What is melanoma skin cancer? Melanoma skin caner is a type of cancer that develops in melanocytes, a skin pigment cell that acts as a melanin producer. Melanin is works to absorb ultraviolet light and protect the skin from damage. Melanoma is a rare and very dangerous type of skin cancer. This condition starts from the human skin and can spread to other organs in the body. The appearance of a new mole or a change in an existing mole is usually a common sign or a melanoma symptoms. This can happen all over the body, but some parts of the body that often experience its appearance are:
Skin Cancer Melanoma Patients
According to WHO data, there are about 132,000 cases of melanoma emerging every year worldwide. Every 3 cases of cancer found one case of melanoma skin cancer and it is estimated that this will continue to increase because the ozone layer in the sky is constantly thinning. A 10 percent reduction in the ozone layer alone could lead to an increased incidence of melanoma skin cancer by 4500 additional new cases.
The risk of melanoma is greater for women under the age of 40 years. This type of skin cancer can be fatal if not diagnosed early.
Causes Of Melanoma Skin Cancer
Melanoma occurs when skin pigment cells develop abnormally. Until now, it is not known why this happened. Some people who think the cause of the emergence of melanoma Â because the skin is too often exposed to natural or artificial ultraviolet (UV) rays. But it's not all people who are often exposed to UV melanoma sufferers. Researchers are still trying to find out the cause. Some of the known factors that can increase the likelihood of contracting melanoma are having multiple moles or spots on the skin, pale and flammable, having a family member with melanoma, as well as a redhead or blonde.
Diagnosis of Melanoma Skin Cancer
Doctors can diagnose melanoma after performing a physical exam. Your doctor will refer you to see a dermatologist or plastic surgeon if they think you have melanoma. So if you notice any changes in the shape of a mole, see your doctor immediately.
In most of the existing cases, suspicious mole tissue will be removed surgically and studied whether it has become cancerous. This process is known as biopsy. As for checking whether melanoma has spread to other body parts, a sentinel node biopsy procedure may also be performed.
Melanoma Skin Cancer Treatment
One of the major procedures of melanoma treatment is surgery, although all types of treatment are done depending on your condition. Surgery can be successful if melanoma is diagnosed in the early stages. But, to prevent melanoma reappear, you should undergo further treatment. If melanoma is not diagnosed until at its most severe stage, treatment can only slow the spread of cancer and relieve symptoms. At this stage, it usually takes drugs, such as chemotherapy.
Reappearance of melanoma
There is a possibility that melanoma will return if you have previously suffered from melanoma. If the cancer has spread and severe, then your risk of re-exposure will increase.
You may need to have regular checkups to monitor your health, especially if your cancer handling team feels that there is a high probability that melanoma will reappear. How to check if there are tumors in your skin and lymph nodes, usually will be taught by a team of doctors on duty.
Prevention of Melanoma Skin Cancer
You can lower your risk of melanoma by avoiding the skin from exposure to ultraviolet light, both natural and artificial, although the appearance of melanoma is not always preventable. One of the easiest melanoma prevention is to use sunscreen and wear complete clothing to protecting the skin from harmful sun exposure.
To improve the success of treatment and to be able to get a diagnosis early on, you are advised to check the moles and spots regularly.
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Symptoms Of Melanoma Skin Cancer
The symptoms of melanoma skin cancer are often characterized by the appearance of a new mole or when there is a change in the shape of the old mole. The normal mole shape usually has one color, round or oval, and is less than 6 millimeters in diameter. While melanoma usually has the characteristics:
- Has more than one color
- The shape is irregular
- Its diameter is larger than 6 mm
- Feels itchy and can bleed
- Asymmetrical A ( asymmetrical ): melanoma has an irregular shape and can not be divided equally
- B ( border ) periphery: melanoma has uneven and rough edges, unlike normal moles
- C ( color ) color: melanoma is usually a mixture of two or three colors
- D ( diameter ) diameter: melanoma usually diameter greater than 6 millimeters, and different from ordinary mole
- E ( enlargement or evolution ) enlargement or evolution: a mole that changes shape and size after a while will usually become a melanoma
Causes Of Melanoma Skin Cancer
Although almost all cases of melanoma are related to the effects of ultraviolet light on the skin, the exact cause is still unknown.
