Skin Cancer
The largest organ of the body, the skin serves many important functions in protecting other organs from the external environment. It helps the body retain water and other necessary fluids while also helping to regulate its temperature and protect it from infections. The skin has three layers: the epidermis, the dermis and the subcutaneous layer. Melanocytes, located in the bottom layer of the epidermis, make a pigment called melanin, which gives the skin a tan or brown color and helps protect the deeper layers of the skin from the harmful effects of the sun. Melanoma is a type of skin cancer that begins in the melanocytes.
Because most melanoma cells keep making melanin, melanoma tumors are often brown or black. Melanoma most often appears on the trunk of fair-skinned men and on the lower legs of fair-skinned women, but it can appear other places as well. Melanoma is almost always curable in its early stages.
Incidence
Cancer of the skin is the most common of all cancers. Melanoma accounts for only about 1 percent of skin cancer cases but causes a large majority of skin cancer deaths. The American Cancer Society estimates that 87,110 new cases of melanoma (about 52,170 in men and 34,940 in women) will be diagnosed in the United States in 2017, and that about 9,730 people will die from the disease. The rates of melanoma have been rising for the last 30 years.
Symptoms
The main warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape or color. Other possible symptoms of melanoma include:
- A sore that doesn't heal
- Spots with irregular edges
- Multicolored spots or moles (may include different shades of brown or black, or patches of pink, red, white or blue)
- Asymmetry (both halves of the mole not matching in size or shape)
- Itchiness
- Oozing or bleeding
- Spread of pigment from the border of a spot into surrounding skin
- Redness or a new swelling beyond the border of the mole
Consult a doctor if you notice a change in the pigment of your skin.
Diagnosis
If your doctor suspects you have melanoma, he or she will perform a biopsy, during which a sample of the lesion is examined via a microscope.
Treatments
Treatment options for melanoma patients may include surgery, chemotherapy, immunotherapy, targeted therapy, and/or radiation therapy. Your treatment will depend on the stage and location of the disease and your overall health.
Surgery
Surgery is the main treatment option for most melanomas and usually cures early-stage melanomas. Your doctor may remove the tumor using the following operations:
- Wide excision (removal of melanoma as well as a margin of normal skin around it)
- Lymph node dissection (removal of lymph nodes near the primary melanoma)
- Sentinel lymph node biopsy (During this procedure, the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present. If cancer cells are not found, it may not be necessary to remove more lymph nodes
Chemotherapy
Chemotherapy (chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. The drugs can either be injected into the patient's vein or taken by mouth (in the form of a pill). The way the chemotherapy is given depends on the type and stage of the cancer being treated. The medical oncology/hematology division at Sinai Hospital directs the chemotherapy program at LifeBridge.
Radiation therapy
Radiation therapy uses high-energy X-rays, particles or other types of radiation to kill cancer cells. The Department of Radiation Oncology at Sinai Hospital provides the most advanced radiotherapy for many cancers.
Immunotherapy
Immunotherapy uses medicines to stimulate the patient’s own immune system to kill cancer cells.