Melanoma skin cancer begins when normal melanocytes in the epidermis (top layer of skin) begin to develop abnormal cells cause by a genetic mutation. These cells are often referred to as cutaneous melanoma and malignant melanoma. Melanocytes are skin cells that produce melanin, a brown pigment that gives skin a brown or tan color. The melanin in the monocyte protects the deepest layers of skin from the damaging effects of sun rays.
Women tend to develop melanoma skin cancer on the legs, whereas, men tend to develop it on the back and chest. However, the disease can start anywhere, including on the face and neck. Individuals with darkly pigmented skin tend to have a lower risk of developing melanoma in those areas. However, it can also form under the fingernails, toenails, the soles of the feet and the palms of both hands.
Some melanoma skin cancer can develop on other body parts including the genitals, anal area, mouth, and eyes. While melanoma skin cancer is significantly less common than squama cell and basal cell skin cancers, it is by far more dangerous. This is because this type of cancer easily spreads (metastasizes) to other body parts if not detected in its early stage.
- Who Is at Risk for Melanoma Skin Cancer?
- What Causes Melanoma Skin Cancer?
- Diagnosing Melanoma Skin Cancer
- Staging the Disease
- Treating the Condition
Who Is at Risk for Melanoma Skin Cancer?
Some individuals have a higher potential risk of developing melanoma skin cancer than others, based on specific risk factors. Some of these include:
- Fair Skin – Individuals with minimum melanin (pigment) in the skin are more likely to develop melanoma skin cancer compared those with darker complexions. These people tend to have light-colored eyes, red or blonde here, freckles and sunburn easily. However, it can still develop in those with darker complexions including African-Americans and Hispanics.
- A History of Sunburns – The risk of developing melanoma increases significantly after experiencing one or more severe sunburns that blistered the skin.
- Excessive Exposure to Sunlight and Ultraviolet Light – Skin that is exposed to excessive amounts of UV radiation from tanning beds/lamps or sun rays are more likely to develop melanoma and other forms of skin cancer.
- Geographical Location – Those who live close to the earth's equator or at a high-level elevation are exposed to more direct ultraviolet light from the sun.
- Genetic Predisposition – People who have a close relative including a sibling, child or parent that has developed melanoma have a much higher risk of developing the condition compared to others without a family history of the disease.
- Moles – Those with skin that has formed an unusual type of mole or a higher risk of developing melanoma cancer, as are those who have more than fifty ordinary moles on their body.
- Weakened Immune System – Organ transplants and other conditions can weaken the body's immune system and increase the potential risk of developing melanoma cancer.
What Causes Melanoma Skin Cancer?
Melanoma is caused by genetic mutation when the melanocyte skin cell DNA becomes damaged. This can occur from exposure to the sun, ultraviolet rays, genetic predisposition, smoking and having fair skin. Normal melanocyte cells are predestined through genetic DNA code to mature, reproduce and die off leaving healthy cells behind. However, when the genetic DNA is damaged, the code produces abnormal results by constantly reproducing new cells without the old cell dying off.
Additionally, the abnormal melanocyte can still produce melanin, which is why it continually develops as a deep brown or black mass that resembles a mole on the surface of the skin. Without treatment, the melanoma skin cancer mass can easily metastasize (spread) to other areas of the skin, into the limp notes and out to distant body sites including other organs like the lungs, liver, and brain.
Diagnosing Melanoma Skin Cancer
A routine skin assessment performed by a competent dermatologist is essential to screen the body for skin cancer. However, the skin can be examined at home if the patient detects any unusual skin marks including moles and freckles by standing naked in front of a large full-length mirror and using hand-held mirrors to inspect every part of the body, including areas that are difficult to see. This means checking the back, front, and sides of the trunk, legs, arms, scalp, groin area, soles of the feet, genitals, between the toes and the fingernails and toenails.
While melanoma skin cancer and other forms of skin cancer can be detected by viewing the skin, an accurate diagnosis of the disease requires a biopsy that includes:
- Punch Biopsy – A circular blade tool is used to punch a round area skin and remove it from the epidermis to be examined under a microscope.
- Excisional Biopsy – The entire growth or mole can be removed through an excisional biopsy to ensure all the affected area is excised from the epidermis.
- Incisional Biopsy – Dermatologist will use in incisional biopsy procedure when the growth or mold has an irregular shape.
Choosing the most optimal skin biopsy procedure depends on the recommendation of the dermatologist. An excisional and punch biopsy will usually remove the entire skin growth. The dermatologist may choose to surgically remove the affected area with an incisional biopsy procedure when the mole is believed to be extremely large.
The available options for treating melanoma depend on its stage or the extent of how much cancer has progressed. In staging the melanoma, the doctor will categorize the affected area by:
- Determining Its Thickness – Determining how thick the melanoma skin cancer has grown requires careful examination under a microscope using a micrometer for measuring. The cancerous tissue usually becomes thicker as the disease progresses.
- Determining If the Melanoma Has Metastasized – A surgeon may recommend the patient undergo a sentinel node biopsy procedure to determine if the melanoma has metastasized (spread) to neighboring lymph nodes. Before the procedure is performed, the surgeon will inject a dye into the affected area and allow it to flow to neighboring lymph nodes. The surgeon will see if the dye reached the first lymph node, take a biopsy of that node and test it for cancerous cells. If no cancer cells are detected in the node, there is a good chance that the disease has not yet metastasized to other areas of the body.
Doctors use the Roman numerals I through IV to stage all cancers including melanoma skin cancer. Stage I means the cancer is newly formed where stage IV refers to metastasize cancer that is already spread from the skin out to distant sites including other organs like the liver, lungs, or brain.
Treating the Condition
Doctors can recommend numerous options for treating melanoma from its early stage to its most advanced. In its initial stage, simply removing the affected site through a punch, excision, or incision procedure might be all the treatment that is required. However, if the melanoma has spread beyond the affected skin area, the doctor will likely recommend:
- Radiation therapy
- Biological therapy
In addition, the doctor may prescribe targeted therapy medications including Zelboraf (vemurafenib), Mekinist (trametinib), or Tafinlar (dabrafenib) medications to treat melanoma in its most advanced age. However, these medications are only effective when the cell has been damaged by a specific genetic mutation.