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
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
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

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


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
-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
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
act on malignant cells by inhibiting division and by enhancing the body’s
responses to such cells.

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

* Surgery, which removes tumors or reduces their size. Surgery enables
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