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Melanoma

How does melanoma kill you?

How does melanoma kill you?

Melanoma can spread to parts of your body far away from where the cancer started. This is called advanced, metastatic, or stage IV melanoma. It can move to your lungs, liver, brain, bones, digestive system, and lymph nodes.

Melanoma

Melanoma, or melanoma, is the most dangerous type of skin cancer that  develops in the cells responsible for producing melanin, the pigment that gives skin its Color. Melanoma may develop inside the eyeball and rarely in internal organs such as the intestine.

It is not yet known exactly what causes different types of melanoma, but exposure to ultraviolet rays from the sun increases the risk of developing melanoma-type skin cancer.

Avoiding unnecessary exposure to sunlight may help prevent the development of melanoma, and attention and vigilance should be given to warning signs of skin cancer to ensure early detection of  precancerous changes in the skin in order to treat tumors before they spread. Melanoma-type skin cancer can be successfully treated if It was detected in its early stages.

Symptoms of melanoma

Melanoma may arise anywhere on the body, but often areas of the skin that have been exposed to a lot of sunlight, such as: the back, legs, arms and face are more susceptible to the development of melanoma, and melanoma may also appear in areas that have not been exposed to much sunlight, such as: feet, hands or on nail surfaces.

In the following are the most prominent symptoms, noting that it is the primary symptoms that are shed and silence is dull

The initial signs that accompany melanoma include changes in a mole or birthmark on the skin, or the emergence of a new tumor with a strange appearance on the skin.

Ordinary moles:

Ordinary moles (or: birthmarks) are usually of a homogeneous color, such as tanning, brown or black, with clear boundaries separating them from the normal skin tissue that surrounds them. They are oval or round in shape and are about 6mm in diameter on average – the same as the eraser on the tip of a pen.

Most people have moles, usually 10-40, on average. Most develop before the age of 20, although the appearance of moles can change over the years or even disappear with age. Some people have one large mole with a diameter of more than 12 mm, or flat moles without clear borders and heterogeneous color and it is tanned or brown mixed with red or pink. These moles are called dysplastic nevi in ​​the medical language, and they are more likely to become cancerous (malignant) over time, compared to normal moles.

2 Abnormal moles may indicate melanoma:

Characteristics of abnormal moles (unusual / strange) that may indicate the presence of melanoma, or other skin cancer , described according to the A – B – C – D – E guide developed by the American Center for the Study of Dermatology:

A: Asymmetry – look for moles with unclear shapes, such as asymmetric halves of a mole.

  B : Border – look for moles with irregular borders, serrated or bumpy borders, which are the most visible and prominent characteristic of melanoma.

C: Color changes – look for moles of different colors or a heterogeneous color.

  D: Diameter – look for moles over 6 mm in diameter.

 E: Evolving – Look for a mole that changes over time, such as changing its size, color or shape.

3. The change in the mole may also include the appearance of new signs, such as local irritation or bleeding.

There are other changes that raise suspicion and suspicion that may occur in the mole, including:

  • The appearance of a crust on the mole
  • Itch
  • Changes in the mole’s texture, such as a hardening or lump
  • The spread of pigment (pigment) from the mole to the skin that surrounds it
  • dripping fluid or bleeding from it

 The appearance of a malignant mole varies from case to case. Some may present with all of the signs (characteristics) listed above, while others may present with one or two abnormal features.

4..Cryptic melanoma:

Melanoma may develop in areas of the body exposed a few of the amount of rays of the sun, or even not exposed at all, such as the space between the toes or fingers of the hands, feet on the boy, scalp or genitals.

Tumors in these areas are sometimes called “hidden” (invisible) melanoma because they appear in areas of the body that most people would not think of examining. In people with darker skin color, melanoma usually appears in hidden places.

This “hidden melanoma” includes:

  • Subungual melanoma
  • melanoma in the oral cavity, in the digestive system, in the urinary system or in the vagina
  • Melanoma inside the eyeball

Causes and risk factors for melanoma

Melanoma (melanoma) is one of the most dangerous and deadly types of cancer. Although it is responsible for the smallest proportion of all skin cancer cases, it leads to the largest number of deaths. This is because it is more likely to spread in the body and spread to other parts of it. In addition, there is a rise in the incidence and incidence of melanoma. 

Melanoma begins to form as a result of a defect in the process of melanin production in cells (melanocyte), which forms the color of the skin. In a normal situation, skin cells develop under a controlled and orderly manner. The new cells push the aging (old) cells toward the surface of the skin, where they die and fall off.

This entire process takes place, under the control of deoxyribonucleic acid – DNA – the genetic material that contains the instructions for any chemical and biological process that takes place in the body. If DNA is damaged, new cells grow uncontrollably and may eventually form a tumor or mass of cancerous cells.

What is the factor that disrupts the DNA in skin cells and how does this lead to the formation and development of melanoma? This question is still the subject of research and study. Cancer is a complex disease, and its emergence is often the result of a combination of several different factors, including environmental and genetic factors, and not as a result of one factor.

Despite this, excessive exposure to ultraviolet (UV) rays is still the main factor in the emergence and development of melanoma, whether it is exposure to sunlight or sunlamps and beds.

UV rays and melanoma:

The source of ultraviolet (UV) radiation is the sun. Ultraviolet light is divided into three wavelengths: UVA (UVA), UVB (UVB) and UVC (UVC). Only UVA and UVB rays reach the globe, while UVC rays are completely absorbed by the ozone layer, a natural layer that envelops the globe and filters out UV rays. It also produces lamps and sunbeds, as well, ultraviolet rays.

