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Skin Cancer, Malignant Melanoma

A skin cancer that spreads to other areas of the body, primarily the lymph. nodes, liver, lungs and central nervous system. Most melanomas begin in a mole or other pre-existing skin lesion. Excessive exposure to sun is a major factor in causing malignant melanoma. It usually affects the skin of the head, neck, legs or back, but rarely occurs in the eye, mouth, vagina or anus. Melanomas are more likely to occur in adults, but some affect children. The incidence of melanomas has increased since 1970.

Causes

Uncontrolled growth of cells that give skin its brownish color (melanocytes). When the cells grow down into deep skin layers, they invade blood vessels and lymph vessels and are spread to other body areas. The following factors increase the likelihood of developing a melanoma:

• Moles on the skin.
• Excessive sun exposure.
• Pregnancy.
• Genetic factors. This is most common in light-complexioned, blonde people, and is rare in black people.
• Radiation treatment or excessive exposure to ultraviolet light, as with sun lamps.

Signs and symptoms

Diagnosis

A skin examination by a physician, nurse specialist, or nurse practitioner can uncover suspicious moles. A suspect mole is entirely or partially removed (biopsy) and the tissue examined under a microscope. This is the only way to make a definite diagnosis.

Treatment

The treatment plan takes into account the type of melanoma, its location, whether it has begun to spread, and the person's age and health. The standard treatments are:

• Surgery - remove the melanoma and a ring of tissue around it (to make sure no cancer cells were missed)
• Chemotherapy - to kill cancer cells that have spread throughout the body
• Immunotherapy - interferon-alfa and interleukin-2 may be given to help the body's immune system prevent a recurrence of the melanoma
• Radiation therapy - to kill cancer cells that may have spread beyond the tumor.

Prevention

If you are in a high-risk group:

• Protect yourself from excessive sun exposure. Wear broad-rimmed hats and protective clothing. Use maximum protection sun-block preparations on exposed skin.
• Examine your skin, including genitals and soles of the feet, regularly for changes in pigmented areas. Ask a family member to examine your back. See your doctor about any skin area (especially brown or black) that becomes multicolored, develops irregular edges or surfaces, bleeds or changes in any way.