Melanoma skin cancer
May is skin cancer awareness month, a time to raise awareness and educate people about skin cancers. Melanoma is a serious type of cancer, which affects the melanin pigment producing cells of the skin known as melanocytes. These melanocytes are cells that give humans their tan to brown colour of the skin and hair. Like other cancers in the body, in melanoma there is an uncontrollable growth of abnormal melanocytes (pigment producing cells) that spread quickly in the skin, then progress to spread to other areas of the body.
These areas of spread include the lymph nodes, the brain and other body organs. Melanoma can arise from the skin, the eyes and parts of the nervous system called the Leptomeninges that contain these melanin producing cells. The causes of melanoma include a complex interplay of genetic factors, ultraviolet rays of sun, and factors that affect the immune system.
Who is at risk for melanoma?
A previous history of having had a melanoma skin cancer
A positive family history of melanoma in first-degree relatives
Large giant birthmarks that are dark and arise from the melanocytes (melanin producing cells of the skin)
The presence of multiple birth marks on the body (birth marks known as bo nkuku in Setswana)
A history of multiple sunburns
Frequent sun tanning or indoor tanning Sun exposure
Individuals who are of very fair complexions and burn easily when exposed to the sun
Individuals with weak immune systems
What are the signs and symptoms of melanoma?
Melanomas tend to occur in areas of the body that receive the most amount of sun exposure such as the face, arms the legs and back.
However, some arise in hidden areas such as the soles of the feet. Initial signs include evolution of pre-existing moles or the development of new dark lesions of the skin or an unusual growth of the skin
Dr Neo Sekgoma states that, Dermatologists frequently advise patients to use the ABCDE rule during self-examinations of the skin to check for the possible warning skin signs of melanoma (see the pictorial representation)
Asymmetry. When a brown black spot or mole appear to have half of the mole dissimilar to the other half
Border - a brown black spot or mole with irregularly shaped borders
Colour - the spot or mole having various colour changes within the skin lesion, which include red, blue tan or black areas
Diameter. A size of more than 6mm
Evolving - the spot or mole is changing in size colour or shape
Melanoma in skin of colour
As Dr Sekgoma explains, in darkly pigmented people of African or Asian descent, an uncommon type of melanoma known as the Acral Lentiginous Melanoma predominates, accounting for over 70% of the melanomas found in people with skin of colour. Unlike other melanoma types, the Acral Lentiginous Melanoma typically occurs on the palms, soles and around the finger and toe nails.
Acral Lentiginous Melanoma, like most melanomas, presents as a brown to black small to large mole that has colour variations and irregular borders. So unlike normal moles, which have a normal oval to round symmetrical architecture and shape, melanomas tend to have irregular shapes. Melanoma also tends to present with symptoms that include pain swelling bleeding and ulcerations.
Acral Lentiginous Melanoma can also present as a longitudinal band on the nail that extends to the skin folds of the fingers. This type of melanoma is often misdiagnosed or overlooked for a long time and most individuals present late with complications and advanced disease that has spread to other body organs (metastasis).
Is there a cure or treatment for melanoma?
The management of melanoma is a multidisciplinary team approach, which involves Dermatologists, General Surgeons, Radiologists and Oncologists. It is important for all patients who suspect any abnormalities in their skin or formation of new spots or moles to be seen by a Dermatologist urgently. When detected early, Melanoma is treatable and the response to surgical removal by Specialist Surgeons is favourable. However, when detected late melanoma can be fatal. Advanced disease requires intervention by Oncologists in the form of radiation, chemotherapy and other modalities of treatment.
Prevention of melanoma?
The majority of the melanomas types have been attributed to exposure to the sun, with sunburn in childhood being one of the risk factors. The following measures can be taken to lessen the risk
Use of broad brim hats, umbrellas and protective skin clothing when an individual is in the sun
Avoidance of direct exposure to the sun between 11am and 4pm
Daily use of sunscreen that is broad spectrum (SPF 30+ and higher, one that covers UVA and UVB.) and reapplication every two hours when in the sun.
Avoid tanning by all means