Sunlight is a major source of ultraviolet that can affect the skin. In most cases, melanoma is thought to be caused by exposure to sunlight. But know that not all melanomas are associated with ultraviolet light exposure, as these conditions can still appear on areas of the skin that are rarely exposed to sunlight.
There are two main types of ultraviolet light that can penetrate the ozone layer in the earth's atmosphere, namely ultraviolet A (UVA) and ultraviolet B (UVB). If it is too long and repeatedly exposed to UVA and UVB, the skin will be damaged and make it more susceptible to skin cancer (including melanoma).
All of the factors below make your skin more sensitive to the harmful effects of sunlight. Factors that may increase the risk of developing melanoma include:
- Have lots of moles .
- Has a lot of spots on the skin.
- There are areas of burnt skin or after treatment with radiotherapy.
- Pale skin is flammable and skin is difficult to turn black.
- Have blue eyes and reddish or blond hair.
- Aging age.
- Experiencing a condition that lowers the immune system, such as HIV.
- Drugs that lower the immune system (immunosuppression), usually this type of drug consumed after undergoing organ transplants.
- Ever been diagnosed with skin cancer.
- There are family members who suffer from melanoma as well as other types of skin cancer.
- Exposure to chemical compounds in the form of arsenic compounds or creosote pepticide products.
Diagnosis Of Melanoma Skin Cancer
Your doctor will check your skin condition and decide if you need further examination by a specialist. This is the beginning of the process before diagnosing melanoma.
If the doctor suspects a mole is examined as melanoma, you will be referred to see a dermatologist or plastic surgeon for further examination.
A dermatologist or plastic surgeon may perform a biopsy. A small operation to remove a mole that is likely to be melanoma for further study by microscope. This process is done to determine whether the mole was a cancer or not. Biopsy is usually done by local anesthesia. The area around the mole will be numb and you will not feel any pain.
More surgery is necessary if the mole is cancerous. In most cases, this surgery is performed to remove the affected skin and is handled by a plastic surgeon.
A further test needs to be done to you if there is a concern that the cancer is already spread to other organs, such as to the bone or into your circulatory system. Other tests that may need to be done include:
- Blood test
- X-ray imaging
- MRI Scan
- CT Scan
Biopsy of the Sentinel Lymph Node
Early patterns of melanoma spread generally spread through channels in the lining of the skin called the lymphatic system, to the nearest lymph nodes. Medically, the lymph nodes are also known as the 'lymph nodes'. This gland can be found anywhere in the body. These glands that are part of the immune system help to wipe out unwanted bacteria and particles in the body.
A very small collection of melanoma cells capable of spreading through the lymphatic system vessels to the lymph nodes. For example, melanoma in the arm often spreads to the lymph nodes in the armpit. While melanoma in the legs often spread to the lymph nodes in the groin.
The process of a plastic surgeon named lymph node sentinel biopsy is a test to determine whether melanoma in very small amounts has spread to the lymph nodes. Small spreads are usually invisible on the results of X-ray tests, but more easily known by lymph node sentinel biopsy processes.
A mixture of blue ink and a weak radioactive element will include a plastic surgeon around your wound before partial removal of the skin. Just like melanoma cells, blue ink and radioactive elements will flow along the lymphatic channels in the skin. Logically, the combination of these elements leads to the first lymph node, just like the lymph node targeted by the cancer, this is called the sentinel lymph node.
With the blue ink and radioactive elements injected, sentinel nodes can be found and removed, while uninfected nodes are usually left unchecked. It will be left to a pathologist to examine, recognize, or separate a very small melanoma cell. The whole process can take several weeks.
For patients with lymph nodes that have been infected with melanoma, there is a high probability that melanoma has spread elsewhere. If the sentinel lymph nodes are clean of melanomas, then other lymph nodes are also clean.
