MELANOMA
SKIN CANCER OVERVIEW
What Is Melanoma Skin Cancer?
Normal skin The skin can be considered as the largest
organ in the body. It covers and protects the organs inside the body. It also protects the
body against germs and prevents the loss of too much water and other fluids. The skin
sends messages to the brain about heat, cold, touch and pain. Another type of
cell, melanocytes, is also present in the epidermis. These cells produce the pigment
called melanin. Melanin gives the tan or brown color to skin and helps protect the deeper
layers of the skin from the harmful effects of the sun. A layer called the basement
membrane separates the epidermis from the deeper layers of skin. The middle layer of the skin ‘dermis’ is much thicker
than the epidermis. It contains hair shafts, sweat glands, blood vessels and nerves. Melanoma skin cancers Melanoma skin cancers begin in the
melanocytes. Other names for this cancer include malignant melanoma and cutaneous
melanoma. Because most cancerous melanoma cells continue to produce melanin, melanoma
tumors are often brown or black. Melanoma is much less common than basal and squamous cell
skin cancers and it is mostly
curable in its early stages. But it is more
likely that melanoma can spread to the other parts of the body than basal or
squamous cell cancer. Melanoma most often appears on the trunk of
fair-skinned men and on the lower legs of fair-skinned women, but it can appear in other places as well. Having darkly
pigmented skin lowers the risk of melanoma but it does not mean that a person with dark
skin will not develop melanoma. People with darker skin can have this cancer on the palms
of the hands, soles of the feet and under
the nails. Rarely, melanomas can occur in parts of the body not covered by skin
such as the eyes, mouth, vagina, large intestine
and other internal organs. What Causes Melanoma Skin Cancer?
A risk factor is anything that increases a
person's chance of getting a disease such as cancer. Different cancers have different risk
factors. For example, smoking is a risk factor for
lung and other types of cancers. It is important to remember, however, that while
these factors increase the risk, they do not necessarily cause the disease to develop.
Many people with risk factors never develop cancer, while others with cancer have no known
risk factors. Risk Factors for Melanoma Skin Cancer
Moles: A mole (nevus) is a benign skin tumor.
Moles are not usually present at birth, but begin to appear in children and teenagers.
Having certain types of moles make a person
more likely to develop melanoma. Fair skin: The risk of melanoma is about 20 times higher for people with white or fair skin than for those with darker skins. This is because the melanin of darker skin offers some protection. Family history: The risk of melanoma is
greater if one or more of a person's close relatives (mother, father, brother, sister,
child) have been diagnosed with melanoma. Immune suppression: People who have been
treated with medicines that suppress the immune system, such as organ transplant patients,
have an increased risk of developing melanoma. Over
exposure to ultraviolet (UV) radiation. People with too much exposure to UV rays of
sunlight or tanning light are at greater risk for all types of skin cancers, including melanoma. Age: About half of all melanomas occur in
people over the age of 50. However, young people (ages 20 to 30) can also have melanoma.
In fact, melanoma is one of the most common cancers in people less than 30 years of age. Can
It Be Prevented? The best way to lower the risk of melanoma is
to avoid too much exposure to the sun especially during the middle of the day when the
light is most intense and other sources of UV light. Protect yourself with clothing,
sunglasses, and a hat with a broad brim. Use quality sunscreens with a sun protection
factor (SPF) of 15 or more on exposed skin. People with fair skin who burn easily should
be very careful to use sunscreen. People who have many moles should check them regularly
to see if the moles have changed in shape/size. A
dermatologist should also check them regularly as well. How Early Is Melanoma Skin Cancer Detected?
Melanoma can be found early and both doctors
and patients play important roles in finding skin cancer. Part of a routine checkup should
include a skin examination atleast every three years for people between 20 and 40 years of
age and every year for those aged 40 and more. It's also important to have self-examination of your skin once a month. You should know the pattern of moles, freckles and other marks on your skin so that you'll notice any changes. Spots on the skin that change in size, shape, or color, any unusual sore, lump, blemish, marking, or change in the way an area of the skin looks or feels could be a sign of skin cancer and should be seen by a doctor right away. It's important to know the difference between
melanoma and an ordinary mole. We can keep an eye on the difference between normal moles and melanoma.
