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Overview

Malignant melanoma is a type of skin cancer which begins in cells called as melanocytes (these cells give pigment to the skin). It is more commonly seen in the white population and is related to the skin damage caused by ultraviolet rays of sun.

Warning signs

  • Change in size, shape, colour of any pre-existing mole
  • Bleeding or ulceration of any pre-existing mole
  • Any new spots/moles – brown, black or red
  • New pigmentation at the base of the nails

Risk factors

  • Previous sun exposure (UV light)
  • Family history of melanoma
  • Family history of multiple nevus syndrome
  • Race—common in white population

Progression

  • Stage I: Melanoma is confined to skin
  • Stage II: Melanoma has grown thicker but is confined to skin
  • Stage III: Melanoma has spread in lymph nodes near the primary tumour
  • Stage IV: Melanoma has spread to distant areas like the draining lymph nodes, visceral organs like lungs, liver, bone etc.

Diagnosis

Early melanomas can be differentiated from the benign nevus by the popular mnemonic ABCDE

  • Asymmetrical lesion
  • Border is usually irregular
  • Colour is variable
  • Diameter is >6mm
  • Enlarging lesion

Diagnosis

  • Medical history and physical examination
  • Excisional biopsy or Incisional biopsy
  • Sentinel lymph node biopsy (for evaluation of draining lymph nodes, required for lesions >1mm deep) and Cross sectional imaging

Treatment in a nutshell

Wide local excision of the primary tumour is curable in early stage melanomas.

Biopsy of sentinel lymph nodes is a widely used procedure for skin melanoma. It is commonly performed for lesions >1mm thick. If a lymph node comes positive for disease, a radical lymph node dissection will often be required.

For patients with metastatic disease, medical management and/or radiation therapy will also be required. Medical treatment can include targeted therapy, immunotherapy and combination chemotherapy.

Milestones

At Kokilaben hospital we offer standard of care treatment for patients with melanoma with molecular testing (BRAF analysis), standard surgical and medical care.

Reported Outcome

In patients with metastatic disease, survival depends upon the extent of distant metastasis, feasibility for resection and kind of treatment administered.

For patients with disease 1mm or less in thickness More than 90%
For patients with localized disease > 1mm thickness 50- 90%
For patients with distant metastasis Less than 10%

Top tips

Melanoma patients have a higher risk of having melanoma in future. You must take care in the sun. The area where the melanoma was should be completely protected from sun.

Protect your skin

  • Wear a brimmed hat to protect your face and neck
  • Wear sun glasses to protect your eyes
  • Use a high factor sun cream when you are in the sun
  • Wear close weave cotton clothing in the sun
  • Wear long sleeves and long trousers
  • Stay out of the sun altogether between 11am and 3pm
  • NEVER use a sun bed
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