Skin Cancer - Melanoma

Melanoma can develop from a mole, which can be a risk factor for melanoma, but most moles do not become melanoma. However, melanoma is the most serious type of skin cancer due to its tendency to spread, or metastasize, to lymph nodes and other areas of the body, as compared to the other types of skin cancer (Basal and Squamous Cell Carcinoma).

When melanoma spreads, it can spread to almost any other organ in the body but most commonly spreads to the liver, lungs, bones, and brain.

Symptoms of melanoma and other skin cancers vary from person to person. It is important to note that not all skin cancers and melanomas fall into these categories, so just use this list as a guideline:
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• A change on the skin. This could be a new spot, or a change in color, shape or size of a current spot.

• A sore that doesn’t heal.

• A spot or sore that becomes painful, itchy, tender or bleeds.

• A spot or lump that looks shiny, waxy, smooth or pale.

• A firm red lump that bleeds or appears ulcerated or crusty.

• A flat, red spot that is rough, dry or scaly.

If a melanoma is suspected, a skin biopsy will be performed. For this, Dr. Green will remove a sample of skin tissue and send it to a dermatopathologist to be looked at under a microscope. If the biopsy shows melanoma, the dermatopathologist will measure the thickness of the melanoma to find out how advanced the cancer is.

Treatment

The best treatment for you depends on your stage of cancer and your age, overall health, and personal preferences. The most important factor in determining both the treatment and prognosis is the depth of the tumor. Quite simply, how far below the top skin layers does the melanoma go?

Treating early-stage melanomas

Treatment for early-stage melanomas usually includes surgery to remove the melanoma. Usually, the physician will remove cancer as well as a small border of normal skin and a layer of tissue beneath the skin. For people with early-stage melanomas, this may be the only treatment needed. However, for late-stage, thicker, or even invasive and aggressive melanomas, the doctors will work with surgical oncologists and plastic surgeons to increase the cure rate of these melanomas.

Treating Late Stage Melanoma

Ipilimumab was approved by the FDA in March 2011 to treat patients with late-stage melanoma that has spread or cannot be removed by surgery. Yervoy acts more like a vaccine in that it stimulates the patient’s own immune system to fight the melanoma. Although it is not highly effective, the vaccine shows promise for the most advanced cases.

ZELBORAF is a prescription medicine used to treat melanoma that has spread to other parts of the body or cannot be removed by surgery, and that has a certain type of abnormal BRAF gene. This new medication also shows promise as it attacks certain types of melanomas. The person is first tested for the Braves gene and a treatment plan is used depending on the presence of that gene

• Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can be given intravenously, in pill form or both so that it travels throughout your body. Or chemotherapy can be given in a vein in your arm or leg in a procedure called isolated limb perfusion. During this procedure, blood in your arm or leg isn’t allowed to travel to other areas of your body for a short time so that the chemotherapy drugs travel directly to the area around the melanoma and don’t affect other parts of your body.

• Radiation therapy. This treatment uses high-powered energy beams, such as X-rays, to kill cancer cells. It’s sometimes used to help relieve symptoms of melanoma that has spread to another organ. Fatigue is a common side effect of radiation therapy, but your energy usually returns once the treatment is complete.