Where does Melanoma most often metastasize?

What is malignant melanoma?

Malignant melanoma is a less common form of skin cancer. When diagnosed early, it is easily cured. But if it is not found soon enough, it can be very difficult to treat. It is dangerous because, unlike the other skin cancers, it mestastasizes early and spreads quickly. It is one of the more uncontrollable cancers. The cell involved is the melanocyte, the cell which produces melanin, the dark protective pigment of the skin.

What is the difference between an ordinary mole and melanoma?

An ordinary mole is evenly colored, and either brown, tan or black. It may be flat or raised. It is round or oval and its edges are sharply defined. An ordinary mole is usually less than 6 millimeters in diameter about the size of a pencil eraser. Ordinary moles may be present at birth. Sometimes several appear at the same time, usually on areas of the skin which have been exposed to the sun. Once the mole develops, it usually stays the same size, shape and color for many years. In older people, moles eventually fade away. The moles that are melanoma, called unusual moles or dysplastic nevi, are more complicated. One half usually does not match the other half that is, they are not round or oval. The color is not uniform. Shades of tan, brown and black, red and pink can be found within the same mole. The edges are ragged, notched or blurred, not clear and sharp. They are usually bigger than a pencil eraser. They usually appear on the back, although they may also be seen below the waist and on the scalp, breast and buttocks.

Are new techniques being used to detect melanoma?

There are some new techniques being used. One is an imaging technique called tomographic gallium scanning, which can be used to detect melanoma early. Another approach is the use of antibodies tagged with isotopes to locate the melanoma.

Melanoma - Overview (signs and symptoms, pathology, risk factors, treatment)

Link

Should moles which do not show any change be removed ?

No. Moles are very common in various places on the body. It is estimated that most people have from fifteen to fifty of them on the body. Since melanoma is relatively rare about one to two percent of all human cancers the odds that any one mole will become malignant melanoma are less than one in several million. It would be impractical to recommend removal of all moles.

Are there any places on the body where moles should be removed?

Moles on the palms of the hands, the soles of the feet, or the genitalia are more apt to turn into malignant melanoma than are moles elsewhere. In addition, if you have a mole in a location that is likely to be repeatedly irritated, such as where a brassiere strap rubs, or where it might be nicked in shaving, it is wise to have it removed. You can have this done in a doctor's office or in an outpatient clinic in the hospital. Usually it will be examined under the microscope just to make certain it is not cancerous.

Understanding the Prognosis of Metastatic Melanoma

Link

I am pregnant. The moles on my body are getting darker. Should I be worried about that?

No. Moles on a woman's body may become darker than usual during pregnancy. This is normal and not a sign of melanoma, but you should mention it to your obstetrician.

Is it true that a hair growing from a mole means that the mole is not malignant?

Most doctors agree that the presence of hair suggests that a mole is not malignant, but this is not a hard and fast rule. As with any other mole, any change in the color, size, or shape should be regarded as a symptom that should be investigated by the doctor.

Who usually gets melanoma?

Most often, malignant melanoma of the skin occurs in people with light complexions, sandy hair, with skins that burn and freckle easily. It is most commonly seen in younger people between 15 and 50 and is about evenly distributed between men and women. Persons with a family history of melanoma or those who have many moles or certain types of moles (dysplastic nevi) are at higher risk. It is now also believed that people who get blistering sunburns early in life are at more than average risk. Although rare in black persons, they can develop this cancer especially on the palms of the hand, the soles of the feet and under the nails. In whites, melanoma is usually found on the trunk area in men, on the lower legs in women. Other common sites are head, neck, and arms.

Is melanoma inherited?

There seems to be a predisposition of melanoma in some families. Studies have shown that dysplastic nevi carry with them a very high risk among persons with a family history of melanoma. Suspicious moles should be surgically removed as soon as possible.

Persons without a family history of melanoma may also get dysplastic nevi. The risk of melanoma is increased for these people but it is not as high as for those with a family history of the disease. Their moles should be watched carefully for any changes and removed if changes take place.

Are there any prevention guidelines for a person at high risk of developing melanoma?

People who are at high risk for developing melanoma should follow these guidelines:

 • Do a monthly skin exam. Get familiar with your skin and the pattern of moles, freckles and beauty marks on it.

• If you see any changes in your skin, see the doctor right away.

• Find a doctor with experience in melanoma for your skin care. This doctor should know the importance of your family background and be willing to remove any changing skin lesions early.

• Spend as little time in the sun as you can. Ultraviolet (UV) radiation from the sun is the major known factor for causing melanoma. Avoid getting sunburned, and do not try to get a "good" tan. Use a 15 SPF-rated sunscreen,especially from 10 a.m. to 3 p.m. Reapply the sunscreen after swimming or sweating. Remember that UV radiation can pass through clouds or be reflected from snow or water. Thus, sunscreens may be needed even on a cloudy or winter day.

