Melanoma: if you know it, you can win!
My dermatologist defines me as a "polinevical woman at high risk", that means that I have a lot of moles and pigmented spots all over my body. I've been operated by various surgeons nine times in order to take some of them away but, unluckily, this summer we weren't on time and I discovered that one of them had suddenly become a melanoma. I already thought I knew nearly everything about skin cancer, but now that I live it (and I'm really lucky!), I understand that there are lots of things I could have done and that you could do to avoid it. So, here's my lens.
What is skin cancer?
Skin cancer is a malignant growth on the skin which can have many causes. Skin cancer generally develops in the epidermis (the outermost layer of skin), so a tumor is usually clearly visible. This makes most skin cancers detectable in the early stages. There are three common types of skin cancer, each of which is named after the type of skin cell from which it arises. Cancers caused by UV exposure may be prevented by avoiding exposure to sunlight or other UV sources, wearing sun-protective clothes, and using a broad-spectrum sun screen.[citation needed]Skin cancers are the fastest growing type of cancer in the United States. It represents the most commonly diagnosed malignancy, surpassing lung, breast, colorectal and prostate cancer. More than 1 million Americans were diagnosed with skin cancer in 2007.
What skin cancer looks like?
The most common warning sign of skin cancer is a change to your skin. This change can take many different forms, including:* Translucent pearl-shaped growth
* Mole that has begun to grow, bleed, and/or itch
* Mole with any of these features: Asymmetrical (if lesion were folded in half, the two sides would not match), Borders irregular, Color varies, or Diameter greater than 6 mm (size of a pencil eraser). While melanomas are usually greater than 6 millimeters in diameter when diagnosed, they can be smaller. If you notice a mole different from others, or one that changes, itches, or bleeds even if it is smaller than 6 millimeters, be sure to see a dermatologist.
* Brown or black streak underneath a nail
* Sore that repeatedly heals and reopens
* Smooth, waxy lesion
* Cluster of slow growing, shiny or scaly lesions that are pink or red
To help you recognize the many different forms that skin cancer may take, the links below take you to pages that describe the most common types of skin cancer and show several photographs of each.
If you notice a lesion on your skin that resembles any of examples shown on these pages, see a dermatologist. Don't delay. The cure rate for skin cancer is 95% only when it is detected and properly treated in the early stages.
7 rules to prevent skin cancer!
Even if you have spent a lot of time in the sun or developed skin cancer, it's never too late to begin protecting your skin.
1. Avoid deliberate tanning. Lying in the sun may feel good, but the end result is premature aging (wrinkles, blotchiness, and sagging skin) as well as a 1 in 5 chance of developing skin cancer. Tanning beds and sunlamps are just as dangerous because they, too, emit enough UV radiation to cause premature aging and skin cancer. If you like the look of a tan, consider using a sunless self-tanning product. These products do not protect skin from the sun, so a sunscreen should be used.
2. Get vitamin D safely through a healthy diet that includes vitamin supplements. Don't seek the sun.3. Generously apply sunscreen to all exposed skin every day. The sunscreen should have a Sun Protection Factor (SPF) of at least 15 and be broad-spectrum (provides protection from ultraviolet A (UVA) and ultraviolet B (UVB) rays). Most people do not apply enough sunscreen to help protect against harmful ultraviolet (UV) radiation. One ounce, enough to fill a shot glass, is considered by the Academy to be the amount needed to cover the exposed areas of the body properly. Prefer sunscreen for babies, with total protection: it has good screen, good smell and you won't feel like putting white paint on yourself!
4. Wear protective clothing, such as a shirt, pants, a wide-brimmed hat, and sunglasses, where possible. Clothing protects your skin from the sun's harmful rays. The tighter the weave, the more sun protection provided. In fact, clothing plays such an important role in sun protection that clothing designed specifically to protect against the sun as well as laundry additives created to boost clothing's protective function are available. Your dermatologist may be able to provide you with more information about these products.
5. Seek shade when appropriate. The sun's rays are strongest between 10 a.m. and 4 p.m.6. Use extra caution near water, snow, and sand as they reflect the damaging rays of the sun. This can increase your risk chance of sunburn.
7. Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.
Should I go to a dermatologist?
With early detection and proper treatment, skin cancer is highly curable. The average cure rate when detected and treated in the early stages is 95%. Even melanoma, the most deadly form of skin cancer, when limited to the outermost layers of the skin yields a 95% cure rate.A person's ability to recognize the signs of skin cancer and perform regular self-examinations are key to early detection. Any time skin cancer is suspected, the lesion should be examined by a dermatologist.
Dermatologists detect skin cancer through a visual examination of the skin and mucous membranes. If malignancy (cancer) is suspected, a biopsy will be performed. This involves numbing the area and removing the lesion, or part of it, for microscopic examination. A biopsy is the only way to definitely tell if skin cancer is present.
Since a skin biopsy is generally a quick and simple procedure, it is usually performed in a dermatologist's office or outpatient setting. Even if you need a day hospital treatment, this won't include any total anesthesia: it will only be local, consisting in small punctures around your mole. The surgical treatment is quick: just half an hour for a 1cm-large mole, and you'll be able to walk home on your own. You'll just have to avoid physical stress for a couple of weeks. Actually, last time I had a biopsy, the same night I went out to dinner with my friends, so... don't worry!
What if the biopsy is positive?
The removed sample is examined under a microscope to determine if cancer cells are present and if so which kind. If an excisional biopsy was performed, the physician examining the sample also should be able to determine how deeply the cancer has penetrated the skin.Frequently, the removed sample is sent to a laboratory to be examined by a dermatopathologist, a medical doctor trained in both dermatology and pathology, who uses this expertise to microscopically examine tissue in order to diagnose skin conditions. Dermatopathologists provide expertise in diagnosing difficult cases.
