Carcinoma of the Skin

Melanoma is a type of malign skin cancer that may instantly appear on normal skin without any warning or may develop on an already existing mole. It is therefore of paramount importance that suspicious moles are monitored carefully.

What is melanoma?

The source of melanoma, which is the most life-threatening form of skin cancer, is the cell known as melanocytes. Melanocystes produce the melanin pigment which gives the skin its color and allows it to tan. Melanoma is caused as a result of excessive and uncontrolled proliferation of melanocytes, while bearing the potential to spread to other organs.

What are the risk factors?

As in other types of skin cancer, overexposure among fair skinned people to the sun is a very important risk factor in the occurrence of melanoma. People whit a family history of melanoma, especially those who have a high number of moles (75-100 or more) are also at risk. Although melanomas is mostly seen in fair skinned people and those who easily become freckled, being dark skinned is no guarantee against melanoma. In dark skinned people, melanoma tends to develop in the sole of the foot and palm of the hand, under the fingernails or, in rare circumstances, in the mouth. 

What are the symptoms?

Melanoma may instantly appear on normal skin without any warning, or may develop on an already existing mole. Therefore, the locations and the appearance of moles on the body must be monitored closely as to ensure that changes may be identified. Melanoma moles may sometimes be confused with other atypical moles. Sometimes a mole, which may have been afflicted by melanoma since it first appeared may be mistaken for a normal mole.

Other alerting symptoms are desquamation, skin leakage, bleeding and changes on the surface of the mole, such as swelling or exanthema of the mole. Moreover, other symptoms include changes of feeling related to the mole, such as itching, sensitivity or pain. However, the respective physician (generally a dermatologist) must issue a recommendation regarding the removal or close monitoring of the mole in question.

What are methods of diagnosis?

Dermatoscopy is a very important auxiliary diagnosis method which displays moles at 10-20 times magnification, and which is used particularly in distinguishing pigmented moles from skin cancers. This method is performed with the help of a manual device or by recording images via computerized systems.

The diagnosis of skin cancer is based on features observed with the naked eye and findings indentified through dermatoscopic examinations. The final diagnosis of skin cancer may only be established through a pathological examination of the surgically extracted tissue. However, most people are under the misconception that it becomes cancerous when the scalpel touches it! This is not true surgical removal of a benign or pigmented lesion does not bring any additional risk to that specific mole. Unnecessary removal of moles can only be prevented by use of proper methods of diagnosis.

How is it treated?

If the pathology report confirms that a mole, which , is general, should be completely removed and examined and then is  found to be melanoma, a surgical operation must be applied to the area. However, during the operation, some volume of healthy tissue is left around the area for treatment purposes. The only known and effective method of therapy for melanoma is surgical operation. If the melanoma cannot be diagnosed in the early stages, there is a risk that it may spread (metastasis) to other organs of the body beginning from the lymph system. Therefore, a lymph node biopsy must be carried out in order to determine whether or not it has spread..

How can people protect themselves from melanoma?

Since melanoma generally first appears on the surface of the skin, melanoma is a type of cancer where there is a high likelihood of identification in its early stages. To ensure early diagnosis, the patient should check their own skin at regular intervals, standing naked in front of a tall dressing mirror in a sufficiently strong light and examine their own skin from head to toe, using a hand mirror for areas which are difficult to see. All areas, beginning from the face and including the hair skin (where the help of another person may be needed), the neck, shoulders, back, chest and so on, must be examined downwards. Also, inguinal regions, inside parts of arms and legs, the sole and the parts between fingers should also be examined. This procedure, which may seem long, does not in fact last for more than 5 minutes.

ABCD method for mole follow-up

To easily determine any changes in moles, a method known as the ABCD rule is applied. According o this method, patients should see their physician if they observe any of the following changes of color and/or shape)

A (Asymmetry): Half of the nevus does not resemble the other half (in terms of color and/or shape)

B (Border): Borders of the nevus are irregular (wavy)

C (Color): The color of the mole is not homogenous (two or mole colors among brown, black, red, gray and white are present at the same time or there is a multicolored appearance)

D (Diameter): The diameter of mole is more than 6 mm (the mole is wider in diameter than a pencil).