Melanoma

What is melanoma?

Melanoma is the deadliest type of skin cancer, which is particularly disconcerting since more and more people are being diagnosed each year. According to the Centers for Disease Control, the incidence of melanoma in the United States has doubled over the past 30 years.

Melanoma arises when your melanocytes develop a mutation leading to their uncontrolled multiplication and growth. Melanocytes are the cells in your body responsible for giving your skin its color. It’s difficult to pinpoint the exact cause for this mutation that leads to melanoma, but it’s likely a combination of genetic and environmental factors. Many experts think that exposure to ultraviolet (UV) radiation is the leading cause of melanoma. UV radiation exists in high concentrations in tanning beds and the sun.

The most important component in the treatment of melanoma is early diagnosis. Maintaining regular skin cancer screenings with the team of experts at Absolute Dermatology & Skin Cancer Center is crucial to effectively treating and preventing melanoma. 

What are the symptoms of melanoma?

Melanomas tend to be visible blotches of color on your skin. They’re similar to moles as they both are derived from melanocytes, but more often than not, melanomas arise on their own and NOT in an existing mole. They can develop anywhere on your body, from highly visible areas that are exposed to the sun (like your face, legs, arms, and back) to hidden areas, like in your eye, mouth, digestive tract, or under your nail. 

To distinguish normal moles from melanomas, it helps to remember your ABCs:

• Asymmetrical shape
• Borders that are irregular
• Color that’s changed, uneven, or irregular
• Diameter larger than ¼ inch
• Evolving, or changes in size, shape, or appearance over time
• Look infected
• Suddenly change in size and shape
• Are itchy
• Spontaneously bleed

If you notice any changes in your moles or skin that seem abnormal, schedule an appointment with Absolute Dermatology & Skin Cancer Center immediately for an evaluation.

What are the risk factors for melanoma?

You’re more likely to develop melanoma if you have:

• A weakened immune system
• A family history of melanoma in a first-degree relative
• Many moles or unusual moles (also called ‘atypical’ or ‘dysplastic’)
• Excessive exposure to ultraviolet (UV) light
• A history of frequent sunburn, especially blistering sunburns at a young age
• Fair skin and/or red hair

Living closer to the equator or living at a higher elevation also puts you at a higher risk of developing melanoma, since you’re exposed to higher amounts of UV radiation from the sun.

How do you treat melanoma?

If your doctor suspects that you have a melanoma, they first take a biopsy, which involves removing a sample of tissue for testing. If your biopsy tests positive, the depth of your melanoma will determine your treatment plan. All melanomas need to be removed in their entirety with some margin of normal skin surrounding them to ensure they are completely gone. 

If your melanoma has reached a certain depth in your skin, your doctor may send you for evaluation of your lymph nodes. If it is determined that your melanoma has spread beyond your skin, to your lymph nodes or beyond, you might need more aggressive treatment, which can include:

• Surgery to remove your affected lymph nodes
• Immunotherapy
• Radiation therapy
• Chemotherapy

Slow Mohs Surgery for Melanoma in Situ

Melanoma in situ is a superficial form of early melanoma that involves only the top layer of skin.  There are several forms of melanoma in situ, some of which tend to spread out over the surface of the skin like an oil slick.  When these cancers develop on the head and neck, or other critical anatomic sites, they can be treated with a modified form of Mohs surgery called “slow Mohs,” with the goal of minimizing the amount of normal tissue sacrificed while still removing the entire cancer.  

In this procedure, Dr. Gillen will surgically remove the cancer with a narrow margin of normal tissue that will be sent to a dermatopathologist for microscopic evaluation using special stains.  The dermatopathologist will communicate results to Dr. Gillen, typically the following morning. Patients return the following day for either an additional stage of “slow Mohs” or for reconstruction with stitches, depending on the results communicated by the dermatopathologist.  

Because results are not immediately available, patients will be bandaged after removal of the skin specimen and sent home, returning the following day for the next stage of the procedure.  This process allows comprehensive margin evaluation, similar to standard Mohs surgery while using special stains that are helpful in evaluating melanoma. The most important benefit of this technique is that it allows Dr. Gillen to follow any microscopic extensions of the melanoma, thereby avoiding any cancer being left behind.

To learn more about your melanoma treatment options, schedule a visit with Absolute Dermatology & Skin Cancer Center today by calling the office nearest you, or send us a message to book an appointment on our contact page.

References and Resources:

https://www.curemelanoma.org/about-melanoma/melanoma-statistics-2/

https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

https://www.skincancer.org/skin-cancer-information/melanoma/

https://www.cancer.org/cancer/melanoma-skin-cancer.html