Skin Cancer: Malignant Melanoma

  • Basics

    Malignant melanoma is a skin cancer that is becoming increasingly common worldwide. Although it is often deadly, it can be cured if caught in its earliest stages. Malignant melanoma, also known simply as melanoma, is the sixth most common cancer in the U.S., and is the cancer increasing most rapidly worldwide. The estimated lifetime risk for melanoma has skyrocketed from 1 person in 1,500 for those born in 1935 to 1 in 75 for those born in the year 2000. Like other types of skin cancers, malignant melanoma is closely associated with excessive sun exposure, although genetic susceptibility is also a factor. People with light skin who sunburn easily are at the highest risk, but darker-skinned individuals can also develop melanoma.

    Malignant melanoma, while not as common as the nonmelanoma skin cancers, is the most deadly form of skin cancer. Malignant melanoma can arise from a pre-existing mole, or from normal skin. It often appears as an unusual, odd-shaped lesion, with irregular shape or color. The thicker the lesion, the greater the chances are that it has already spread (metastasized) to lymph nodes and distant sites. At this point, prospects for long-term survival tend to be poor.

    However, cure rates are high if the lesion is discovered and removed in its earliest stage. A variety of new treatments are currently being tested for this feared disease, which often strikes adults in the prime of life.

    Melanoma can occur in people of all races, but is much less common in dark-skinned individuals.

  • Causes

    Melanoma is predominantly associated with excessive sun exposure, but can also arise in areas of the body protected from sunlight. Like all skin cancers, malignant melanoma is most common in fair-complexioned individuals who have a history of bad sunburns and chronic sun exposure. It also tends to run in some families with a recognized gene mutation, which seems to confer increased susceptibility to the disease.

    For unknown reasons, a small percentage of melanomas occur on areas that are normally protected from sunlight, such as the palms of the hands, the soles of the feet, or under the nails.

    Melanoma originates from cells that are actually supposed to protect our skin from sunlight (melanocytes). Melanoma develops from melanocytes, cells that contain melanin, the pigmented chemical that protects our skin from sunlight. Melanocytes are located in the deepest (or basal) layer of the outermost layer of the skin (epidermis). Early melanomas may grow slowly, and only on the surface of the skin for a period of months or several years. Later, lesions tend to get thicker and grow deeper into the skin. Melanoma then tends to grow aggressively, and spreads to distant sites. The cancer cells spread to lymph nodes in the area, and through the bloodstream to the liver, lungs, bones, and brain.

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