what does this skin cancer look like?

Melanoma is an aggressive skin cancer. It represents 10% of this type of cancer. The most common skin cancers (90%) are carcinomas. 80% of skin melanomas develop from healthy skin, that is to say, skin showing no spots or lesions, explains the National Cancer Institute. They appear as a pigmented spot that looks like a mole. In the remaining 20% ​​of cases, they develop from a pre-existing mole (also called nevus). Melanoma can appear at any age, even if its existence in children is exceptional. Sun exposure, especially during childhood, UV rays, hereditary factors, numerous nevi and fair skin are factors associated with a greater risk of melanoma.

What is a melanoma?

Melanoma is a form of skin cancer. This type of cancer develops at the expense of melanocytes, cells that produce melanin and are the source of skin color. They are located in the epidermis. melanoma differs from nævi (moles of beauty), which also germinate from melanocyte cells, but are benign. The term malignant melanoma is actually a pleonasm, because melanoma is never benign. There are 4 types of melanoma:

• superficial extensive melanoma (60-70% of cases) linked to sunburn (neck, trunk, legs)
• Dubreuilh melanoma (5-10% of cases) mainly in people over 50 (face, neck, hand)
• nodular melanoma (less than 5%), it spreads rapidly in depth.
• acrolentiginous melanoma, mainly in people with dark skin (palms of the hands, soles of the feet, under the nails)

What are the symptoms of melanoma?

Melanoma appears as a mole, but with specific characteristics:

• a lesion that appears asymmetrical;
• a lesion with irregular edges;
• a lesion whose color is not homogeneous, with different shades;
• a large lesion with a diameter greater than 6 millimeters;
• “A lesion whose recent evolution has been altered with an increase in size, change in color, appearing more raised on a new-emergent lesion”explains Dr. Michael Naouri, dermatologist.

These criteria are easily memorized by the ABCDE rule: (Asymmetry, Edges, Color, Diameter, Evolution). “It is also recommended to consult when a mole is different from the others. It’s here ugly duckling theory‘ “recommends the dermatologist.

Diagnosis aims to confirm the presence of melanoma and to identify its type and stage. “For this, a excision of the lesion is done”, explains the specialist. This sampling is performed under local anesthesia, usually in less than half an hour at the dermatologist’s office. The result is then sent to the pathologist (doctor specializing in tissue analysis) who will study this sample by analyzing its cellular composition, confirming the melanocytic nature of the lesion. He will also look for its thickness and depth. If the diagnosis of melanoma is confirmed and according to its evolutionary stage classified by the pathologist, other examinations in search of damage to lymph nodes or other organs will be carried out.

What are the treatments for melanoma?

Treatment varies depending on the stage of the melanoma and the patient’s medical condition. Surgery is done to remove the melanoma. Monitoring of the skin will then be necessary on a regular basis for life. A drug treatment (interferon alpha or a chemotherapy classic, one or more targeted therapies or one or more monoclonal antibodies in clinical trials) can be associated with surgery. In some situations, a external radiation therapy can also be used as an adjuvant treatment (i.e. in addition to surgery and/or drug treatments). the course of treatment is carefully planned by the medical team depending on each situation. The doctor following you gives you a calendar that determines the place and days of treatmentas well as the names of the drugs used.

As long as the tumor is located within the epidermis, we speak of “melanoma in situ”. If the melanoma is removed at this stage, there is no risk of metastatic progression. When the melanoma is metastatic it means that it has spread beyond the initial area. Of the cancer cells can then break away from the tumor and travel through lymphatic vessels and blood vessels to invade other parts of the body (ganglia, lymphatic channels, lungs, liver…). The medical team will then decide on the most appropriate treatment, which may be chemotherapy, surgery, radiotherapy or immunotherapy.

To prevent the appearance of melanoma, it is essential to limit exposure to the sun, especially when the skin is very fair. The use of a sun cream with a high protective factor is recommended. In subjects at risk, monitoring by the patient for changes in moles is recommended.

Thanks to Dr. Michael Naouri, dermatologist. Source: Treatments for skin melanoma, Cancer Info, 2016.