If melanoma is present in the sentinel lymph node, there is a risk that at least the lymph nodes in the same group also have melanoma. In this condition, to remove all remaining lymph nodes in the affected group will usually be advised. This larger operation is usually referred to as a complete lymph node surgery or a thorough lymphadenectomy.
Melanoma Skin Cancer Treatment
Treatment of melanoma is highly dependent on the condition of the individual to be treated, the type of cancer and also the stage of cancer suffered. The main handling of melanoma is through surgery.
Stage of Melanoma Skin Cancer
This type of melanoma treatment depends on the stage of melanoma you are suffering from. The stage system is used by professional medical personnel to explain how far the development and spread of melanoma in both the skin and other organs. The sequence of melanoma stages is described as below:
- Stage 0: melanoma is on the skin surface.
- Stage 1A: melanoma thickness less than 1 mm.
- Stage 1B: melanoma thickness 1-2 mm or less than 1 mm but with damage or injury to the skin surface.
- Stage 2A: the thickness of melanoma 2-4 mm or 1-2 mm but with damage or injury to the skin surface.
- Stage 2B: melanoma thickness greater than 4 mm or 2-4 mm with damaged skin surface.
- Stage 2C: thickness of melanoma more than 4 mm and skin surface damaged.
- Stage 3A: melanoma has spread to one to three closest lymph nodes, but the nodes do not swell. At this stage there is no skin damage and has not spread further.
- Stage 3B: The skin surface of melanoma has been naturally damaged and melanoma has spread to one to three lymph nodes, but not enlarged. Or, the skin surface of melanoma is not damaged and spread to one to three lymph nodes and the node is enlarged. Or melanoma has spread to small areas of skin or lymphatic channels, but not to the lymph nodes.
- Stage 3C: melanoma skin surface damaged and has spread to one to three lymph nodes and enlarged. Or melanoma spread to four or more lymph nodes.
- Stage 4: Melanoma cells have spread to other areas of the body such as the lungs, brain, and other parts of the skin.
The following is the handling of melanoma adjusted for its severity:
Stage 1 Skin Cancer Melanoma
To deal with melanoma stage 1, the plastic surgeon will perform surgery to remove melanoma cells and a small skin in the surrounding area.
Sometimes in the process of surgery, for some cases melanoma will be total anesthesia, so you will fall asleep or unconscious. But surgery for stage 1 melanoma is generally done by means of local anesthesia. You will remain conscious, but the area around melanoma will be numb and you will not feel pain.
If surgical operation leaves a marked scar, you can choose a joint surgery to transplant the skin. Skin transplantation means taking part of the skin from other parts of the body, to be grafted or attached to the operated area.
The likelihood for melanoma stage 1 that has been removed will be very small, so it is usually not necessary follow-up treatment after surgery.
Stage 2 and 3 Skin Cancer Melanoma
Handling performed the same as in stage 1, the area infected with melanoma will be removed and if necessary skin grafting surgery. If melanoma has spread to the nearest lymph node, you may need further surgery to remove it. Total anesthesia should be performed for this surgery.
The lymph node removal process poses a risk to your lymphatic system disorders. The effect can cause fluid accumulation in the body. In medical terms it is known as lymphedema. You are advised to continue consulting your doctor about the recovery process and be wary of signs of melanoma going back.
Stage 4 Skin Cancer Melanoma
Melanoma stage 4 as the worst stage can be divided into two conditions:
- Melanoma has spread to other body parts (metastasis) when first diagnosed.
- Melanoma reappears in other parts of your body after previous treatment.
Surgical surgery may be possible in melanomas that appear far from where the first melanoma cells appear. Meanwhile, to reduce the effects of symptoms that occur, some of the treatment that can be done is radiotherapy and consumption of drugs.
Treatment and treatment usually have side effects that can affect the quality of your life. If treatment results do not add much to your age or you do not feel any symptoms that cause pain or discomfort, you may be refusing to perform all existing cancer treatments.
If you decide not to receive treatment, painkillers and special nurses may be available if you need them. This is a type of palliative care. All the decisions are yours.
