Melanoma

Overview of Melanoma

Melanoma Meaning in Urdu

میلانوما جِلد کے کینسر کی سب سے خطرناک قسم ہے، یہ کینسر جِلد کے ان خلیات یا سیلز کو متاثر کرتا ہے جو میلانن پیدا کرتے ہیں، میلانن ایک پگمنٹ ہوتا ہے جو کہ جِلد کی رنگت کو برقرار رکھتا ہے۔ میلانوما آنکھوں، گلے اور ناک کے اندرونی حصے کو بھی متاثر کر سکتا ہے، تاہم اس بات کے امکانات نہایت کم ہوتے ہیں۔ جِلد کے اس کینسر کی وجوہات تو ابھی تک معلوم نہیں کی جا سکی ہیں، تاہم یہ سمجھا جاتا ہے کہ الٹر وائلٹ شعاؤں کی وجہ سے اس کینسر کے خطرات میں اضافہ ہو جاتا ہے۔

Melanoma is a type of skin cancer that develops from the cells called melanocytes, which produce a pigment known as melanin, which gives skin its unique color. Melanoma occurs when these cells become malignant and grow uncontrollably, invading surrounding tissues and potentially spreading to other parts of the body.

Melanoma is one of the most dangerous types of skin cancer because it has a high potential to metastasize, which means it can spread to other organs and tissues through the bloodstream or lymphatic system. It occurs due to excessive exposure to ultraviolet (UV) radiation from the sun or artificial sources, such as tanning beds. It is a serious skin disease but is highly curable if caught early.

Prevalence of Melanoma:

Since it only accounts for around 1% of all skin cancers, melanoma is the leading cause of death from skin cancer. It is one of the most prevalent cancers in people under 30, particularly among young women. According to CDC, Melanoma accounted for 1.7% of global cancer diagnoses in 2020.

Signs and Symptoms of Melanoma

The symptoms of melanoma can vary depending on the stage of the cancer. In some cases, there may be no symptoms at all. However, here are some common symptoms of melanoma to look out for:

  • A mole or growth on the asymmetrical skin with an irregular border or is not uniform in color
  • A mole or growth that is larger than a pencil eraser
  • A mole or growth changing in size, shape, or color
  • A mole or growth that is itchy, painful, or bleeding
  • Dark lesions on the palms of the hands, soles of the feet, or under the nails
  • A sore that does not heal
  • A lump or thickening under the skin

To do a self-assessment of moles or freckles, you can follow the ABCDE rule of Melanoma. This rule implies that a cancerous mole or freckle should have A: Asymmetry, B: Border Irregular, C: Color Uneven, D: Diameter larger than 6 millimeters, E: evolving in shape, size, color, etc.   

It's essential to understand that not all melanomas follow the ABCDE rule. Some melanomas can be pink, red, or even colorless. If you notice any changes in your skin or have concerns about a mole or growth, consult a dermatologist for evaluation. 

Types of Melanoma

There are several types of melanoma, and they are classified based on their location, growth pattern, and other characteristics. The most common types of melanoma include:

  1. Superficial Spreading Melanoma: This is the most common type of melanoma, accounting for around 70% of cases. It typically begins as a flat or slightly raised lesion with irregular borders and varies in color, often showing shades of brown, black, or red.
  2. Nodular Melanoma: This type of melanoma starts with a rapidly growing, dome-shaped lesion in the deeper layers of skin that may be dark or have varying shades of blue or red. Bleeding or oozing is a distinct symptom. 
  3. Lentigo Maligna Melanoma: This type of melanoma usually occurs in older adults and typically develops on sun-exposed skin, such as the face or neck. It often begins in the sideway surfaces of the skin as a large, irregularly shaped flat lesion with uneven pigmentation.
  4. Acral Lentiginous Melanoma: This type of melanoma is less common and usually appears on the palms of the hands, soles of the feet, or under the nails. It appears as a dark-colored lesion that may be irregular in shape.
  5. Amelanotic Melanoma: It is a rare type of melanoma that lacks pigmentation, which makes it difficult to detect. It often appears as a pink or flesh-colored lesion that may be mistaken for a noncancerous skin condition. 
  6. Desmoplastic Melanoma: This is a rare melanoma, often difficult to diagnose and treat. That’s because it can resemble scar tissue or benign skin lesions. It usually appears as a firm, raised nodule that may be white or pink. 

It is important to note that these types of melanoma can have different subtypes. A dermatologist or other medical professional can provide more detailed information and guidance on the specific type and stage of melanoma.

