80% of skin melanomas develop from healthy skin, with no stain or injury.
Melanoma is aggressive skin cancer. It represents 10% of this type of cancer. The most frequent skin cancers (90%) are carcinomas. 80% of skin melanomas develop from healthy skin, That is to say a skin with no stain or injury, explains the National Cancer Institute. They appear in the form of a Pigmented spot that looks like a mole. In the 20% of the remaining cases, they develop from a preexisting meal grain (also called Nævus). Melanoma can appear at any age, even if its existence in children is exceptional. Solar exposure, especially during childhood, making UVs, hereditary factors, many Naevi and clear skins are factors associated with a greater risk of melanoma.
What is a melanoma?
Melanoma is a Skin cancer form. This type of cancer develops at the expense of Melanocytes, cells that make melanin and are the cause of the skin coloring. They are located in the epidermis. Melanoma is distinguished from nævi (beauty grains), which also germinate from melanocytic cells, but are mild. The term clever melanoma is actually a pleonasm, because melanoma is never benign. There are 4 types of melanoma:
- Extensive superficial melanoma (60-70% of cases) linked to sunburn (neck, trunk, legs)
- Dubreuilh melanoma (5-10% of cases) rather in people over 50 (face, neck, hand)
- Nodular melanoma (less than 5%), it quickly extends.
- Acrolantiginous melanoma, rather in people with dark skin (palm of the hands, soles of the feet, under the nails)
What are the symptoms of melanoma?
Melanoma manifests itself as a grain of beauty, but whose characteristics are particular:
- an asymmetrical lesion;
- a lesion whose edges are irregular;
- a lesion whose color is not homogeneous, with different shades;
- a large lesion whose diameter is greater than 6 millimeters;
- “A lesion whose recent evolution has been modified with an increase in size, modification of the color, appearing more in relief on a new lesion that appeared”explains Dr. Michael Naouri, dermatologist.
These criteria are easily memorized by the ABCDE rule: (asymmetry, edges, color, diameter, evolution). “It is also recommended to Consult when a mole is different from others. It’s the Theory of the Vilain Petit Duck‘”recommends the dermatologist.
The diagnosis aims to confirm the presence of melanoma and identify the type and stadium. “For this, a Lesion excision is done “explains the specialist. This sample is taken under local anesthesia, In general in less than half an hour in the dermatologist’s office. The result is then sent to anatomopathologist (doctor specializing in tissue analysis) which will study this sample by analyzing its cellular composition, affirming the melanocytic nature of the lesion. He will also seek his thickness and his depth. If the diagnosis of melanoma is confirmed and according to its evolutionary stage classified by anatomopathologist, other examinations looking for lymph nodes or other organs will be carried out.
What are the treatments for melanoma?
The treatment varies depending on the stage of melanoma and the patient’s state of health. Surgery is practiced to remove melanoma. Skin monitoring will then be necessary regularly for life. A drug treatment (alpha interferon or a chemotherapy classic, one or more Targeted therapies or one or more monoclonal antibodies as part of clinical trials) can be associated with surgery. In some situations, a external radiotherapy can also be used as adjuvant treatment (that is, in addition to surgery and/or drug treatments). THE processing is carefully planned by the medical team depending on each situation. The doctor who follows you gives you a calendar that determines the place and days of treatmentas well as the names of the drugs used.
As long as the tumor is within the epidermis, we speak of “in situ melanoma”. If melanoma is removed at this stage, there is no risk of metastatic evolution. When melanoma is metastatic it means that it has spread beyond the initial area. Of the cancer cells can then detach from the tumor and take the lymphatic vessels and blood vessels To invade other parts of the body (lymph nodes, lymphs, lungs, liver …). The medical team will then decide on the most suitable treatment, it can be chemotherapy, surgery, radiotherapy or immunotherapy.
To prevent the appearance of melanoma, it is essential to limit its exposure to the sun, especially when the skin is very clear. The use of a sunscreen with a high protective index is recommended. In risk subjects, patient monitoring changes in his beauty grains is recommended.
Thanks to Dr. Michael Naouri, dermatologist. Source: Skin melanoma treatments, Cancer Info, 2016.