To remove the lymph nodes after surgery and to relieve the symptoms of high-grade melanoma, radiotherapy treatment can be done. Radiotherapy implements controlled dose radiation to kill cancer cells. This procedure is performed at the hospital in several daily sessions for 10-15 minutes, with the weekend left to rest.
Side effects of radiotherapy include fatigue, nausea , loss of appetite, hair loss , and skin rashes . Consult the side effects experienced by your doctor. Doctors can provide medicines to prevent or control these side effects. These side effects will diminish little by little as the sessions are followed.
Drugs For Melanoma
Handling melanoma that has spread to other body parts is to use chemotherapy. Chemotherapy is generally done to reduce the pain of symptoms caused by melanoma at high stage. Chemotherapy uses the use of anti-cancer drugs or cytotoxins to kill cancer.
Some types of drugs can be used to treat melanoma. The specialist will discuss the drugs with you. There are various types of chemotherapy drugs, and can sometimes be combined. The most commonly used to treat melanoma is dacarbazine Â and temozolomide.
Patients undergoing chemotherapy do not need to stay in the hospital. Chemotherapy is given once in three or four weeks. The time lag is given to allow your body to have time to recover. Dacarbazine is administered by infusion and temozolomide is given in tablet form.
Chemotherapy has several side effects caused by the effect of the drug on body resistance. Most side effects can be prevented or controlled with medications prescribed by your doctor. Side effects of chemotherapy include infection, nausea and vomiting, fatigue, and sprue .
Immunotherapy application uses drugs that have been derived from elements that exist in the blood naturally. This treatment aims to encourage the immune system to fight melanoma. The two drugs commonly used for melanoma are interferon-alpha and interleukin-2 . Both of these drugs are administered by injection into a vein, under the skin, or into a melanoma clot. Side effects that often occur from the use of immunotherapy resembles symptoms of flu , such as fever , joint pain, and fatigue.
The human body produces antibodies that control infection. In addition to the body, there are also antibodies that can be produced in the laboratory, which is named monoclonal antibodies.
Patients will be given artificial antibodies in certain doses. Then the antibodies will recognize tumor cells and destroy them.
Prevention Of Melanoma Skin Cancer
The best prevention is to avoid the skin from direct exposure to sunlight for a long time. This is especially important for people who have had melanoma or other non-melanoma skin cancers, to help prevent the reappearance of skin cancer that has been removed. Below will explain some steps to prevent skin from exposure to sunlight.
Checking Mole Conditions
Check the mole on your body if there are signs of melanoma. Consult your doctor if you notice any form changes in moles or spots on your body. If early diagnosis can be obtained, it will help in improving successful treatment.
Avoid Sunlight When on the Hot Peak
At 10:00 to 14:00, the sun will be on the hottest peak. But at different times, the sun can still feel very hot and has a damaging effect. In those hours, try to stay in the shade and cover yourself with the right clothes and wear sunscreen.
If you work outdoors and have to be exposed to the sun for long periods of time, use clothes that protect you from the sun. The outfits that are meant here include long sleeved shirts, hats to protect your face and scalp, as well as goggles to protect your eyes.
It is recommended to wear sunscreen with SPF levels (sun shielding factor) of at least 15. Make sure the sunscreen is suitable for your skin type and can block UVA and ultraviolet B (UVB) radiation.
Use sunscreen is recommended to be done 15 minutes before you are exposed to sunlight and applied again every two hours. If you want to spend time in the water, use a waterproof sunscreen and apply it regularly.
Before engaging in the outdoors during the day, make sure your children wear the right clothes and wear a sun hat and sunscreen with high SPF. Try to pay more attention to the protection of infants and children because their skin is more sensitive than adult skin. If too often exposed to sunlight, skin cancer may appear when they grow up.
Try not to get sunburned. If it happens frequently, the skin is already affected by ultraviolet radiation. The likelihood of future cancer occurrence will increase as skin exposure to radiation.
Avoid artificial ultraviolet light
Artificial ultraviolet light can be more dangerous than natural ultraviolet rays coming from the sun. Because artificial UV rays use a concentrated source of ultraviolet radiation. UV radiation can increase the risk of developing melanoma.