UVB rays cause harmful changes to the DNA in skin cells, including the activation of an oncogene – a type of gene that, when activated, can turn healthy cells into cancerous cells.

As for UVA rays, they usually damage the melanin-producing cells and lead to melanoma.

The main rays from sunbeds and lamps are UVA rays.

Ultraviolet (UV) radiation is particularly intense along the equator and in regions at very high meridians. No matter where a person lives, his skin absorbs ultraviolet rays every time he goes outdoors, unless he wears protective clothing that protects him from rays or puts a protective cream that filters the rays.

Other factors that cause melanoma:

Ultraviolet (UV) rays are not the only cause of all cases of melanoma, especially cases in which cancer appears in hidden places of the body, which are not exposed to sunlight. This indicates the presence of additional factors that contribute to an increased risk of developing melanoma.

Factors that may increase the risk of developing melanoma include:

  • Light skin tone
  • Previous exposure to a large number of sunburns
  • Excessive exposure to sunlight
  • Living in sunny areas or high meridians
  • Moles/Birthmarks (Nevi)
  • A family history of skin cancer
  • Weak immune system
  • Exposure to cancer-inducing factors (carcinogens)
  • Rare genetic disorders (disorders)

Diagnosis of melanoma

Cancer is sometimes discovered by looking at the skin, but an accurate diagnosis is made only after a biopsy is taken .

During this procedure, a dermatologist removes a sample of (part, or all) of the skin tissue of a suspicious mole, and the sample is examined by a pathologist.

Graduation:

If melanoma is diagnosed, the next stage is to determine the extent or stage of the cancer.

Melanoma is graded according to the following criteria:

  • thickness and depth
  • diffusion

In the recent past, surgeons would remove as many lymph nodes as possible to make sure that there were no cancerous cells inside the nodes. But this procedure increased the risk of developing lymphedema, a very dangerous swelling, as well as other side effects.

For this reason, a new procedure has been devised to locate and find sentinel lymph nodes, with the aim of finding the first lymph nodes draining fluid from malignant tumors, and thus the first nodes in which cancer will develop. If the extracted nodes are free of cancer, the chance of the remaining nodes developing cancer cells is very low, and there is no need to remove them.

Melanoma is graded in degrees from 0 (zero) to IV (four): 

Grade 0 – This grade of melanoma is called localized (local) melanoma. At this degree, the cancerous tumor has spread only to the epidermis and has not yet begun to spread. Treatment at this stage includes surgical excision (Surgical ectomy) for the affected area, only nothing more. Detecting and treating the cancer at this stage ensures the best chance of a speedy and full recovery.

Grades I through IV – These grades indicate an aggressive cancer that has the ability to spread to other areas of the body. Grade I cancer is a small, localized tumour, and the chances of a cure are good. However, the higher the score, the lower the chances of a full recovery from the disease.

Grade IV cancer is cancer that has spread into the inner layers of the skin and to other organs, such as the lungs (lungs), liver (liver) and bones (bones). Although it is not possible to eliminate cancer at this stage, radiation therapy (or: radiotherapy), biological therapy, and experimental therapies can help relieve symptoms of the disease.

melanoma treatment

Treatment of melanoma in the early stages:

Surgical ectomy (minor surgical removal) is the best treatment for melanoma in its early stages.

Small melanomas can be completely removed with a biopsy. In this case, melanoma does not require any additional treatment. However, if the cancer is more widespread, the surgeon will remove the tumor as well as the healthy skin tissue surrounding the tumor and the skin tissue underneath. In most cases, this procedure completely kills the cancer.

In the past, the most common (invasive) and early-stage surgical excision of the tumor involved cutting and removing the tumor as well as removing very wide margins of healthy skin surrounding the tumor (widespread excision).

This procedure usually requires a skin graft , a procedure in which a surgeon removes a piece of skin from another area of ​​the body and implants it in place of the removed skin while removing the tumor. But the removal of narrow edges of the healthy skin tissue surrounding the disseminated melanoma has proven itself as an effective treatment as effective as a large-scale excision, in addition to eliminating the need for a skin transplant.

Treatment of melanoma spread to organs other than the skin:

If the melanoma has spread to organs other than the skin, treatment options include:

  • Surgical Ectomy
  • Chemotherapy
  • Radiation therapy
  • Biological treatment (immunotherapy)

Melanoma prevention

The good news about melanoma is that this cancer can be prevented in most cases, by taking the following precautions:

  • Avoid exposure to the sun between ten in the morning and four in the afternoon
  • The use of sunscreen lotion from rays throughout the year
  • For maximum protection, use the sunscreen for about twenty minutes to one hour before exposure to the sun, then apply the sunscreen again every two hours during daylight hours.
  • Make sure to apply the protective cream again after entering the water and after exercising. Paying attention to applying protective cream on children’s skin before they go out to the fresh air, and teaching children and adolescents how to use protective cream in order to protect themselves
  • Make sure that there is a package of sunscreen in the car, in the garden tool box, in the sports bag and the like
  • Wear sunscreen
  • Refrain from sunbathing inside the beds prepared for that and avoid the use of accelerators for sunbathing
  • Awareness of medications that increase sensitivity to the sun
  • Examine the skin from time to time and inform the doctor of any change observed
  • Make sure to get regular skin checks at the doctor’s office

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