Skin cancer is the most common form of cancer, and in most cases it is curable after a trip to the dermatologist. Melanoma is one of those skin cancers that can be excised easily with no consequences or can develop into a serious condition that may be life threatening.
Melanoma is a cancer that originates in the pigment producing cells of the skin, called melanocytes. They often begin as small pigmented growths on normal skin, but at least half develop from existing pigmented moles. While most other skin cancers are locally invasive, melanoma may spread to distant parts of the body, when they become destructive and sometimes fatal over time.
Melanomas occur most frequently in fair-skinned individuals. Exposure to sunlight is a key risk factor - exposure to both ultraviolet UVA and UVB radiation is a particular risk factor. Age is another risk factor- melanomas become more common with advancing years. Even the presence of benign nevi is thought to increase the incidence of eventual transformation into malignant growths.
People who have what are called dysplastic nevi are at risk of developing melanomas which can become malignant. Dysplastic nevi as a rule are larger, have different color pigment within the same lesion, have very irregular borders and are multiple throughout the body. Dermatologists have a classification system that ranks these nevi on a probability scale of developing melanoma that goes from A to D2. The A lesions are usually non-familial in origin, B and C nevi involve a family history of melanoma, and D lesions often involve a history of malignant melanoma in the family or in the affected person. The closer to D the lesion is the more malignant the potential.
People with dysplastic nevi syndrome should be monitored by a dermatologist regularly. Their risk of developing malignant melanoma is greatly increased, and a general internist or family practitioner may not recognize changes in skin moles until they become problem some past the benign stage. Additionally, those with any history of malignant melanoma, even successfully excised, must be followed carefully as well as the incidence of repeat malignancies likewise is substantially higher over time.
Once a melanoma becomes malignant, it is classified by two factors: thickness of the lesion in millimeters (a Breslow number) and the level of invasion in the skin (a Clark stage). Clark systems go from Level 1 (generally superficial within the epidermis of the skin) to Level 5, when it invades the subcutaneous tissue. Staging a melanoma ranges from Stages 1 and 2 (confined to skin) to Stages 3 and 4 (invasion of lymph nodes and blood stream). Another prognostic factor involves ulceration of the affected skin. Melanomas that have been excised, particularly malignant melanomas, must have a pathology report and generally a Breslow and Clark staging for the underwriter to consider.
Melanomas are generally considered by lay individuals to be benign growths, and in fact before a melanoma has spread, the cure rate by excision is virtually 100%. Once the growth has spread through the lymph node or blood stream, the odds decrease markedly. Chemotherapy and radiotherapy at that point are not very effective except in shorter term survival. The important thing to remember is that people can die of melanoma if it has not been treated early and excised. Additionally, those who have melanomas or dysplastic nevi must be followed closely by a dermatologist throughout their lifetime.
Summer is a great time of year, but be careful! Always take care to protect your skin from the sun!
The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.