Skin Cancer & Melanoma Surgery

What is melanoma?

Melanoma, the most serious type of skin cancer, begins in skin cells called melanocytes. Melanocytes produce the pigment, melanin, which determines the colour of skin, hair and eyes. It is the leading cause of death from skin disease. Melanoma begins on the surface of the skin and can grow down into the skin reaching the blood vessels and spread around the body. When cancer spreads, it is called metastasis.  Melanoma can occur anywhere on the skin but often occurs on sun exposed areas of the body such as arms, face, back and legs.  Melanoma cancer can also occur in the eyes, mouth or the internal organs but this is much rarer than melanoma skin cancer. It is a very dangerous type of cancer, and the patient’s chances of survival often depend on early diagnosis and treatment. Skin cancer is the most common type of cancer and is seen in people of all ages.

What are the causes of melanoma?

Skin cancer is caused by intense exposure to ultraviolet radiation from sun exposure or tanning bed usage. This can start a change in melanocytes that eventually turns them into melanoma cells.

What are the risk factors for developing melanoma?

• Frequent sun exposure
• Fair, sun-sensitive skin
• History of sunburns
• Reduced Immunity
• Irregularly shaped moles
• Previous history of melanoma
• Older age (>50 years)
• Hereditary conditions

What are the signs and symptoms of melanoma?

Melanoma is often painless and usually produces the following signs:

The first sign is a change in shape, size, and colour of an existing mole. It may also appear as a new irregular mole. It may appear black or blue black in colour. They are typically located on the back, the shoulders or on the back of the legs. They often have an irregular border and uneven colours. Skin may become reddish or swollen and may be painful.

What are the treatment options for melanoma?

Your dermatologist diagnoses melanoma by visually examining the lesions. If any lesions are suspicious, a skin biopsy will be done where a part or the entire lesion will be removed and observed under a microscope for cancer cells.  If a diagnosis of melanoma is confirmed, the cancer is staged based on its severity as stage 0–IV. Treatment will depend on the stage of cancer, size and location of the tumour, and the patient’s general health. Some of the treatment options include:

• Surgical treatment: This is the standard treatment for melanoma. Wide surgical excision is done for removal of the tumour along with the surrounding normal skin, depending on the depth of the melanoma.
• Immunotherapy:Also, known as biological therapy, immunotherapy uses the body’s immune system to fight cancer or reduce side effects caused by some cancer treatments. Some forms of immune therapy are cytokines such as interferon-alpha and interleukin-2, T-cell therapy, and vaccine immunotherapy.
• Gene therapy:Another new approach in treating melanoma is gene therapy. It involves the insertion of normal genes into cells to replace the defective genes causing cancer spread.
• Chemotherapy:This is the use of drugs to kill the cancer cells. The drugs are given in cycles, where a treatment period is followed by a recovery period before beginning another treatment period. Some of the drugs used are carmustine, tamoxifen, cisplatin, or dacarbazine. Also, combination regimens are used in the management of melanoma.
• Radiation therapy: Treatment method where high- energy rays are used to kill cancer cells.

How can the development of melanoma be prevented?

• Avoid excessive exposure to the sun, especially the midday sun (from 10 a.m. to 4 pm)
• Use a sunscreen every day with an SPF of 15 or higher that blocks both UVA and UVB rays.
• When outdoors, try to stay in the shade either under a tree or an umbrella.
• Clothing and sun hats can protect the skin from the harmful rays.
• Children must be protected from sunburn until age 16. This means using a good sunscreen that blocks both UVA and UVB rays when in the sun and reapplying at least every two hours and after swimming.

Consult your doctor if you have sores that will not heal