Melanoma originates in melanocytes (cells that make the pigment melanin and colors our skin, hair, and eyes). The majority of melanomas are black or brown, but frequently they can also be skin-colored, pink, red, purple, blue or white. It may start in a mole, but can also begin in other pigmented tissues, such as eyes. Most melanomas are brown or black and, a few melanomas are pink or red; these are called amelanotic melanomas. These melanomas are more aggressive. Signs of malignant melanoma are changeable in the size, shape, color or elevation of a mole.
Melanoma is more serious than the other forms of skin cancer. It may spread to other organs (metastatic melanoma) and may cause death. 68,130 new cases of melanoma are diagnosed and estimated 8,700 deaths from melanoma in the United States in 2010.
For melanomas, an often-used mnemonic is ABCDE;
o A= asymmetry
o B= borders (irregular)
o C= color (variegated)
o D= diameter (larger than 6 mm (0.24 in)
o E= elevation
These mnemonic is helpful. But the problem is that many normal moles are not totally symmetrical in their shape or color. This means that many spots, which seem to have one or more of the ABCDE but they are not melanomas. In addition, some melanomas do not have this description.
Melanoma Staging
Melanoma staging system divided into three general categories: localized melanoma (stage I and II), regional disease (stage III), and distant metastatic disease (stage IV).
Early-stage (I and II) localized melanoma is based on the T classification without evidence of lymph node metastasis.
The melanoma staging system includes range of Stage 0- IV
Stage 0 (melanoma in situ); melanoma involves the epidermis but has not reached the underlying dermis.
Stage I -II Early-stage (I and II) localized melanoma is based on the T classification without evidence of lymph node metastasis.
Stage III is involvement of regional lymph nodes. There is no evidence of distant metastasis.
Stage IV patients in this category have distant metastatic melanoma.
Metastatic melanoma may cause non-specific paraneoplastic symptoms. These symptoms include loss of appetite, nausea, vomiting and fatigue. Metastatic melanoma can spread to lungs, bones, liver, abdomen, lymph nodes. Metastatic melanoma is also an important cause of brain metastases.
The most aggressive form of melanoma is called Nodular melanoma (NM). Nodular melanoma tends to grow rapidly.
Melanoma Treatment by Melanoma Staging
Stage 0 Melanoma Treatment
Stage 0 (melanoma in situ) melanomas have not developed deeper than the epidermis. Stage 0 melanoma is treated by surgery to remove the melanoma.
Stage I Melanoma Treatment
In the Stage I melanoma, surgery is an option to remove the melanoma. The amount of normal skin removed depends on the thickness of the melanoma.
Stage II Melanoma Treatment
Large excision is the standard melanoma treatment for stage II melanoma.
If the melanoma may have spread to lymph nodes, it is recommended a lymph node biopsy. If it is done and the node contains cancer, then a lymph node dissection is an option.
In particular cases, adjuvant therapy may use with interferon after surgery.
Stage III Melanoma Treatment
For stage III melanoma treatment, surgery provides lymph node dissection. Adjuvant therapy (with interferon) can help some patients with stage III melanomas.
Stage IV Melanoma Treatment
Stage IV melanoma treatments are very hard because of spread to distant lymph nodes or other parts of the body. Metastases that not be removed surgically may be treated with radiation, immunotherapy, or chemotherapy.
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