Melanoma

HOW IMPORTANT IS MY SKIN?

Your skin is actually the largest living organ on your body. Not only does it protect and cover all internal organs, but it also protects your body from your environment. Your skin helps control your body temperature as well as shield your body from the sun’s damaging ultraviolet (UV) rays. It even uses the sun to produce vitamin D!

HOW COMMON IS SKIN CANCER?

Melanoma is the most dangerous and threatening type of skin cancer. It accounts for more than 73,000 cases of skin cancer diagnosed last year in the U.S alone.

WHAT IS MELANOMA?

Melanoma is a skin cancer that begins in the melanocytes – the cells that make the brown skin pigment known asmelanin, which gives the skin its color. Melanin helps protect the deeper layers of the skin from the harmful effects of the sun. It is the most serious and fast spreading form of skin cancer. Early detection is key to treatment

Melanoma can start on nearly any part of the skin, even in places that are not normally exposed to the sun, such as the genital or anal areas. Though melanoma most often affects the skin (including under the nails), it can also start in other parts of the body, such as in the eyes or mouth.

Melanoma is almost always curable when it’s found in its very early stages. Although melanoma accounts for only a small percentage of skin cancers, it’s much more likely to grow and spread to other parts of the body, where it can be hard to treat. Because of this, melanoma causes most skin cancer deaths, accounting for nearly 10,000 of the more than 13,000 skin cancer deaths each year.

Am I at Risk? Those most vulnerable to developing skin cancer typically have fair skin and blue eyes. Skin cancer is also very common in individuals who have had multiple or repeated sunburns or those who have a family medical-history of skin cancer.

HOW CAN I TELL IF A MOLE IS CANCEROUS?

The first step would be a home cancer self-detection. Be aware, self-detection is not always 100% reliable, so a yearly visit to the dermatologist is highly recommended. The method used for self-detection is known as:

The ABCDE Method:

• Asymmetry
  • Does one half of the mole or lesion look different than the other?
• Border
  • Do the border edges of the mole appear blurred?
• Color
  • Is there more than just a brown color to the mole? Are there signs of blue, black or red?
• Diameter
  • Is it a large mole? Large meaning more than 1/2″ to 1″ in size.
• Evolving
  • Does the mole change in size, shape and/or color?

HOW IS MELANOMA TREATED?

The choice of treatment is based on the tumor’s type, size, location on the body, as well as the patient’s age and general health.

Treatment is almost always offered on an outpatient basis in a in-office. A local anesthetic is used during the procedures. Pain or discomfort is minimal.

Based on the stage of the cancer and other factors, your treatment options might include:

• Surgery – With this surgery, the doctor examines the lymph nodes near the melanoma. Whether this is done by physical exam or by imaging test (such as CT or PET scans) depending on the thickness and location of the melanoma. If the nearby lymph nodes feel abnormally hard or large, a fine needle aspiration (FNA) biopsy or excisional biopsy is used to find melanoma.
• Immunotherapy – Immunotherapy uses medicines to stimulate a patient’s own immune system to recognize and destroy cancerous cells more effectively. There are several types of immunotherapy available to treat patients with melanoma.
  • PD-1 inhibitors: PD-1 is a protien found on immune system cells known as T cells. By blocking PD-1 with drugs such as Pembrolizumab (Keytruda) and nivolumab (Opdivo) which boost the immune response against melanoma cells, doctors are often able to shrink tumors and help people live longer. These drugs are administered by an intravenous (IV) infusion every 2 or 3 weeks.
  • CTLA-4 inhibitor: Ipilimumab (Yervoy) is another drug that helps boosts the body’s immune system response, but it has a different target. It blocks CTLA-4, another protein found on T cells. This drug is distributed throughout the body via intravenous (IV) infusion, typically once every 3 weeks for 4 treatment sessions. This drug has proven to help individuals live longer. Specifically with patients who suffer from melanomas that cannot be removed by surgery or that have spread to other parts of the body.
• Chemotherapy – Chemo is usually only recommended for those suffering from late-stage melanoma since it is not as effective in melanoma as it is in some other types of cancer. However, it has been reported to it relieve symptoms and in some cases extend survival for some patients.
• Palliative Radiation Therapy – This option can be used to treat melanoma that has recurred after surgery. Palliative radiation therapy is most often used to relieve symptoms caused by the spread of the melanoma – especially to the bones or brain. Radiation therapy is not expected to cure melanoma, but it may help shrink it or slow cancer growth for enough time to assist with symptom control.
• Early-stage melanomas can often be treated effectively with surgery alone, but more advanced cancers often require other treatments. In special cases, a combination of more than one treatment is used to control melanoma symptoms.