Many people do not consider the skin as an organ of the human body, but that is exactly what it is. Human skin is responsible for exchanging heat and water with the environment and for protecting internal organs against pathogens, such as bacteria. This organ has three layers: the epidermis (more external), the dermis and the subcutaneous tissue (located more deeply).
Because it is very exposed to external agents, such as air conditioning and sunlight, our skin can suffer serious consequences if it is not well treated and protected. One of these consequences is Melanoma, the most dangerous type of skin cancer of all. And that is exactly what this article is about.
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What is Melanoma
Melanoma is a malignant tumor that originates from the melanocyte cells that produce melanin, the pigment in our body. As much as skin cancer is the most frequent in our country, this disease represents only 3% of the cases of malignant tumors – and even so it is the most dangerous, as it has a high level of lethality.
According to INCA (National Cancer Institute), 5670 new cases of melanoma were estimated in 2016 alone, with 3000 cases in men and 2670 in women. Based on the number of deaths caused by this type of cancer, data collected in 2013, the incidence of the disease is higher in men than in women, since of the 1547 deaths, 903 were men and 644 women.
What are the causes and risk factors
Melanoma happens when there is an error in the cells that produce melanin, but there are still no studies that prove exactly the damage that this can cause to our skin. Most cases indicate that the main cause is overexposure to UV rays – which can come from both sunlight and tanning beds. In addition, some risk factors can also increase the chances of the disease appearing in certain people. Check below what they are.
Prolonged exposure to the sun
Excessive exposure to sunlight, especially without proper protection, helps with skin aging and increases the chance of developing cancer in the future.
People with fair skin
The risk of having skin cancer is much higher in people with fair skin than those with black skin. This does not mean, however, that blacks do not have skin cancer as well.
Severe sunburn
If you have already suffered a severe sunburn, whether in childhood or adolescence, your chances of developing cancer are increased.
Another case of melanoma previously
If you have already had another melanoma, your chances are very high of having it again.
Owning certain types of spots
Some types of moles greatly increase a person’s risk of developing melanoma. If you have a lot of spots on your body, regular medical follow-up is necessary, especially if they are large.
Family history
It is estimated that 10% of melanoma patients have a close relative who has the disease as well. Called familial melanoma, it can also occur due to an inherited genetic defect.
Xeroderma pigmentoso
Rare genetic disease, people who have xeroderma pigmentosum are not able to repair the damage of DNA damaged by the action of the sun’s rays, which can cause several other types of skin cancer, starting as early as childhood.
Age
Melanomas are more common among adults over 50 years of age.
People with low immunity
People who have a weakened immune system due to some factor, such as organ transplantation, leukemia or the use of certain medications, are at an increased risk of getting skin cancer.
Types of Melanoma
Melanomas can be classified into different types, totaling 13, such as mucosal melanoma, superficial spreading and polypoid. However, the main ones are 4:
Superficial extensive melanoma
This type of melanoma is the most common. It is usually flat and irregular and occurs in different shades of black and brown. It can manifest itself in people of different ages and different parts of the body. It is more common in people with fair skin.
Melanoma nodular
Usually this type of melanoma begins as an elevated area of a bluish black or bluish red color. However, some nodular melanomas have no color at all.
Lentigo maligna melanoma
Malignant lentigo melanoma occurs to a large extent in the elderly and is more common in sun-damaged skins in the face, neck and arms.
Melanoma lentiginoso acral
This type of melanoma is the most unusual form of cancer. It usually occurs on the palms of the hands, on the soles of the feet or under the nails and is more frequent in people with dark skin.
What are the symptoms of Melanoma?
The most recurrent place for melanoma to appear is on the skin, but it can also appear in other places such as eyes, ears, lungs, gastrointestinal tract, brain, heart and genitalia – this is called metastasis. Generally, the first signs of a melanoma are:
- Change in an existing stain or paint;
- Development of a new spot or paint that is well pigmented or that has an unusual appearance;
- Other suspicious changes, such as itching, itching, bleeding and non-healing of the affected area.