• Avoid indoor sunlamps, tanning parlors or tanning pills.

• Pay extra special attention to changes in skin moles during adolescence, pregnancy and menopause when hormonal changes take place in the body.

Although the scientific evidence is not fully developed, there is enough to suggest that women at high risk should discuss the use of oral contraceptives, estrogens, and even the question of whether or not to get pregnant, with their specialists. The most important point to remember is that for persons at high risk, careful, regular self examination, combined with regular visits to a physician who specializes in melanoma will detect skin changes early when they can be carefully cared for.

How can I do a skin exam for melanoma?

The American Cancer Society suggests the following skin exam monthly, after a bath or a shower:

1. Use a full length mirror and a hand mirror so you can check any moles, blemishes or birthmarks from the top of your head to your toes, noting anything new a change in size, shape or color or a sore that does not heal.

2. Examine your body front and back in the mirror, then right and left sides, arms raised.

3. Bend elbows and look carefully at forearms and upper underarms and palms.

4. Sit, if that is more comfortable, to look at backs of the legs, feet and spaces between toes and soles.

5. Examine the back of your neck and scalp with the help of a hand mirror, part your hair (or use blow dryer) to lift it and give you a closer look at the scalp.

6. What you are looking for is something different and doing the exam regularly will help you to know what is normal for you and make you feel confident. If you find something, check with your doctor.

Where does malignant melanoma metastasize?

Malignant melanoma can metastasize to any part ofthe body but most commonly to the lungs, liver, and brain. The cells in malignant melanoma show a tendency to metastasize early, traveling through the lymph system and/or the blood system. The commonest route of spread is to the regional lymph nodes.

What kind of doctor treats melanomas?

Melanomas are usually found by dermatologists, who usually perform the biopsy, which is then read by a pathologist. If the lesion is found to be malignant, further treatment should be carried out by a specialist either a surgeon who specializes in cancer or a medical oncologist.

Is there more than one kind of malignant melanoma?

There are four fairly distinct forms of primary melanoma. They are superficial spreading melanoma, nodular melanoma, acral lentiginous melanoma, and lentigo maligna melanoma. Superficial spreading melanoma and nodular melanoma start from a preexisting mole or as a new growth. Acral lentiginous melanoma appears as a dark mark on the palms, soles, or around the nails. Lentigo maligna melanoma (also known as Hutchinson's melanotic freckle) is a relatively rare tissue abnormality which tends to occur on the face or in areas of the body exposed to the sun in light skinned individuals.

What will the doctor do to a mole which has shown some change?

The doctor will arrange to have it removed for examination under the microscope. If it is small, he will take out the whole mole. If it is large, a partial biopsy will be done. It is generally considered wise for the doctor to take out the entire mole if possible, although there is no strong scientific evidence that a partial biopsy is harmful to the patient.

Is it easy for the pathologist to tell whether or not the mole is malignant melanoma?

Diagnosis of this kind calls for an experienced pathologist, since malignant melanoma is a very difficult cancer to diagnose correctly. If there is any doubt at all about the diagnosis, the slides should be reviewed by several pathologists before any decision about treatment is made.

After biopsy, what other tests are needed before treating malignant melanoma?

Usually, before any treatment is begun, patients with malignant melanoma undergo a complete evaluation. This usually includes a complete physical, documentation ofthe size and location of any tumor present and the site of primary origin, a history of past and current symptoms, complete blood count, a survey of blood chemistry, and a chest xray. In addition, if needed, a bone marrow aspiration and biopsy, x-rays of the skull and lumbar spine, liver and spleen scans, an electroencephalogram and brain scan, and a stool examination for the presence of occult blood are done.

What is the treatment for malignant melanoma?

The treatment for malignant melanoma depends upon the location, extent, and stage of the disease. If the microscopic examination shows that the mole is a malignant melanoma, then further surgery is usually done. The doctor will remove some of the normal appearing skin around the mole. Sometimes the nearby lymph glands are also removed.

Is chemotherapy ever used for malignant melanoma?

Sometimes single drug or combination chemotherapy is used, usually in combination with surgery or immunotherapy. If a limited treatment of a single part or organ of the body is needed, chemotherapy in isolation perfusion (introducing the drug to an isolated part of the circulatory system) may be the treatment.

Is radiation treatment ever used for malignant melanoma?

Although surgery is generally considered the treatment of choice for malignant melanoma, radiation therapy is sometimes used for treatment, especially for those patients who cannot have an operation for some reason. Radiotherapy is used in certain eye tumors and is frequently used to control localized pain.

