Melanoma is a cancer of the melanocytes in the body. The normal role of the melanocyte is to live on the body’s surface and protect the body from ultraviolet light (UV). When melanoma occurs the normal melanocytes mutate and become an aggressive cancer. UV exposure from the sun and tanning bed/booths are the most common causes of melanoma. The disease can start in the skin, eyes, sinuses, vagina or anus. Melanoma can affect patients of all ages, color or ethnicities.
Limiting UV exposure is the key to reducing risk of melanoma. Avoiding the sun from 10-2 and seeking shade will lower your UV exposure which will protect your skin. Wearing long sleeves, hats, sunglasses and pants will help protect your body as well. Using sunscreens with both UVA and UVB protection is important. SPF 45 or higher will help protect your skin for the harmful UV light from the sun.
Signs of melanoma are seen with new or changing moles. The most well known tools for early detection are the ABCDEs of melanoma.
A – Asymmetry – one ½ of the mole is not symmetrical with the other ½
B – Boarder Irregularity – the edges are irregular and not smooth
C – Color – changes to the color of the mole or skin
D – Diameter – greater then 5-6 millimeters or a growing mole
E – Evolving – the mole is changing characteristics
For eye melanoma patients will often notice blurred or changed vision, a change to the appearance to the pupil or a dark spot in the visual field.
If there is a suspicious mole or change to your skin a biopsy will be done of the suspicious area to make a diagnosis. A skin biopsy is an office procedure where a small piece of skin is taken and sent to the pathologist to review under a microscope. If the sample demonstrates melanoma cells then the diagnosis of melanoma is confirmed. Further management will be needed as appropriate.
If you notice any of these signs or symptoms you should contact your doctor immediately since early detection and treatment is the key to preventing spread of melanoma to other organs.
The diagnosis of melanoma is often frightening and can be confusing as well. Melanoma treatment needs to be individualized for each patient based on their pathology, staging and other related clinical factors. There have been amazing advances in the options for patients diagnosed with melanoma but appropriate management is based on individualizing care. At Cancer Center of South Florida we use a wide range of new treatments for patients with melanoma including pill targeted treatments, immunotherapy and surgical approaches. We have clinical trials focused on new approaches to helping patients with melanoma in addition to FDA approved strategies. Current treatment options are listed below.
• Surgical Management
• Radiation Therapy including gamma knife and cyberknife in selected cases
• Immunotherapy including ipilimumab, nivolumab, and pembrolizumab
• Targeted Therapy which includes pill treatments in selected patients with BRaf mutations of their tumors.
The follow up of patients with melanoma is individualized based on a patients stage and other related personal factors. Follow up can include skin exams with your dermatologist, lymph node exams with your oncologist, blood work and when appropriate imaging studies.
Dr. Abraham Schwarzberg
Dr. Schwarzberg is the Senior Vice President of Network Development & Chief of Oncology at Tampa General Hospital. He is a member of the American Society of Clinical Oncology.