One of the most severe types of skin cancer, melanoma, begins in the melanocytes, the cells responsible for generating the pigment melanin and providing the skin with color. Melanoma moves in stages, starting with stage 0 and progressing to stage 4.
Melanoma can affect the face, arms, back, legs, and eyes, especially on skin that has experienced significant sun exposure. In rare cases, it may also occur in internal body parts, such as the throat or nose. The most significant risk factors for melanoma development are ultraviolet (UV) light in sunlight and tanning beds. In its earliest iteration, stage 0, the melanoma sits "In situ” or “in position.” Melanoma remains confined to the outer layer of skin, with abnormal, precancerous cells found only in the epidermis. Symptoms include freckles and moles with ragged borders, irregular shapes, or various such as brown, red, and tan. Therefore, medical professionals recommend that individuals regularly check for moles that grow, shrink, itch, bleed, or change color. Dermatologists should examine and evaluate any changes to skin lesions on the body to determine if they represent the initial stages of cancer or are benign. Medical professionals treat Stage 0 melanoma with excision surgery to target the affected area, often a mole. They also remove skin with margins or the skin at the edges of the tumor to prevent the cancer from spreading further. Medical professionals examine the excised skin under a microscope to ensure they have removed all cancerous cells. In some instances, medical professionals recommend specialized Mohs surgery and radiation therapy. They may also prescribe imiquimod cream for application on abnormal skin growths. Lastly, the medical professionals may order a biopsy to examine the surrounding lymph nodes. Ulcers that measure two millimeters or less in thickness that have broken the skin characterize stage 1 melanoma. However, the tumor has not reached nearby organs or lymph nodes. Medical professionals treat stage 1 melanoma similarly to stage 0. They remove the affected area and stitch and bandage it. By stage 2, the tumor may extend to four millimeters in thickness, but it still hasn’t spread to the lymph nodes or organs. Many localized stage 0 to stage 2 treatments succeed, with five-year survival rates at 97 percent. Stage 3 represents a significant escalation of melanoma severity as the tumor has spread to nearby lymph nodes or organs. Stage 3 falls into subcategories, from 3a to 3d, depending on the degree of tumor advancement and severity. Simply excising skin is not enough to halt the tumor’s progression by this stage. Thus, medical professionals will palpitate the lymph nodes and take samples. If a review under a microscope reveals melanoma, they will remove them. Follow-up treatment includes radiation therapy or immunotherapy. The larger excision required for Stage 3 melanoma often leaves a noticeable scar, and five-year survival rates are around 63 percent. Known as metastatic melanoma, stage 4 melanoma indicates that it has spread to distant organs and lymph nodes, possibly affecting the brain, liver, and lungs. Treatment involves a combination of radiation and tumor excision surgery. While the latter is not likely to obliterate the cancer, it can slow its progression. Targeted therapy drugs, which focus on specific cancer-related proteins, are also an option. For those with this advanced and incurable form of the disease, the chance of survival stands at 22.5 percent after five years.
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AuthorDr. Rajan D. Bhatt - Cardiologist in Scottsdale, Arizona Archives
February 2022
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