MELANOMA

General Information

DEFINITION--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.

BODY PARTS INVOLVED--Usually in skin of the head, neck, legs or back. It appears rarely in the eye, mouth, vagina or anus.

SEX OR AGE MOST AFFECTED--Adults.

SIGNS & SYMPTOMS--A flat or slightly raised skin lesion that can be black, brown, blue, red, white or a mixture of all colors. Its borders are often irregular and may bleed.

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.

RISK INCREASES WITH

• Moles on the skin.
• Occupations or activities involving excessive sun exposure, such as farming, construction work, athletics or sunbathing.
• Pregnancy.
• Genetic factors. This is most common in light-complexioned, blonde people. It is rare in black people.
• Radiation treatment or excessive exposure to ultraviolet light, as with sun lamps.
• Family history of melanoma.
• Living in "sunbelt" areas of the U.S.

HOW TO PREVENT

• Protect yourself from excessive sun exposure. Wear broad-rimmed hats and protective clothing. Use maximum protection sun-block preparations on exposed skin. This is especially important in the adolescent years.
• Examine your skin, including 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. See Skin Examination in Appendix.
• Community provided, skin cancer screening clinics available in some areas.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of suspicious growths.
• Medical history and physical exam by a doctor.
• Biopsy (See Glossary) of suspicious lesions. The melanoma's depth must be established to determine appropriate treatment.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to remove suspicious skin lesions or to remove nearby lymph glands, if the tumor has spread. Skin graft may be necessary to avoid an unsightly scar. (See Melanoma Removal in Surgery section.)
• Radiation treatment, if the tumor has spread.

POSSIBLE COMPLICATIONS--Fatal spread to lungs, liver, brain or other internal organs.

PROBABLE OUTCOME--Varies greatly. Early melanomas that have not grown downward are curable with surgical removal. Once the tumor has spread to distant organs, this condition is currently considered incurable and fatal in a short time. However, symptoms can be relieved or controlled. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• Once diagnosis is made, get frequent body examinations to check for other lesions.
• The more you can learn and understand about a disease, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe anticancer (chemotherapy) drugs.

ACTIVITY--No restrictions except those involving sun exposure.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of melanoma.
• During treatment, changes occur in another skin area.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.