Causes of Melanoma

The exact causes of melanoma are not fully understood. It generally happens due to a combination of genetic and environmental factors. Here are some of the known risk factors for melanoma:

  • Exposure to Ultraviolet (UV) Radiation: Exposure to UV radiation from the sun or tanning beds is a major risk factor for melanoma. People with fair skin, light eyes, and a history of sunburns are particularly susceptible.
  • Family History: People with a family history of melanoma are at increased risk for developing the disease.
  • Genetics: Certain genetic mutations, such as mutations in the CDKN2A gene, have been linked to an increased risk of melanoma.
  • Age: Melanoma is more common in older adults, although it can occur at any age.
  • Weakened Immune System: People with weakened immune systems, who have undergone organ transplants or are taking immunosuppressant drugs, are at increased risk for melanoma.
  • Moles: People with several atypical moles are at increased risk for melanoma.
  • Gender: Melanoma is more common in men than in women.

Having one or more risk factors does not necessarily mean a person will develop melanoma. However, people with these risk factors should be vigilant about protecting their skin from UV radiation and monitor moles or other skin lesions for changes.

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Risk Factors of Melanoma

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Prevention

There are several ways to reduce the risk of developing melanoma, including:

  • Protecting your Skin from UV Radiation: Wear protective clothing, such as long-sleeved shirts and wide-brimmed hats, and use a broad-spectrum sunscreen with an SPF of 30 or higher. Avoid tanning beds, which can expose your skin to high levels of UV radiation.
  • Avoiding Peak Sun Hours: Avoid being in the sun during peak hours, typically between 10 a.m. and 4 p.m.
  • Checking your Skin: check your skin regularly for any changes in moles, freckles, or other spots. If you notice any changes, see a dermatologist for an evaluation.
  • Avoiding Tanning: Avoid using tanning beds or sunlamps, which can increase the risk of melanoma.
  • Being Cautious with Medications: Be cautious with medications that increase sensitivity to sunlight.
  • Protecting Children from the Sun: Protect children from the sun by using protective clothing and applying sunscreen regularly.
  • Knowing your Risk Factors: If you have risk factors for melanoma, such as a family history of the disease or several moles, be particularly vigilant about protecting your skin and monitoring any changes.

Remember, early detection leads to the successful treatment of melanoma. If you notice any changes in your skin or have concerns about a mole or growth, consult a dermatologist for an evaluation.

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Diagnosis

Physicians diagnose Melanoma through physical examination, imaging tests, and biopsy.

  • Physical Examination: A dermatologist will examine the skin for suspicious moles or lesions. They can use dermatoscopy, a magnifying lens that allows them to see the skin in detail, to look for signs of melanoma.
  • Imaging Tests: If the dermatologist suspects that the melanoma may have spread beyond the skin, they may order imaging tests such as a CT scan, MRI, or PET scan to look for signs of cancer in other parts of the body.
  • Biopsy: If the dermatologist finds a suspicious mole or lesion, they will perform a biopsy, which involves removing a small sample of the tissue for examination under a microscope. 

If the biopsy confirms the presence of melanoma, the dermatologist will determine the stage of cancer, which will help guide treatment decisions. The staging process typically involves additional imaging tests and examination of nearby lymph nodes to determine if cancer has spread.

Treatment of Melanoma | When to Consult a Doctor

Treatment options for melanoma include:

  • Surgery: Surgery is often the first line of treatment for melanoma. The surgeon may remove the melanoma and a margin of healthy tissue around it. If the melanoma has spread to nearby lymph nodes, the surgeon may also remove those lymph nodes.
  • Radiation Therapy: Radiation therapy uses high-energy X-rays to kill cancer cells. It is used after surgery to destroy any remaining cancer cells or treat melanoma that has spread to other body parts.
  • Immunotherapy: Immunotherapy uses drugs to help the body's immune system fight cancer. These drugs work by targeting specific proteins on the surface of cancer cells or by stimulating the immune system to attack the cancer cells.
  • Targeted Therapy: Targeted therapy uses drugs targeting specific genetic mutations or proteins in melanoma cells. These drugs work by blocking the growth and spread of cancer cells.
  • Chemotherapy: Chemotherapy uses drugs to kill cancer cells and treat advanced melanoma that has spread to other body parts.
  • Clinical Trials: Clinical trials are studies that test new treatments or treatment combinations for melanoma. People with melanoma may choose to participate in clinical trials to access new treatments that are not yet widely available.

It's important to note that treatment for melanoma can be complex and may require a multidisciplinary team of specialists, including dermatologists, surgeons, medical oncologists, radiation oncologists, and other healthcare providers.