What is the role of immunotherapy in malignant melanoma?

There is a great amount of research now going on in the use of immunotherapy as an adjuvant therapy for malignant melanoma. Clinical trials are being conducted with immunostimulants such as BCG and monoclonal antibodies.

How are monoclonal antibodies used in treating melanoma?

In some centers, monoclonal antibodies are being used to see if the melanoma has spread anywhere else in the body. This is done by attaching radioactive material to monoclonal antibodies and, with x-rays, determining if the antibody shows up in any other part of the body.

There are also investigational treatments using monoclonal antibodies. In some centers, toxins are attached to the antibody with the substance given intravenously to the patients. Some patients with certain stages of melanoma are also being treated with interferon. Other treatments under discussion include using antibodies combined with interferon and the use of tumor necrosis factor, a natural substance which selectively kills tumor cells.

Will reconstructive surgery be needed in a person with malignant melanoma?

It depends upon the location and the extent of the operation. Patients with facial and neck areas involved usually need cosmetic surgery, either skin grafts or other plastic surgery.

Other articles

What is intraocular melanoma?

IS MALIGNANT TUMOR DANGEROUS?

Signs and Symptoms of Skin Cancer





Comments

Post a Comment

Popular Posts

Oral(Mouth) Cancer: Symptoms, Bleeding, Treatment and Diagnose

Image
What kinds of cancers are found in the mouth? The cancers of the mouth (oral cavity) include the lip, tongue, floor of the mouth, cheeks (buccal mucosa), and gums (gingivae). Who is at high risk to get cancer of the mouth? This cancer is predominantly found in men between the ages of 60 and 70. People who are heavy smokers (more than a pack a day), drink alcohol heavily, are over 45, and have a family history of this kind of cancer are at a higher risk to develop cancers of the oral cavity, the mouth, and the throat. Is cancer of the mouth easy to detect? Yes, it is usually discovered early, since it can be seen easily. White patches ( leukoplakia ), velvety red spots (erythroplasia), or dark patches are symptoms which should be seen by a doctor, who will do a biopsy of them. Many cancers of the mouth are first discovered by dentists. What are the symptoms of oral cancer? The warning signs of oral cancer are as follows: • A lump in the cheek that can be felt with the ...
Read more

Ejaculation and sexual life problems after prostate surgery

Image
Yes. After prostatectomy , the ability to ejaculate through the penis is lost. What happens is that ejaculation occurs but it is directed backward into the bladder , rather than forward through the urethra. The semen remains in the bladder until urination, and is carried out via that route. The man who ejaculates in this manner has the very same sensations during sex that he had before except that there is no discharge through the penis. Can a total prostatectomy be done without impairing the ability to have an erection?  Dr. Patrick C. Walsh, a surgeon at Johns Hopkins University Hospital in Baltimore, Maryland, has developed a way of removing the prostate which preserves potency by bypassing the intricate nerve branches of the pelvic plexus. This technique is now being adopted by many surgeons for patients with early stage prostate cancer. Until the advent of this type of surgery, 90 percent of those having prostatectomies lost their sexual ability, and 2 to 5 percent becam...
Read more

How to know if your ankle is broken? How is a broken ankle treated?

Image
Fractures of the Ankle How do ankle fractures occur?  Ankle fractures are caused by a forceful and excessive twisting of the ankle , either in or out. The twist comes from stumbling, catching the foot in a crevice, or falling, in which the weight of the body is unevenly distributed. Many skiers suffer fractured ankles, and some of the best treatments have been evolved by surgeons practicing near ski slopes. The stress and strain factors in the ankle are so uniform that the pattern of the injury, dislocation and deformity is specific. Many varieties of ankle fractures are grouped together under the name of Pott's fracture. What shall I do, Doctor? I'm at a gas station phone and my wife just fell down and twisted her ankle.  If it is painful and she can't walk, it may be a fracture. Don't manipulate it, don't pull it. Just wrap a towel or pillow around it and take her to a hospital for an X ray. It is best if she does not walk. You can carry her in a chair. ...
Read more

How painful is a bone marrow transplant for the donor

Image
What is a bone marrow transplant?  Bone marrow transplantation is an approach used over the past 10 years for the treatment of acute leukemia and lymphoma. It is a complex procedure and should be undertaken only by physicians with the experience and resources needed to get the best results. When is a bone marrow transplant used?  It may be used in some cases of several types of diseases aplastic anemia (when patients do not have enough red cells to carry oxygen, enough white cells to fight bacteria, or enough platelets to help clotting), in some types of acute and chronic leukemia, for some lymphomas, for severe combined immunodeficiency syndrome, and for certain inherited blood disorders such as thalassemia. A bone marrow transplant replaces a patient's abnormal or diseased marrow with healthy marrow from a donor. Can any leukemia patient undergo a bone marrow transplantation?  No. When patients and doctors consider the possibility of treatment with a bone marr...
Read more

What are the most important side effects of taking female hormones?