Watch for these possible signs of melanoma: · One half of the mole does not match the other
half. · The edges of the mole are ragged or notched. · The color of the mole is not the same all
over. There may be shades of tan- brown or black
and sometimes patches of red, blue or white. · The mole is usually wider than about 1/4 inch
Skin biopsy
If the doctor thinks a melanoma might be
present, he or she will take a sample of skin to examine under a microscope. This is
called a skin biopsy. Different methods can be used for a skin biopsy. The choice depends
on the size and location of the affected area. Any biopsy is likely to leave a scar. The
skin around the area of the biopsy will be numbed before the biopsy. You will feel a small
needle prick and a little burning with some
pressure for less than a minute, but no pain. Staging of medical findings
Staging is a process of finding out how
widespread a cancer is. Staging includes describing the size of the cancer as well as
whether it has spread to any other organs. How Is Melanoma Skin Cancer Treated?
There are four types of treatment for
melanoma skin cancer: Surgery, Radiation, Chemo Therapy and Immuno Therapy. Each of these
is explained below. Surgery
Surgery to remove the melanoma is often the
main treatment as long as the cancer is not spread to other distinct organs such as lungs
and brain. Lymph nodes are sometimes checked for cancer during surgery. Thin melanomas can
be completely cured by a minor operation called simple excision. The tumor is cut out,
along with a small amount of normal skin at the edges. The wound is carefully stitched
back together. This surgery will leave a scar. Sentinel node biopsy is another procedure.
The doctor injects a small amount of a dye or tracer substance into the site of the
melanoma. After about an hour, lymph nodes are checked to find which one is draining lymph
fluid from the skin near the melanoma. When the correct lymph node, called the sentinel
node, has been found, it will be removed and looked at under a microscope. If melanoma
cells are found in this lymph node, the remaining lymph nodes in this area are removed. If
the sentinel node does not contain melanoma cells, further lymph node surgery can be
avoided. Because this type of biopsy is new, different doctors may disagree, about the
timing of this method. Chemotherapy Chemo Therapy refers to the use of drugs to
kill cancer cells. The drugs are given in the form of shots or pills. Once they enter the
bloodstream they reach all parts of the body. The drugs attack cancer cells that have
spread beyond the skin to the lymph nodes and other organs. Sometimes doctors prescribe
Chemo Therapy after surgery to make sure any remaining cancer cells are destroyed. Several types of Chemo Therapy can be used
for stage IV melanoma. Although Chemo Therapy is usually not as effective in melanoma as
in some other types of cancer, it may relieve symptoms or extend the life of some patients
with stage IV melanoma. While Chemo Therapy drugs kill cancer cells, they also kill some
normal cells, causing side effects. The exact side effects depend on the type of drugs
used, the amount taken, and the length of treatment. Temporary side effects of Chemo
Therapy might include nausea and vomiting, loss of appetite, loss of hair and mouth sores. Because Chemo
Therapy can kill normal blood cells, patients may have low blood cell counts. These low
counts increase the chance of infection, bleeding or bruising after minor cuts and fatigue. Most side effects
disappear once treatment is stopped. One of the most effective chemotherapeutic agent
towards skin melanoma is “Platinol” or Cisplatin”. However there are
certain crucial rate limiting toxicities associated with Cisplatin. One of the breakthroughs to mitigate the toxicities of
Cisplatin is the recent discovery of a novel chemoprotectant by BioNumerik
Pharmaceuticals, San Antonio, TX, and USA bearing the code name of BNP7787. This highly
promising clinical candidate by BioNumerik
Pharma has already received the fast track approval from Food & Drug Administration
Agency. BNP7787 is at present
undergoing phase III clinical trials in the United States exhibiting its astonishing
results with a fast track approval for human use as a Chemoprotectant. Chemoprotectant is
a novel class of therapeutic compounds that could reduce or eliminate the undesired
toxicities exhibited by a chemotherapeutic agent. In
this particular case chemotherapeutic agent (cytotoxic agent) is the one that cures the
cancer. A chemoprotectant is extremely useful in conjunction with the actual drug. For
example the rate limiting toxicities of cisplatin is kidney failure. In conjunction with
BNP7787 patients are currently receiving much higher doses of cisplatin with out suffering
any damage to their kidney functions. Such higher doses could be lethal if the cytotoxic
agent is given without the aid of a chemoprotectant. Radiation Therapy
This treatment uses high-energy x-rays to
kill cancer cells or slow down their rate
of growth. One method can be even in the same way as the type of x-ray used to find a
broken bone. The main role of Radiation Therapy for melanoma is to relieve symptoms if the
cancer has spread to the brain. This type of radiation therapy is not expected to cure the
cancer. Immuno Therapy
Immuno Therapy is a type of treatment that
helps a patient's immune system to find and destroy cancer cells. Immuno Therapy may be
used by itself, but more often it is used along with another treatment. There are several
types of Immuno Therapy for patients with advanced melanoma. Cytokine
therapy uses proteins that activate the immune system in a general way. Side
effects of Cytokines may include fever, chills, aches
and severe tiredness. HARRY
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