Melanoma is a cancer type in which melanocytes, the cells responsible for skin pigmentation, develop cancer cells. Melanocytes are collectively called melanin, which gives skin its complexion. These cells are found on the epidermis, the upper layer of the skin and visible to naked eye. Melanin becomes more active when exposed under the sun and cause hyperpigmentation or dark skin.
Melanoma is one of the three skin cancer types. Unlike other skin cancer, melanoma tumors often present as a simple skin lesion. Its can be mistaken for a blemish with its dark color. However, its appearance should not be taken for granted as melanoma has high fatality rate, especially if not treated immediately. Recent statistics state estimates that around 76,000 melanoma cases will be diagnosed in 2014. An estimated death count of more than 9700 is projected because of this condition, which highlights the importance of undergoing early melanoma treatment.
Melanoma has four stages. These stages show different symptoms and require different treatment procedures with varying aggressiveness levels. Technically, however, stages become five if the early cancer stage is also included.
Also known as Stage 0, melanoma in situ is the early onset or presentation of abnormal melanocytes on skin. Cells present as superficial lesions, but damages may spread deeper as it affects surrounding normal skin cells.
Around 99 percent of diagnosed melanoma in situ cases showed to have five-year survival rate after excising the tumor. Surgical approach is the main treatment option at this stage.
Stage I is where the cancer cells started to penetrate deeper into the epidermis. This stage is divided into two types. Stage IA is where the cancer cell penetrated within a millimeter deep into the epidermis. A millimeter can be compared to a size of a pencil’s tip.
Its appearance is limited to being a colored blemish.
Tumors in Stage IB presents in two ways upon checkup. One is as an ulcerated tumor with cancer cells penetrating within a millimeter deep the epidermis. Its penetration depth won’t go over a millimeter. Another presentation is a non-ulcerated tumor with deep penetration by up to two millimeters. In this case, cancer cells have already penetrated the dermis, or the second layer of skin.
Melanoma cure for this stage includes surgical approach by removing tumors and its adjacent cells. Some cases may require lymph node mapping and lymph node removal if necessary. Clinical trials of prospective treatments may be conducted to check for metastasis in the lymph nodes. Additional treatment is lymph node removal with accompanying post-lymph surgery treatments like chemotherapy, targeted therapy, and radiation therapy.
Stage II can be classified further into three types according to their scope of penetration. Stage IIA can spread within 2 millimeters deep in the skin with ulceration. However, it can also spread within 4 millimeters without ulceration.
Stage IIB is when an ulcerated tumor penetrates 4 millimeters deep in the skin. A non-ulcerated tumor in this type goes beyond 5 millimeters deep in the dermis. People suffering from this condition can have a five-year survival rate of 57% after surgery.
Stage IIC is an ulcerated tumor that penetrates beyond 4 millimeters deep. It may reach the subcutaneous tissue or fat layers underneath the dermis.
Surgical excision is still the main treatment for this melanoma stage, but it is more invasive considering the thicker layer of tumor and surrounding tissues to remove. Lymph node mapping and lymph node studies will test the cancer’s spread. A melanoma doctor may also remove lymph nodes part of treatment. Apart from excision, additional treatment options may be included to prevent cancer cells from growing back.
Tumor thickness and ulceration details are irrelevant in describing Stage III melanoma. The most essential detail to check this tumor is identifying if melanoma spread to the lymph nodes. Cancer that spread on lymph node can be classified as Stage III if cancer cells are found on one or more lymph nodes, a main lymph vessel in between the main cancer site and lymph nodes, or if affected lymph nodes joined. Melanoma may be in Stage III if other small cancer tumors are present within 2-centimeter from the primary tumor.
Treatment for melanoma in this stage can be done surgically or through other approach. Surgery, however, can be extensive due to the affected cells and lymph nodes. This often requires skin grafting or the process of taking a skin layer from another part of the body.
The obtained graft will cover the main surgery site. High risk of cancer relapse may require additional biologic therapy or chemotherapy to prevent regrowth.
Alternatively, high-strength medications and therapy could be used if the tumor is inoperable. Combinations of biologic therapy and chemotherapy with medications like ipilimumab, vemurafenib, or dabrafenib would be used aggressively to treat the issue.
Other clinical trials for testing and medications may be introduced in diagnosing and treating melanoma in this stage.
Stave IV melanoma is where cancer cells have already metastasized or spread in other parts of the body. Aside from the main cancer site, cancer cells may spread to the liver, bones, liver, lungs and others.
Surgery is still a good solution although overall treatment becomes more aggressive at this later stage of melanoma. Tumor and lymph node excision techniques vary depending on the affected organs. Aside from tumor excision, a patient can undergo surgical procedures to relieve pain and discomfort to improve the patient’s quality of life.
Chemotherapy, radiotherapy, and biologic therapy combined with other medications like those used for Stage III melanoma plus interleukin-2. New combination therapies and medications may be explored to improve the patient’s quality of life or as potential treatment option.
Survival rates on melanoma vary depending on the diagnosed stage, patient’s health state, and reaction to medications and surgery.
Knowing the disease will be helpful in emphasizing the importance of undergoing checkup and proper treatment for the disease. The next part is knowing the best clinics or hospitals where to undergo treatment or checkup.