Cancer | Skin Cancer

Melanoma is the most common cause of death from skin cancer. With early diagnosis, however, 85 percent of patients can be cured. The goal is to recgonize malanoma early when it's potentially curable.

Melanoma begins in cells called melanocytes, which are pigment-producing cells. When melanoma starts in the skin, the disease is called cutaneous melanoma. Melanoma also may occur in the eye, a condition called ocular melanoma or intraocular melanoma. Rarely, melanoma may arise in the meninges, the digestive tract, lymph nodes or other areas where melanocytes are found.

It can occur on any skin surface. In men, it is often found on the trunk or the head and neck. In women, the condition often develops on the lower legs as well as the upper back. The chance of developing melanoma increases with age, but it affects people of all ages and is one of the most common cancers in young adults.

When melanoma spreads, cancer cells are found in the lymphatic system. If the cancer reaches the lymph nodes, cancer cells may have spread to other parts of the body such as the liver, lungs or brain. In these cases, cancer cells in the new tumor are still melanoma cells and the disease is called metastatic melanoma rather than liver, lung or brain cancer.

Often, the first sign of melanoma is a change in the size, shape, color or feel of an existing mole. Most melanomas have a black or blue-black area. Melanoma also may appear as a new, black, abnormal or "ugly-looking" mole. Rarely, melanoma is not pigmented and is more difficult to diagnose. It may appear as a non-healing ulcer or a new scar-like lump in the skin.

The warning signs of melanoma sometimes are referred to as ABCDE:

If your doctor suspects that a spot on the skin is melanoma, you will need a biopsy, which is the only way to make a definite diagnosis. In this procedure, your doctor tries to remove all of the suspicious-looking growth. If the growth is too large to be removed entirely, your doctor may remove a sample of the tissue. A biopsy usually can be done in the doctor's office using a local anesthetic. A pathologist then examines the tissue under a microscope to check for cancer cells.

Surgery to remove melanoma is the standard initial treatment. It is necessary to remove not only the tumor but also some normal tissue around it to reduce the chance that any cancer remains. The width and depth of surrounding skin to be removed depends on the thickness of the melanoma and how deeply it has invaded the skin. When the melanoma is very thin, enough tissue may be removed during the biopsy and no further surgery may be necessary. If the melanoma is not completely removed during the biopsy, your doctor will take out the remaining tumor. In most cases, additional surgery is performed to remove normal-looking tissue around the tumor, called the margin, to make sure all melanoma cells are removed. For thick melanomas, it may be necessary to take out a larger margin of tissue.

Surgery generally isn't effective in controlling melanoma that has spread to other parts of the body. In such cases, doctors may use other methods of treatment, such as chemotherapy, biological therapy or immunotherapy, radiation therapy or a combination of these methods.

Chemotherapy is the use of drugs to kill cancer cells. It is generally a systemic therapy, meaning that it can affect cancer cells throughout the body. In chemotherapy, one or more anticancer drugs are given orally or by injection into a blood vessel. Either way, the drugs enter the bloodstream and travel through the body.

Chemotherapy usually is given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient -- at the hospital, at the doctor's office or at home. Depending on which drugs are given and your general health, a short hospital stay may be needed.

Biological Therapy

Biological therapy, also called immunotherapy, is a form of treatment that uses the body's immune system, either directly or indirectly, to fight cancer or to lessen side effects caused by some cancer treatments. Biological therapy also is a systemic therapy and involves the use of substances called biological response modifiers (BRMs). The body normally produces these substances in small amounts in response to infection and disease. Using modern laboratory techniques, scientists can produce BRMs in large amounts for use in cancer treatment. In some cases, biological therapy given after surgery can help prevent melanoma from recurring. For patients with metastatic melanoma or a high risk of recurrence, interferon-alfa and interleukin-2 may be recommended after surgery. Colony-stimulating factors and tumor vaccines are examples of other BRMs under study.

Radiation Therapy

In some cases, radiation therapy, also called radiotherapy, is used to relieve some of the symptoms caused by melanoma. Radiation therapy is the use of high-energy rays to kill cancer cells. Radiation therapy is a local therapy. It affects cells only in the treated area. Radiation therapy is most commonly used to help control melanoma that has spread to the brain or bones, and other parts of the body.