It must be kept in mind that sometimes a person with melanoma may not have all of these symptoms. Therefore, the existence of a didactic rule helps a lot in time for a person to check if their spots or spots correspond to a case of melanoma. This didactic, which aims to recognize skin cancer at an early stage, is called ABCD.
- Asymmetry: mentally divide your spot and check that the two sides of it are the same. If not, there is a need for an investigation.
- Irregular edges: check if the edge of your spot is irregular, serrated and not uniform.
- Color: if there are colors mixed in the same spot, see your doctor.
- Diameter: check if your paint or stain is growing progressively. Melanomas usually have a diameter equivalent to 5mm.
The characteristic spots of the disease appear more frequently on the back, among men, and on the legs, among women, according to the explanatory table below.
Body location | Men | Women |
Head and neck | 22% | 14% |
Stem | 38% | 17% |
Arm | 17% | 21% |
Leg | 15% | 42% |
No specification | 8% | 6% |
How the diagnosis is made
If you have noticed any sudden changes while doing the ABCD method of checking the spots or stains on your body, you need to go to a specialist doctor on the subject – dermatologist or oncologist. If you have been diagnosed with melanoma before and have one of the symptoms below, seek medical help as well.
- Difficulty breathing or swallowing;
- Cough or spit with blood;
- Blood in vomiting or diarrhea;
- Urine or black stools.
Once at the doctor, the disease diagnosis procedure takes place through one or more steps described below:
Clinical evaluation
At first, your doctor will evaluate your skin clinically. He can also check your lymph nodes in order to find out if they are larger than normal or not. After this first evaluation, he will be able to indicate some tests to have a more accurate diagnosis.
Dermoscopy
Complementary exam, very important for the diagnosis of melanoma, dermoscopy can be done in two ways: manual or digital. In manual form, the doctor looks at your spots with a dermatoscope and immediately assesses the risk of injury. The digital form, on the other hand, allows your spots to be evaluated in a more detailed way, being able to identify risky lesions more easily.
Microscopia confocal
Non-invasive diagnostic imaging method, confocal microscopy is performed using a diode laser that makes it possible to view details of the structure of the skin cells in a tissue that is still alive.
Biopsy
The biopsy consists of the collection of part of the tissue in order to be evaluated histologically. This will confirm whether the tissue is cancerous or not.
Other exams
Some tests may be ordered to see if the cancer has spread to organs other than the skin. Among these exams are:
- Fine needle aspiration biopsy (BAAF);
- Lymph node surgical biopsy;
- Sentinel lymph node biopsy;
- RaiosX;
- Computed tomography;
- Magnetic resonance imaging (MRI);
- Positron emission tomography (PET).
Melanoma Treatment
Each type of melanoma will require a different type of treatment. Usually, when he is in an early stage, the surgery performed for his removal is enough. However, when the cancer is at a more advanced stage, that is, when it has spread beyond the skin, other forms of treatment may be necessary. Some of them may not cure the disease, but rather lessen the symptoms caused by it.
The treatments performed in advanced stage melanomas are:
- Surgery to remove the compromised lymph nodes;
- Chemotherapy;
- Radiotherapy;
- Bioquimioterapia;
- Immunotherapy.
Prevention
With some daily skin care, you can prevent melanoma from developing in your body:
- Use sunscreen (with a factor of at least 30) every day, including those when you are sleeping.
- Avoid exposing yourself to the sun from 10 am to 4 pm. If you need to expose yourself during this period, use in addition to sunscreen, sunglasses and a hat / cap.
- Know your skin! Examine yourself at least once a month. Make use of mirrors to see places that you normally cannot see. By doing this, you will identify abnormalities much easier and request medical help as soon as possible.
- It is important that people at risk visit a dermatologist frequently, but this tip is also valid for those who are not.
Melanoma is dangerous, but if diagnosed early, it has a chance of a complete cure. Tell your friends and acquaintances about the seriousness of the disease. To do this, share this article with them and help us pass this information on to as many people as possible!
