Malignant melanoma, in other words, malignant skin cancer, can be defined as a type of skin cancer that occurs in pigment-producing cells called melanocytes in the epidermis layer. Typically, melanomas occur on the skin, and although rare, these formations may also occur in the mouth, eyes, or intestines.
Melanoma occurs when some problems occur in the melanocytes, the cells that produce the melanin that gives color to the skin. Under normal conditions, the cells that make up the skin tissue renew and multiply in a controlled and regular manner. Healthy cells push the damaged old cells toward the skin surface, and the damaged cells die on the surface and are shed. Regenerated cells from below undertake the task of repairing the skin.
As a result of the intense exposure of the skin to the harmful rays of the sun, genetic damage and accumulated mutation in melanocytes may result in the cancerous process. Cancerous melanoma cells can spread primarily horizontally and laterally vertically. The period of vertical spread is considered to be the process of spread to lymph nodes and other organs, that is, metastasis.
How is malignant melanoma treated?
The treatment of malignant melanoma is determined by several factors such as the stage of the melanoma, age, and general health status of the patient. Melanoma is generally staged as 0, I, II, III, and IV.
At this stage, which is described as stage 0, cancer cells are limited to the cells in the epidermis, the uppermost layer of the skin. At this stage, cancer cells have not yet invaded deeper layers. At this stage, extensive removal of the area is the main treatment method.
In stage 1, melanoma can have a thickness of up to 1 mm with ulceration and up to 2 mm without ulceration. The main treatment is surgery. A sentinel lymph node biopsy may be done to check if the melanoma has spread to the lymph nodes. Sentinel lymph node biopsy is recommended for some patients whose melanoma has a Breslow thickness greater than 1 mm or whose melanoma shows other adverse prognostic factors. (Breslow thickness refers to the vertical progression thickness of melanoma cells in the skin)
At stage 2, melanoma is defined by thickness and ulceration. Tumors larger than 2 mm can be seen with or without ulceration. At this stage, cancer cells grow deep into the skin but have not yet spread to the lymph nodes or beyond. The main treatment is the surgically extensive removal of the cancerous area and sentinel lymph node biopsy.
In stage 3, melanoma that has spread to nearby lymph nodes or tissues can be of any thickness. The main treatment is the surgical removal of cancerous cells. Lymph node dissection, medication (chemotherapy, immunotherapy), and radiation treatments may be on the agenda.
In stage 4, cancerous cells have spread to distant lymph nodes and distant organs such as the lung, liver, and brain. Melanoma can be of any thickness at this stage. In this process, surgical intervention or drug treatment (chemotherapy, immunotherapy) may be recommended. Radiation therapy may also be used.
The most common treatment for stage 0, I, or II patients is surgery. If detected early, about 90% of melanomas can be cured with just a simple surgical procedure. In patients diagnosed with stage III or IV melanoma, a combination of different treatments can be applied, including surgery, drug therapy, and radiation.
What to know about malignant melanoma?
Malignant melanoma is a skin cancer that arises from melanin cells in the upper layer of the skin or similar cells that can be found in moles. In this type of skin cancer, cancer cells can progress to deeper layers of the skin. Some of the cancer cells can spread, i.e. metastasize, leading to tumor formations in the vital organs of the body.
Malignant melanoma usually does not cause any specific symptoms in the early stages. In the following periods, non-healing lesions or changes in size and color can be seen in existing moles. To take the necessary precautions in this type of skin cancer, which is very important to detect early, if any pigmented or non-pigmented lesion itches, burns, softens, hardens, crusts, bleeds, is surrounded by a red or inflamed area, changes color, size or shape, a dermatologist should be consulted without delay.
What causes malignant melanoma?
The exact cause of malignant melanoma is unknown. However, excessive exposure to sunlight, especially from adolescence, increases the risk of developing skin cancer.
Genetic factors may be associated with an increased risk for familial malignant melanoma. Familial susceptibility can be transmitted through autosomal dominant genes. Genetic susceptibility to a disease means that some people may carry the defective gene but never develop the disease unless something else triggers the disease.
Malignant melanoma is a type of skin cancer that can be seen in men and women, and its incidence does not increase depending on gender. The risk of malignant melanoma is higher in European people and people with fair skin and blue eyes.
Since the symptoms of basal cell carcinoma, squamous cell carcinoma, and Kaposi’s sarcoma can be similar to malignant melanoma, differential diagnosis is very important for correct diagnosis and treatment.
Beware of Changes in Moles in Your Body!
There are 4 main types of malignant melanoma: superficial spreading melanoma, nodular melanoma, lentigo malignant melanoma, and acral lentiginous melanoma. There are also rare types of mucosal lentiginous melanoma, intraocular melanoma, and desmoplastic melanoma.
Malignant melanoma is the most serious type of skin cancer. Usually, the first symptom is a change in the size, shape, or color of moles on the body.
- Asymmetry in moles, that is, the shape of one half does not match the other,
- Irregular edges of moles,
- Lack of color equality,
- There is a change in size and this change is usually in the form of growth,
- If their appearance changes in the last few weeks or months, a doctor should be consulted.