Malignant Melanoma

A cancer that arises from melanocytes ( the cell which produces the melanin - synthesizing ). More common between the ages of 45 and 55.

There is 3 type of melanoma: 1.) superficial spreading melanoma, 2.) nodular
malignant melanoma, and 3.) lentigo malignant melanoma.

Melanoma spreads through the lymphatic and vascular systems and metastasizes to the regional lymph nodes, skin, liver, lungs, and the CNS ( central nervous system ). Superficial lesions are usually curable, while deeper lesions tend to metastasize (transfer of disease from one organ or part of the body to another). Prognosis varies with tumor thickness. Prognosis is better for a tumor on an extremity (which is drained by one lymphatic network) than for one on the neck, head, or trunk ( drained by several networks)

The cause of malignant melanoma is unknown. Risk factors include, a family history of melanoma, excessive sunlight exposure, skin type ( more common with those who have blond or red hair, fair skin, and blue eyes), and history of severe sunburns. Pregnancy may increase risk and exacerbate tumor growth.


Suspect melanoma when any skin lesion or nevus ( a circumscribed stable malformation of the skin and occasionally of the oral mucosa) is enlarge, if it changes color, becomes inflamed and or if it is sore, itches, ulcerates, bleeds, change texture, or shows signs of surrounding pigment regression.

* Superficial Spreading melanoma: Most common type.
Characteristics; red, white, and blue color over a brown or black background
Irregular, notched margins
Irregular surface
Small, elevated tumor nodules that may ulcerate and bleed.
May have a horizontal growth pattern.

* Nodular malignant melanoma: It usually metastasizes early. Usually grows vertically and invades the dermis. May be grayish, resembling a blackberry. Occasionally, it may match the skin color. It may have pigment flecks around the base, which may be inflamed.

* Lentigo malignant melanoma: Rare type. Usually develops over many years from a lentigo maligna on an exposed skin surface. The lesion usually looks like a large ( 2.5 to 6.4 cm ), flat freckle. Color range from, white, slate, tan, brown, and black. It may have scattered black nodules on the surface and may become ulcerated.

Diagnostic test: May include: physical examination, skin biopsy, lab studies, CT scan, X-ray


Wide surgical resection is imperative for malignant melanoma. The extent of resection depends on the size and location of the primary lesion.

Surgery may also include regional lymphadenectomy.

Chemotherapy with DTIC and cisplatin, and biotherapy with interferons or interleukin -2 to eliminate or reduce the number of tumor cells, for deep primary lesions.

Radiation therapy is usually reserved for metastatic disease. Prognosis depends on tumor thickness.

* Call your doctor if you suspect any of the above symptoms promptly.


Cancer Treatments:

Cancer treatments seek to destroy malignant cells while sparing normal ones, to reduce pain, and to induce cure or remission. A single primary treatment or a combination of treatments may be used. These treatments can provide local and systemic therapy and offer doctors the advantage of attacking cancer cells with several mechanisms. They include:

* Chemotherapy - which interrupts malignant cells life cycles, inhibiting or destroying their ability to divide

* Radiation - which also inhibits cell division by impairing DNA synthesis and causing cell membrane lysis. Radiation can be used as a primary treatment or as an adjunctive procedure intended to kill cancer cells that may have survived other treatments.

* Biotherapy ( immunotherapy ), which employs biological response modifiers that act on malignant cells by inhibiting division and by enhancing the body's immune responses to such cells.

* Bone marrow transplantation, which is used to replace or replenish the bone marrow of patients with leukemia or multiple myeloma

* Surgery, which removes tumors or reduces their size. Surgery enables other treatments because there are fewer malignant cells to combat.

* Several new cancer treatments are emerging. surgical treatments using lasers and intraoperative radiation can effectively remove tumors or reduce their size at the time of initial surgery and staging. Hyperthermia - the use of heat to destroy cancer cells is being investigated as a single modality and in combination with radiation and chemotherapy.

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