Image
Would the doctor prescribe estrogen if my ovaries were removed because of cancer?  No. If there is any sign of a cancerous condition, estrogen would probably not be prescribed.  What is the estrogen controversy?  Estrogen is a female hormone produced by the ovaries. Scientists have also developed chemical estrogen. Both regulate the development of female sexual characteristics. For a number of years, estrogens have been prescribed for women during and after menopause to make up for the decline in this hormone normally produced by the ovaries. Estrogen has been found helpful in relieving symptoms associated with menopause, such as hot flashes, in overcoming drying of vaginal tissues and in retarding osteoporosis (thinning of bones). However, the use of estrogen during and after menopause has been linked to an increase in endometrial cancer (cancer of the lining of the uterus), and it may be linked to other cancers as well. At this time,scientists do not agree a...
Read more

What is the symptoms of a head concussion? Is concussion a brain injury?

Image
Head Injuries The brain is man's most vital possession. Recent details about organ transplants have centered on the definition of death. These discussions have emphasized that, even though the heart may continue to beat, the individual is considered dead if there is no brain activity. Nature provides a thick scalp and skull to protect the brain and further encloses it in envelopes called the meninges. Some injuries to the head may be trivial, others may be fatal. The surgeon who is called upon to evaluate the patient with a head injury tackles the problem from within out. Damage to the brain and its envelope is most important; injury to the skull is of concern in only some instances. Bleeding from the scalp is the most apparent manifestation of injury but is the least important. Survival and the late effects of a head injury depend on the extent of the injury to the brain and not to its coverings. The best possible supportive medical crre is provided to those who will reco...
Read more

How is a broken or cracked rib treated?

Image
Chest Injuries The chest consists of the bony thorax and the organs that lie within it. The thorax comprises twelve ribs on each side of the chest, each of which attaches to the bony spine in the back and to the chest bone ( sternum ) in front. Each chest cavity has a smooth delicate lining ( pleura ) within which the lung rhythmically expands and deflates. The diaphragm is the dome shaped muscle that seals off the lower end of the chest from the abdomen. Its upand down motion provides the bellows action for the expansion of the lungs that fills them with air. The function of the lungs is to provide ventilation. Air is moved in to provide oxygen, and carbon dioxide is moved out as a waste product. The heart is in its own envelope in the center of the chest, behind the breastbone. The heart functions solely as a pump. It circulates the blood into the lung for oxygenation and delivers oxygenated blood to the entire body. The chest also harbors the large blood vessels and the br...
Read more

The most important difference between Hodgkin's disease and non-hodgkin's lymphoma

Image
Hodgkin's Disease and Non-Hodgkin's Lymphoma What are lymphomas? Lymphomas are cancers that affect the white blood cells of the immune system. They are characterized by the abnormal growth of lymphocytes, the infection fighting cells in the lymph nodes, spleen, and thymus. The tonsils, stomach, small intestine, and skin may also be affected. Lymphomas are usually classified as Hodgkin's disease, the most common form, or non-Hodgkin's lymphoma. There are also other rare forms of the disease, such as mycosis fungoides, a primary skin lymphoma. Burkitt's lymphoma , rare in most of the world, is the most common childhood cancer in central Africa and is one of the fastest growing human cancers. What is the role of the lymph system in the body?  The lymph system is made up of nodes and thin walled tubelike veins along which the nodes lie. Its job is to help fight diseases and infection, and it serves as part of the body's drainage system. Lymph nodes are ...
Read more

Common Hand Injuries: Treatment for swollen hand due to injury

Image
Hand Injuries Most of us earn our living with our hands. The goal of the treatment of hand injuries is maximum preservation of function. In terms of possible permanent disability, there is no minor surgery in this area. The magnitude of the problem is apparent in the frequency with which it appears in the statistics of the Workmen's Compensation Board and insurance companies. The best treatment is prevention. One must be constantly alert to the possibility of punctures, door slams, burns, pressure injuries, and the perverse potential of certain mechanical tools. Failing this, early treatment to prevent infection is best. There are relatively clearly defined methods of managing various types of injury. The patient can describe the site of the injury by indicating its relation to the various creases in the palm or to the knuckles and nails on the back of the hand. Physicians can treat all hand and finger injuries under some form of nerve blocking anesthesia, so the patient feels...
Read more