Melanoma is one of the commonest cancers of skin worldwide.
What is melanoma?
Melanocytes are cells seen in the deeper layers of skin. These cells produce a pigment called melanin that gives dark colour to skin when exposed to sun. The cancer that develops in the melanocytes is called melanoma.
What are the risk factors for melanoma?
Common risk factors include:
• Exposure to sunlight: This is the most important factor that increases the risk of skin cancer. Exposure to ultraviolet radiation from sun damages the skin. The risk is related to overall sun exposure over a life time. The risk is also increased if there is a history of several episodes of sunburn in childhood.
• Sunlamps and tanning: Sunlamps and tanning booths also produce ultraviolet light that can cause skin damage and cancer.
• Moles: If there are many moles in the body, the risk of melanoma is increased.
• Personal history of skin cancer: Past history of melanoma or other skin cancers increases the risk of developing melanoma again.
• Family history of skin cancer: Having close relatives (father, brother, sister) with a history of skin cancer, increases the skin cancer risk.
What are the symptoms of melanoma?
If there are many moles in the body, it is important to watch them carefully for any change. Most often, the first sign of melanoma is a change in the mole. The changes may include:
• Getting bigger
• Change in its shape and becoming irregular
• Change in its colour or areas of dark, black, grey, red or pink may be seen
• Looking red, crusty, lumpy, or bleeding
• Becoming tender, painful or itchy
How is melanoma diagnosed?
Diagnosis of melanoma skin cancer is based on the examination of the mole by the doctor and getting a biopsy. Biopsy means taking a small piece of tissue from the melanoma area. The tissue sample is then sent to laboratory where a pathologist checks for cancer cells.
The treatment options for melanoma skin cancer include surgery, chemotherapy, biological therapy and radiotherapy. The type of treatment depends on whether the cancer is in the initial stage, spread to lymph nodes or spread to other parts of the body.
Surgery is the most commonly used treatment for melanoma of skin. Most melanoma operations are done under local anaesthesia but larger cancers need general anaesthesia. Most minor operations are done by the family doctors while others are referred to dermatologist or plastic surgeon especially if the cancer involves a large area in the face.
If large cancers are removed, the patient may also need skin graft or skin flap.
Chemotherapy, biological therapy and radiotherapy are other types of treatment options for melanoma.
Do you need to see doctor after treatment of melanoma?
The patient needs regular checkups after treatment for melanoma. Initially, the checkups may be every 3-6 months, sometimes every 2-3 months for advanced cancer. Then every 6-12 months and gradually becomes less frequent .This will help the doctor to monitor the general health of the patient, problems associated with treatment that the patient had and to check for the signs of the melanoma coming back or that a new cancer has not developed. Checkups may include physical examination, a chest x-ray and CT/MRI scans.
Melanomas can recur even after many years of initial diagnosis. So, follow up for melanoma should be life-long.
Can you prevent melanoma of skin?
Sunlight damages the skin and increases the risk of melanomas. So the best way to protect the skin from sun is:
• Avoid any outdoor activities during the middle of the day, that is, between 10 am and 3 pm. The sun’s rays are strongest during this time. Spend this time in the shade
• Wear sun protective clothing like long sleeves and long pants
• Wear a wide brimmed hat that shades the face, neck and ears
• Use close-fitting sunglasses
• Use sunscreen creams with SPF of 15 or higher. Use this cream 30 minutes before going outside, and apply again every two hours or after sweating or swimming
• Avoid sunburns
• Avoid using sunlamps and tanning booths
Remember to see your doctor regularly and get your moles checked.
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