very different than the other two. The only similarity is that acral lentiginous melanoma also starts out on the top layers of skin, but
eventually goes deeper as it progresses. It does not appear to be a mole, but rather it is a black or brown discoloration found under the nails, on the soles of feet, and on the palms of your hands. This form is most common for African Americans and Asians and least common for Caucasians. The fourth type is called nodular melanoma. It makes up ten to fifteen percent of melanoma cases and is the most aggressive form. Most cases are found in elderly people. Nodular melanoma is found in the torso, legs, arms and scalp. This form is discovered when it becomes a bump. Usually by the time it is diagnosed, it is already invasive. Nodular melanoma is usually black, but can also be blue, red, skin tone, tan, white, brown or gray. (all from 2)
There are several signs of Melanoma. One is a new skin growth, or a skin growth that is changing as far as color, size, or diameter. Melanoma can be brown, black, blue, white, or purple, whereas a regular mole would just appear as a shade of brown. Melanoma is shaped differently compared to a mole. Rather than being round it is blotched and the border is uneven. Melanoma is asymmetrical, so one side of the mole has a different shape and border than the other side does. Moles are nothing to be worried about unless their appearance changes or it looks very different from the rest of your moles.