Melanoma

Melanoma: Overview

Melanoma, accounting for less than 5% of skin cancers, is one of the most dangerous of all cancers and is the most rapidly increasing form of cancer in the United States.  Melanoma arises from pigment cells in the skin and usually takes the form of a very dark, irregularly-colored spot or nodule.  The risk of melanoma is increased with occasional, intense exposure, such as blistering sunburns, especially in childhood, rather than long-term sun exposure.

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Unlike other cancers, melanoma may remain inactive for years, may even regress temporarily, and then suddenly metastasize to lymph nodes or vital organs.  The tendency of melanoma to metastasize is fairly predictable and is related to the thickness rather than the size of the tumor.

Incidence; Causes and Development; Contributing Risk Factors

Melanoma is more common in younger individuals.  In the United States, the risk of melanoma is about 15 cases for every 100,000 people, and at the time of writing (2002) there will be 40,000 new cases with about 8,000 deaths expected in the next year.  Incidence is doubling every 10 years, and this is believed to be mainly due to the depletion of the ozone layer.

Melanoma may occur by itself, or arise from a pre-melanoma mole or skin growth.

Australia has the world's highest incidence of melanoma, because of its location near the equator and population composed largely of people of Celtic extraction.  The fact that melanoma occurs mainly on sites not overly sun-exposed indicates that other factors are involved.

In brief, the risk factors are:

  • Sun exposure and a history of sunburns
  • Caucasian skin
  • Latitude

Signs and Symptoms

Common locations for melanoma include the back and scalp in men and legs in women, areas not usually exposed extensively to the sun.

Major signs of malignant melanoma:

  • A mole with three or more shades of brown and black
  • An existing mole getting bigger or developing an irregular outline
  • A new mole growing quickly (months) in an adult.

Minor signs of malignant melanoma:

  • A mole that is larger than the blunt end of a pencil
  • A mole becoming inflamed or developing a reddish edge
  • A mole that develops bleeding, oozing or crusting
  • A mole starting to feel different (e.g. itching or painful).

Diagnosis and Tests

The systemic evaluation for melanoma metastases involves:

Contrary to circulating myths, hairy moles do NOT differentiate benign from malignant; incisional biopsy into melanoma does NOT spread the tumor.

Prognosis

Five year survival related to tumor depth:

  • Survival 99%: Depth < 0.85mm
  • Survival 80%: Depth 0.85 to 1.69mm
  • Survival 70%: Depth 1.70 to 3.64mm
  • Survival 40%: Depth > 3.65mm

Survival rates are better in women.

Signs, symptoms & indicators of Melanoma:

Symptoms - Hair

Symptoms - Head - Mouth/Oral

Symptoms - Nails

Dark lines under nails

Dark lines beneath the nail should be investigated as soon as possible.

Black/brown fingernails

A longitudinal brown-black streak (which may take up the whole nail and may "spill over" into the proximal nail fold) is a sign of melanoma, and possibly Hutchinson's.

Symptoms - Skin - Conditions

Bleeding/enlarging/tender moles

Melanomas may initially look like moles, but distinguish themselves from normal moles by changing in size (enlarging), shape and color.  In other words, melanomas become larger, more irregularly shaped and usually darker and more uneven in color.

Counter-indicators

Symptoms - Skin - General

Conditions that suggest Melanoma:

Reproductive

Endometriosis

Endometriosis has been linked to the environmental contaminant dioxin and a lack of physical activity, both of which are also associated with an increased risk of melanoma.

Symptoms - Cancer

Risk factors for Melanoma:

Environment / Toxicity

Family History

Melanoma in family members

Individuals with a parent or sibling with melanoma have a 10 times greater chance of developing melanoma themselves.

Symptoms - Cancer

Symptoms - Head - Eyes/Ocular

Symptoms - Skin - Conditions

(Many/very many) irregular dark moles

A person who has more than 5 atypical or "dysplastic" moles has a higher risk of developing melanoma and should check their skin thoroughly several times per year to look for changes.

Having/having very many common moles

A person who has more than 50 common moles has a higher risk of developing melanoma and should check their skin regularly to look for abnormal changes.

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Melanoma suggests the following may be present:

Tumors, Malignant

Recommendations for Melanoma:

Amino Acid / Protein

Not recommended
L-Phenylalanine

Cancer patients, such as those with melanoma, should avoid taking L-phenylalanine and/or Tyrosine as these may stimulate the growth of such cancers.

Not recommended

Drug

Hydrazine Sulfate

See the link between Cancer (General) and Hydrazine Sulfate.

Mineral

Selenium

Serum selenium levels were inversely related to the degree of disease severity in 200 cases of melanoma studied.  As selenium has established cancer prevention effects, its use to reduce the risk of melanoma is advisable.

Preventive measures against Melanoma:

Environmental

Nutrient

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KEY

Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk of
Weak or unproven link:
may be a sign or symptom of; may suggest; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often increases risk of; often suggests
Strong or generally accepted link:
is often a sign or symptom of; often increases risk of; often suggests
Definite or direct link: is a sign or symptom of; strongly suggests
Definite or direct link:
is a sign or symptom of; strongly suggests
Strong counter-indication: often contraindicates
Strong counter-indication:
often contraindicates
May be useful: may help with; may help prevent
May be useful:
may help with; may help prevent
Moderately useful: often helps with; often prevents
Moderately useful:
often helps with; often prevents
Should be avoided: is NOT recommended for
Should be avoided:
is NOT recommended for