What is Melanoma?
Melanoma is the most serious form of skin cancer. It develops in the cells which produce melanin. Melanin is pigment which gives your skin its color. It most commonly develops in the skin. It can, in rare occasion, develop in the intestine or eyes. While the exact cause is not clear, exposure to sunlight or tanning beds which include ultraviolet radiation increases your risk for developing melanoma. Early detection is important as melanoma can be treated successfully when diagnosed before it reaches a later stage.
The board certified surgeons at Central Carolina Surgery specialize in diagnosing and treating skin cancer including melanoma in Greensboro, NC. Learn about melanoma, the types of surgeries available, and call Central Carolina Surgery today at (336) 387-8100.
Signs and Symptoms
Moles with findings that may indicate possible melanoma have the following characteristics:
A asymmetrical shape
B irregular border
C changes in color
D diameter larger than 6 mm or ¼ inch
E involving or changing in size or color over time
Additionally, itchiness, scaliness, or bleeding are concerning symptoms
- Under a finger or toenail
- Mouth, digestive tract, urinary tract, or vagina – these are mucosal melanomas and difficult to detect
- Eye – these develop in the uvea which is the layer beneath the white of the eye which is called the sclera
As skin cells develop, healthy new cells push older cells toward the skin surface where they die and are shed. If some cells which produce melanin developed DNA damage, they may grow out of control forming a melanoma. While it does not cause every case, ultraviolet radiation is believed to be the leading cause of melanomas.
- Fair skin
- History of severe sunburns
- Excessive ultraviolet light exposure
- Having multiple moles
- Living near the equator or at higher elevation
- Family history
- Impaired immune system due to disease, chemotherapy, or organ transplantation
Biopsy is the usual method of diagnosis. A punch or shave biopsy may remove a portion of the lesion. An excisional biopsy removes the entire mole. The specimen is then tested in the pathology lab.
The thickness of a melanoma is very important in determining the necessary treatment plan. The thicker the tumor, the more serious the disease is. Melanomas are classified as thin, intermediate, and thick. Depending on thickness, surgical evaluation of the lymph nodes near the melanoma will may be required. This is often done with a sentinel node biopsy. A dye and a radioactive tracer are injected in the area where the melanoma is located. The first lymph nodes to take up the dye and tracer are removed and tested for cancer cells. If cancer is found in the lymph nodes, the remainder of the lymph nodes in that region may need to be removed. Chemotherapy or other treatment will likely be required in those cases.
In general, melanoma is staged I through IV. Stage I is small and has a very high cure rate. In stage IV, melanoma has spread to other organs such as the lungs or brain with a much lower chance for full recovery.
Treatment Options at Central Carolina Surgery
Thin melanomas, less than 1 mm in thickness are treated with wide excision, removing a rim of normal tissue around the lesion. Intermediate thickness melanomas, 1-4 mm in thickness, are treated with wide excision and sentinel node biopsy as described above. Melanomas over 4 mm in thickness are treated with very wide excision. Sampling the lymph nodes in these cases is often not helpful. If any lymph nodes near the melanoma are enlarged, they may be removed.
If melanoma has spread to other organs, several treatments are available.
Chemotherapy – this includes some new medications which have been effective
Biologic therapy – this boosts your immune system to help your own body fight the melanoma
Targeted therapy – this includes medications that specifically target melanoma with a particular genetic mutation. Cells from the melanoma are tested to see if this therapy would work in a particular case.
Vaccine treatment – this involves injecting cells into the body to direct the immune system to fight the melanoma
Experimental treatments – clinical trials are also available with ongoing research
Your surgeon will discuss the treatment plan specific for your case in detail.