Melanoma – symptoms, treatment

Proven content

Melanoma is one of the cancers that causes us to panic. It is justified because this type of cancer metastasizes faster than others. But if detected early, it can be completely cured.

This tumor arises from melanocytes, i.e. pigment cells that produce and contain melanin, and which can become malignant. Melanoma most often occurs on the skin, but it can also appear wherever there are melanocytes, i.e. on the mucous membranes in the mouth, rectum, and in the retina of the eye. It is dangerous because it is not easy to treat.

Czerniak – What favors him

Melanomas most often occur in middle-aged people. Very rarely in pre-pubertal children. In Europe, there are on average 10 cases per 100 inhabitants. Melanoma is not considered a cancer that can be inherited but does run in families.

Risk factors for melanoma include persistent skin irritation and trauma, and prolonged exposure to the sun. Cancer develops more often in fair-skinned people who are exposed to constant sunlight, especially in childhood. Another risk group are people with congenital pigmented and dysplastic moles and people with a large number of even small moles. Women develop melanoma more frequently, but the course of the disease is much more severe in men.

Melanoma – symptoms

Melanomas most often develop from pigmented nevi, i.e. flat nevi, malignant lentil spots, and less frequently from blue nevi and unchanged skin. Of the flat pigmented lesions, the most dangerous are those strongly colored, almost black, completely flat or only slightly raised, without hair. Very rarely, neoplasms develop from hairy birthmarks, but this rule does not apply to birthmarks. Malignant lentil stains are most common on the face, more common in women and the elderly. A feature of these changes is a very dark color. The spots grow slowly and have an infiltrated base. They should not be confused with common lentil stains, which are mild pigmented spots that resemble large freckles.

Blue nevus are formed by melanocytes found in the deeper layers of the skin. Hence their bluish, sometimes even black color. They are smooth, hairless and rarely become malignant.

Watch yourself

Melanoma is a cancer that is still difficult to treat effectively. Therefore, the most important role in the fight against it is played by prevention and early diagnosis of the disease. If the disease is diagnosed early, the chances of a cure are very good. Some statistics even give a total cure rate of 90-100%. Unfortunately, there are times when the disease comes back, often indicating that the “cure” was apparent. The fact that melanomas quickly metastasize is also dangerous for our health and life. Melanomas originating from lentil spots and superficially spreading have the best prognosis, the worst – nodular, colorless and developing during pregnancy and the puerperium.

So what should attract our attention?

All the changes that we can observe in the already existing birthmarks. So – enlargement of the birthmark, change in shape, borders, color, itching, burning within the lesion. New marks should also be disturbing, especially those that appeared on unchanged skin and are asymmetrical, with irregular and blurred lines or different colors, a red border. Any birthmark that worries us should be shown to the doctor. He can view it with a diascope (special optical device) or refer us to a surgeon who will remove the lesion and undergo a histopathological examination. Sections are not taken from the nevus – its complete removal is not a diagnostic and therapeutic procedure at the same time. The pigmented nevus is completely removed with a margin of healthy skin. Any pigmented lesions must not be removed by cryotherapy or laser, because histopathological examination cannot be performed after the procedure.

Melanoma – prevention

Proper use of the sun plays an important role in the prevention of melanoma. The absolute ban on sunbathing, in the sun and in the solarium, applies to people with dysplastic moles, people with fair skin and those who have many moles. People at risk, before each walk, should apply preparations containing filters with a high degree of protection against UVA and UVB radiation, preferably the so-called blockers, i.e. preparations that completely protect against the sun. People at risk should also exercise moderation in sunbathing and use sunscreen with filters, adapted to the type of skin and sun exposure. Below are some products that will help protect the skin from the negative effects of sunlight, along with links to the cheapest offers:

1. Body cream-lotion SPF50 + (compare prices)
2. Hydrolipid face cream SPF50 + (compare prices)
3. Tanning cosmetics (compare prices)

Time is of the essence

Malignant melanoma has an exceptionally high ability to spread through the lymphatic and blood vessels, i.e. to form metastases. They are divided into the so-called local and distant metastases. Local metastases include satellite metastases (they arise in close proximity to the tumor), transit metastases (located along the lymphatic pathways) and metastases to lymph nodes in the immediate vicinity of the tumor. Distant metastases can appear in the lungs, liver, bones and brain. The peak of metastasis usually occurs after the first and second year after the diagnosis of the disease, but it also happens that the so-called late metastases are diagnosed 5-10 years after the diagnosis of the disease.

Melanoma – Treatment

Usually it is multi-step. The first stage of treatment is leczenie surgical. It consists in a radical excision of the neoplasm with a margin of healthy skin 1 cm wide for melanoma up to 2 mm thick. If the thickness of the infiltration is greater than 2 mm, 2-3 cm of healthy skin is removed. The surgeon also needs to remove the superficial fascia to make sure that no cancer cells are left behind. The fascia is not removed for small tumors.

If the lymph nodes are enlarged, they will also be removed. In other cases, when the tumor is small, only the sentinel node is assessed, i.e. the first node in the path of the lymphatic vessels leading from the tumor side towards the regional lymphatic system.

To assess the condition of the sentinel node under the skin around the melanoma, a methylene blue solution or a technetium isotope dissolved in a suitable carrier, i.e. tags. The marker enters the lymphatic vessels and travels to the sentinel node. Changing the color of the node to green-blue or the presence of radiation from the node detected by a hand-held gamma radiation detector allows the identification of the sentinel node and its removal, if necessary.

The next stage of the operation is to close the wound. If the surgeon has had to remove a lot of skin, a skin graft is required, which is usually taken from the thigh. A pressure dressing is then applied to the wound.

Isolated limb perfusion chemotherapy it is used when metastases to the skin or subcutaneous tissue have occurred, but more than 2 cm from the edge of the primary tumor. The therapy consists in administering large doses of anti-cancer drugs to the patient’s limb, isolated from the systemic circulation. Then the limb is heated to 41-42 ° C, which allows it to destroy cancer cells.

Radiotherapy it is used to treat melanomas when the patient cannot undergo surgery or refuses surgery, and as a local treatment when radical surgery is not possible. Radiotherapy is also used as an adjuvant treatment after surgery when it is suspected that the tumor has not been completely removed for technical reasons. It is also a method of palliative treatment when bone metastases have occurred. In melanoma of the eyeball, radiation therapy is an adjuvant treatment.

For melanomas chemotherapy it is not used routinely as an adjuvant treatment after surgery. The reason is the low effectiveness of traditionally used chemotherapy. If the doctor decides to administer it, they usually do so to alleviate the symptoms of the cancer in the advanced stages of the disease.

Targeted therapy it raises great hopes both among patients with metastases and among doctors themselves. Modern drugs work in many ways. They can neutralize the mutant BRAF protein and thus stop the growth of cancer cells. They can also stop disease resulting from a mutation in the C-kit gene by stopping its proteins from transmitting signals to cell growth. In modern oncology, it is also possible to combine new drugs with those successfully used in other types of cancer and obtain the two-stage blast effect. On the one hand, such a cocktail stimulates the body’s own immune cells, which actively fight cancer and destroy existing cancer cells at the same time.

Immunotherapy, especially with the use of biomodulators, such as interferon, even in combination with chemotherapy, does not bring the expected results. It is similar with vaccines, which have not proved to be an effective weapon in the fight against melanoma.

Text: Anna Jarosz

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