Chronic Sun Exposure Increases Melanoma Risk
Melanoma can occur at any site with melanocytes. Primary risk factors are intense episodic sun exposure at a young age, chronic sun exposure, and tanning. Other risk factors include lightly pigmented skin, blue eyes, red or blonde hair, a family history, moles, and specific genetic conditions (familial melanoma, xeroderma pigmentosum, retinoblastoma, Li-Fraumeni syndrome, Werner syndrome, and certain hereditary breast and ovarian cancer syndromes).
Remember the ABCD's for Mole Changes
Awareness is key to the early diagnosis of melanoma. Signs of melanoma are often described as the ABCD’s (asymmetry, borders irregular, color difference, and a diameter greater than 5 mm- about ¼ inch).
Patients and physicians should be concerned if there’s a new mole or existing mole that changes in size, is multicolored, is large, has irregular borders, is bleeding or has a scab, or is unusual in appearance. Self-examination in a full-length mirror can lead to early diagnosis. Also, evaluation by a primary care physician or dermatologist can diagnose this potentially deadly disease.
Early diagnosis is key to treating melanoma
MaineHealth has physicians who can recognize melanoma at its earliest stages. If you are concerned about a pigmented (dark or colored) lesion, make an appointment to see your family physician or a dermatologist. If it is suspicious, it can be removed and examined by a pathologist. When melanoma is diagnosed early, it can most often be cured with minimal treatment. The key to successful treatment is the early diagnosis.
- The most common sight for melanoma to occur is the head and neck, trunk, and extremities.
- Melanoma can also occur under the fingernails, on the genitals, on the soles of the feet or palms, in the eye, and in the anal canal.
Staging melanoma to determine treatment
After a melanoma diagnosis, your doctor will determine the stage of the cancer. This is an important step in the evaluation of melanoma. The melanoma size and stage will help decide treatment. Roman numerals I through IV (1-4) indicate how far the cancer has spread. Stage I is the earliest stage. At Stage IV, the melanoma has spread from your skin to other organs in your body.
Your cancer doctor will perform the following tests and look at the following factors to decide the size and stage of melanoma:
Tumor thickness: The melanoma will be measured and looked at under a microscope to determine the thickness. A special tool will be used to size it. In early stages the melanoma will not be thick. The thicker the melanoma gets, the greater the chance it has spread.
Sentinel node biopsy: This procedure lets your doctor know whether the cancer has spread to your lymph nodes. With a sentinel node biopsy, dye is injected into the site where the melanoma was removed. The first lymph nodes to collect the dye are removed and checked for cancer. If the lymph nodes are cancer free, it is unlikely the melanoma has spread to other areas in your body.
Taking a team approach to treating melanoma
The treatment of melanoma should be by a multidisciplinary team of providers. At MaineHealth, team members include primary care physicians, your dermatologist, surgical oncologist, medical oncologist, and radiation oncologist. For early cancers, having the mole removed with a wide edge can be the cure. Most often, mole removal is done right in your doctor's office.
More advanced disease treatment must be thoughtfully tailored to the individual patient.
- For melanoma that is deeply invasive of the skin, a wider excision and evaluation of adjacent lymph nodes is imperative.
- Lymph nodes can be evaluated with the procedure called sentinel lymph node biopsy. This procedure identifies lymph nodes that are most likely to contain metastases or spread of the tumor. This procedure not only identifies and treats melanoma in lymph nodes but can define future treatment.
- Additional therapies can improve survival, control cancer, and treat metastatic disease. These therapies include chemotherapy, immunotherapy, radiation, targeted therapy, and clinical trials.
In the last several years there have been tremendous advancements in the treatment melanoma, and as a patient at MaineHealth, you have access to this revolutionary treatment. Also, through collaboration with the Dana-Farber Institute in Boston, patients have expanded access to clinical trials.