Melanoma
How to detect malignant moles? Everything about the symptoms and the most effective treatments for the skin cancer known as melanoma.
Symptoms and Causes
Melanoma is a type of skin cancer that affects melanocytes, which are the cells that produce melanin, the pigment responsible for coloring the skin. Although its incidence is steadily increasing, today it can be prevented and cured in most cases.
Depending on the cancer's development, there are four stages of the disease:
- Melanoma in situ (stage 0): Abnormal cells that may become malignant, remaining in the epidermis.
- Stage I melanoma: A tumor less than one millimeter thick in the epidermis.
- Stage II melanoma: A tumor thicker than two millimeters that penetrates the dermis and may reach the subcutaneous tissue.
- Stage III melanoma: A tumor that has spread to a lymphatic vessel and even to the lymph nodes.
- Stage IV melanoma: Cancerous cells have reached more distant areas of the body. Metastasis typically occurs in the skin, distant lymph nodes, brain, lungs, or liver.
The primary cause of melanoma is excessive sun exposure. As a result, melanocytes transform into malignant cells, leading to a tumor. These cysts can have different characteristics and locations, resulting in various types of melanoma. There are also some genetic mutations that can favor the development of the disease.
Among the most notable types are:
- Superficial spreading melanoma: The most common form. It appears as a flat mole with irregular borders and different colors.
- Nodular melanoma: The second most common form. It progresses rapidly and spreads inward in a short time, making it more aggressive.
- Acral lentiginous melanoma: Appears under the nails, on the soles of the feet, or on the palms of the hands and typically spreads superficially.
- Subungual melanoma: A type of acral lentiginous melanoma that appears under the nails.
- Choroidal melanoma: A type of ocular melanoma where the tumor grows at the back of the eye. It is not related to sun exposure.
Symptoms
The main symptom of melanoma is the appearance of nevi, which are pigmented skin lesions that grow irregularly. Sometimes, they are pre-existing moles that change in shape, texture, or color.
Causes
Melanoma can result from excessive sun exposure, as radiation damages the DNA of cells, and from genetic predisposition.
Risk factors
Some factors that increase the risk of developing melanoma include:
- A family history of melanoma.
- Spending a lot of time in the sun.
- Having suffered sunburns during childhood or adolescence.
- Having fair skin and eyes.
Complications
The most serious complication is when melanoma spreads to other parts of the body and causes metastasis.
Prevention
There is currently a lot of information about melanoma prevention. To do so, the following habits are recommended:
- Always use sunscreen with high protection when going outside.
- Limit direct sun exposure and avoid it entirely during peak hours of the day.
- Do not use artificial tanning devices.
- Observe moles and freckles for any abnormal changes.
What type of doctor treats melanoma?
Melanoma is treated by specialists in medical-surgical dermatology and venereology and oncology.
Diagnosis
Physical examination combined with mole analysis are the first tests performed to rule out or diagnose melanoma. For more accuracy, specialists turn to dermoscopy, a test that allows them to view an enlarged image of the lesions to study their characteristics more easily.
At home, moles can be observed by following the ABCDE rule to determine if a visit to the doctor is needed:
- A. Asymmetry: The lesion has one half different from the other.
- B. Borders: The edges of the mole are irregular.
- C. Color: The mole is not a uniform color. It may have brown, black, or bluish areas.
- D. Distinct: A lesion that is different from the rest is considered suspicious.
- E. Elevation: A lesion that was previously flat but has elevated is considered suspicious.
When there are signs that a mole is malignant, a biopsy is performed: a sample of the lesion is taken and analyzed in the laboratory for cancer cells. If the result is positive, further tests are done to determine the stage of the disease. This includes:
- Measuring the thickness of the melanoma.
- Performing diagnostic imaging tests to check if the disease has spread to other organs.
Treatment
Depending on the type of melanoma, its stage, and the patient's medical history, the most appropriate treatment is selected. The most effective treatments include:
- Surgical intervention: The cancerous lesion must be removed along with a small portion of healthy skin through a wide excision, depending on the melanoma’s initial thickness.
- Chemotherapy: This medication destroys malignant cells. Currently, the most appropriate combination of drugs for each type of cancer is selected.
- Radiotherapy: The tumor is targeted with radiation, including X-rays, gamma rays, electron beams, or proton beams, once the tumor has been removed.
- Immunotherapy: Medications are administered to strengthen the immune system and enhance the body’s ability to attack cancer.
