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Dangers of Melanoma: Are you at risk?
Melanoma affects people of all ages and is one of the most common cancers in young adults.

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Whether it is summer or you are about to embark on your winter vacation in the sun, now would be a good time to learn about a dangerous cancer named malignant melanoma.


Melanoma is a cancerous tumor that grows out of melanocyte cells. These cells make the pigment melanin which colors the skin, hair, ears, and eyes. Melanoma most often develops in the skin (cutaneous), but it can also occur in the eye (ocular), and in other areas of the body where melanocytes are found. Melanoma is a serious cancer that can spread rapidly throughout the body.

 

Melanoma is a cancer that affects people of all ages, and is one of the most common cancers in young adults. The median age at melanoma diagnosis is 53 years; however, it is the most common cancer in women aged 25-29 years and is second only to breast cancer in women aged 30-34 years. It is rare in black people and others with dark skin. The risk of developing melanoma increases with age. It also runs in families. Among Western countries, the number of people who develop melanoma has been increasing over the years. The incidence of melanoma has more than tripled in the white population during the last 20 years, and melanoma currently is the seventh most common cancer in the United States.

 

While melanoma accounts for roughly 4% of all skin cancers, it is responsible for over 77% of skin cancer deaths. In the United States, one person each hour dies from metastatic melanoma. Treatment of melanoma in its early stages provides the best opportunity for cure.  The first sign of melanoma is often a change in the size, shape, color, or feel of a mole on the skin. A changing mole is the most common warning sign for melanoma. Variation in color and/or increase in diameter, height, or asymmetry of borders of a pigmented lesion are noted by more than 80% of patients with melanoma at the time of diagnosis. Symptoms, such as bleeding, itching, ulceration, and pain in a pigmented lesion are less common but warrant evaluation. When in doubt do not hesitate to see your doctor for evaluation and if needed referral to a dermatologist.

 

  • Superficial spreading melanoma - 70% of cases, most likely to occur on the trunk in men, the legs in women, and the upper back in both.

 

  • Lentigo maligna melanoma - found most often in the elderly, in chronically sun-exposed or damaged skin on the face, ears, arms, and upper trunk.
     
  • Acral lentiginous melanoma - appears as a black or brown discoloration under the nails or on the soles of the feet or palms of hands; most common melanoma in African-Americans and Asians, least common among whites.
     
  • Nodular melanoma - 10-15% of cases, spreads quickly, looks like a black bump but may be other colors, found on the trunk, legs, and arms of elderly or scalp in men.
     

Melanoma tends to occur at sites of intermittent intense sun exposure (i.e. on trunk in males and legs and back in females.) The disease shows an increased worldwide incidence in fair-complexioned individuals living in sunny climates and nearer the
equator, suggesting a causative role for ultraviolet radiation.

 

Primary risk factors for melanoma include the following:

  • Changing nevus (a changing mole in size or color)
  • Increased age (particularly in men under the age of 50)
  • Large numbers of moles
  • Fair complexion
  • History of multiple atypical moles
  • Personal or family history of melanoma (first-degree relatives)
  • Geographic location in sunny climates

 

The following easy-to-remember guideline, “ABCD,” is useful for identifying malignant melanoma:

  • Asymmetry - One side of the lesion does not look like the other.
  • Border irregularity - Margins may be notched or irregular.
  • Color - Melanomas are often a mixture of black, tan, brown, blue, red, or white.
  • Diameter - Cancerous lesions are usually larger than 6 mm across (about the size of a pencil eraser), but any change in size may be significant.

 

The treatment plan takes into account the type of melanoma, its location, whether it has begun to spread, and the person's age and health.

The standard treatments are:

  • Surgery - remove the melanoma and a ring of tissue around it (to make sure no cancer cells were missed.)
  • Chemotherapy - to kill cancer cells that have spread throughout the body
  • Immunotherapy - interferon-alfa and interleukin-2 may be given to help the body's immune system prevent a recurrence of the melanoma.
  • Radiation therapy - to kill cancer cells that may have spread beyond the tumor.


I look forward to seeing you this year, and as always, warmest regards and please wear sunblock (SPF 15 or higher)!

 

Andrea Ruman M.D.


If there are other topics which you would like to see addressed in subsequent newsletters, please feel free to email me at newsletter@DrRuman.com  and let me know about them.



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Andrea Ruman, M.D. - Doctor of Internal Medicine
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Dr. Andrea Ruman: Female medical doctor, physician, internist for Marina Del Rey, Santa Monica, West Los Angeles (LA), and Culver City in California. Specialties include women's health (including physical examinations, pelvic exams and pap smears), weight loss support and preventive medicine.