In addition to removing the tumor or part of it, the dermatologist also will ask you some questions, which usually include when the lesion first appeared, symptoms, and your history of sun exposure.
If the biopsy reveals skin cancer, your dermatologist will discuss treatment options. Treatment for skin cancer varies according to the type, location, extent, aggressiveness of the cancer, and the patient's general health.
The goals of treatment for skin cancer are to remove all of the cancer, reduce the chance of recurrence, preserve healthy skin tissue, and minimize scarring after surgery. Actually, skin cancer removals are often performed by aestethic surgeons together with your dermatologist, so that you get the smallest scar possible.
Ok, I want to know everything that could really happen to me...
A diagnosis of melanoma can bring with it a range of emotions, including fear, panic and sadness. It is important to keep in mind that once diagnosed with melanoma the future is not always grim. When caught early, surgical removal shows a cure rate of approximately 95%. Even patients with more advanced cases should have hope as the cure rate continues to rise.A patient's course of therapy is largely determined by the thickness of the primary tumor and stage of the cancer, as every stage requires different treatment. In the earlier stages, surgery is used to remove the primary tumor and determine if all the cancerous cells have been removed.
Once melanoma is confirmed by the biopsy, additional tissue is generally surgically removed from the same site as the original biopsy to determine if any cancer cells remain. Excisional surgery is the procedure most commonly used, but the size of the tumor or location on the body may make another surgical procedure more practical. The thicker the melanoma, the more tissue removed. The removed tissue is sent to a laboratory for microscopic examination to determine if any cancer cells remain. When a melanoma is thin and has not spread beyond the original site, this is frequently the only treatment required.
In my case, as often happens with melanomas that are larger than 8mms, I was treated with lymph node dissection, too. It is not used to remove the primary tumor. Rather the procedure, also known as a lymphadenectomy, involves removing one or, in the worst cases, all of the lymph nodes in a region, such as the armpit or groin, and examining them for cancer.
A lymph node is a mass of lymphatic tissue surrounded by connective tissue. Lymph nodes filter bacteria and other foreign particles, such as cancer cells. If melanoma has begun to spread, it may be possible to find it in the nearest lymph nodes and remove it before it spreads further.
A biopsy is generally performed to find out if the melanoma has spread to the lymph nodes. The biopsy used will depend on several factors, including whether or not a lymph node feels particularly hard or enlarged.
Missing a lymph node won't cause you any living problem! A lymph node is no bigger than a pea. The scar is minimal and you won't feel any "internal loss". Of course, you'll have to avoid any physical activity for a couple of weeks, and then avoid hard physical activities for a couple of months, but you won't have any collateral effects.
I went home by car, accompanied but sitting, had a small walk and then stayed at home for a couple of weeks, going around the house and working on my Mac.
If more than a lymph node is taken away, you could have some collateral effects, such as developing allergy to some creams.
Will I need chemo?
Surgery is generally not effective in controlling melanoma that has spread to other parts of the body. In such cases, surgery may be used to remove tumors; however, other treatment also is necessary. When melanoma is clinically confined to the skin or lymph nodes, adjuvant therapy is often considered to reduce the risk of the cancer spreading or recurring after surgery. The goal of adjuvant therapy is to kill any undetected cancer cells. Chemotherapy, immunotherapy, and radiation may all be used as adjuvant therapy.
ChemotherapyThe chemotherapy used to treat melanoma is taken orally or given as injections. Once the medication enters the bloodstream, it attacks cancer cells as well as some normal cells, such as those that make up hair follicles and line the gastrointestinal tract. This can produce side effects, such as hair loss and nausea. Chemotherapy is usually given in cycles, with each cycle consisting of a treatment period followed by a period of recovery. Side effects generally disappear once chemotherapy is stopped. Combining chemotherapeutic medications may prove more effective in treating melanoma than use of a single medication. Combining chemotherapy medications with immunotherapy may increase effectiveness and reduce side effects.
Immunotherapy
Also known as "biotherapy," this form of treatment uses the patient's own immune system either directly or indirectly to recognize and destroy cancer cells. The purpose is to improve the patient's own defenses against cancer.
When a patient undergoes radiation therapy, high-energy rays are directed to the area(s) of the body affected by the melanoma in order to kill malignant cells. This form of therapy is not used to treat a single melanoma lesion. Rather, radiation therapy is used as adjuvant therapy, or to treat melanoma that has returned or is widespread.
Follow up
In addition to regular office visits, you also will be instructed on how to perform regular self-examinations of your skin and lymph nodes and practice sun protection.
If you have any questions about how to do the above, be sure to ask. Research shows that the majority of metastases and recurrences are discovered by the patient or a family member.
Supporting skin cancer research
Prevention: how to get it!
- Cancer Research UK
- Cancer Research UK is the world's leading independent organisation dedicated to cancer research. They support research into all aspects of cancer through the work of more than 4,250 scientists, doctors and nurses.
- Skin Cancer Net
- A comprehensive online skin cancer resource.
Volunteers!
- Team Pink and Sparkly
- Two brave women who want to do what we can to help more women - and men, to be survivors. They don't have buckets of cash to throw at the problem - but they have health and a determination to do what they can to beat Cancer.
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Acne-Treatment-Guru wrote...
Hey,
You do an excellent in side story of explaining. Thanks for letting us all in the inside story . Great lens!
Thank You,
flaminglacer wrote...
Very well structured lens with lots of good information - Squid Angel Blessing
Jamie123 wrote...
Your lens would be perfect for the Moles, Warts, and Skin Tags Group. Consider joining, it would be great to have this awesome lens (and any others you have like it) included! Thanks.
pososto wrote...
What an excellent lens.
Thank you for sharing your experiences













