What is Melanoma? The most serious type of skin cancer is known as melanoma. It originates in the skin cells that make melanin, which gives skin its pigment and protects the deeper layers of skin from the sun’s damaging ultraviolet (UV) rays. These cells are called melanocytes. The melanocytes produce more melanin and cause the skin to tan when time is spent in the sunlight.

The melanocytes may start to grow abnormally and can become cancerous if the skin obtains too much ultraviolet light. This condition is commonly known as skin cancer or melanoma.The same effect occurs when the skin is exposed to other forms of ultraviolet light such as a tanning bed. According to Diffey’s article (2007) there have been several studies since the 1980’s that have examined the association of sunbed use with malignant melanoma and where case-control studies, particularly more recent ones, have generally found a positive association between the use of sunbeds and melanoma. Where and What to Look For? A change in the size, shape, or color of a mole is usually the first indicator of melanoma. However, melanoma is also capable of surfacing on the body as a new mole.It can appear anywhere on the skin, but in women, melanoma commonly appears on the lower legs. In men, it typically develops on the upper body, in the head and neck region, and between the shoulders and hips.

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People with darker skin may develop melanoma on the palms of the hands, under the fingernails or toenails, and on the soles of the feet. It is important to frequently perform skin self-examinations to check for new moles or changes in moles because these may be the most common places for melanomas to appear, but they can develop anywhere on the skins surface.The chances of recovery are immense with early diagnosis and treatment. Sun Exposure in Childhood As you age the risk of acquiring melanoma increases, but the development of melanoma can happen at any age. One of the most common forms of cancer in young adults is melanoma. In Oliveria et al. ’s (2006) article review conducted using Medline to identify articles linking sun exposure and melanoma the findings indicated an increased risk in individuals who spent their childhoods in sunny geographical locations. Being exposed early on in childhood can make you a higher risk when you get older.

Chances of Recovery Are Good With Early Detection More than 50,000 people in the U. S. discover that they have melanoma each year. It is an acute form of cancer and sometimes life-threatening. The odds of recovery are exceedingly good if the melanoma is found and treated in its early stages. However, if it is not detected early on it is capable of growing deeper into the skin and dispersing to other parts of the body. This is identified as metastasis.

After melanoma has spread further than the skin to additional parts of the body it is arduous to treat. The Diagnosis of MelanomaMelanomas are usually different in appearance from common moles. A skin self-examination is a preeminent way to uncover any suspicious moles located on the body. Any moles that have grown, changed color or shape should be reported to a doctor.

The doctor will refer a dermatologist (a physician specializing in skin diseases) if the mole is irregular to perform a biopsy. The dermatologist will remove diminutive piece of the mole or the entire mole for a pathologist (a physician who examines biopsies to determine the cause of disease) to examine under a microscope for cancerous cells.If a mole proves to be melanoma the dermatologist can uncover more about the disease based on how thick the tumor is as well as how far it may have spread (as cited in Woodall at al. , 2009). This is a process that is known as staging. Staging the melanoma is a crucial step because the selection of treatment has a large amount to do with the stage of the melanoma. A dermatologist or surgeon will remove the entire tumor as well as some surrounding skin to detect how thick it is.Another procedure called a sentinel lymph node (SLN) biopsy may be done at the same time or in a later step to determine if the melanoma has spread to nearby lymph nodes.

If tests reveal that is has in fact spread to the lymph nodes, they will be surgically removed to insure that the cancer does not spread further. Additional testing such as CT (computed tomography), chest x-rays, PET scan (positron emission tomography scan), blood tests, and MRI (magnetic resonance imaging) may possibly play a role in staging as well to determine if the melanoma has spread to any other organs in close proximity.Once all traces of the tumor have been removed an oncologist (cancer specialist) may prescribe supplementary treatment if the melanoma has spread or if there is a possibility that it might return. These treatments are referred to as adjuvant treatments and include immunotherapy, chemotherapy, and radiation therapy. Treatment of Melanoma Surgery alone may be the only treatment needed for early-stage melanoma. Three factors determine the treatment for melanoma such as, the general health of the person, the stage of the disease, and the age of the person.

For all stages of melanoma (IA through IV), surgery is the first method of treatment. The entire tumor is removed as well as surrounding tissue (3/4 of an inch all around). As part of the diagnosis process a surgeon or a dermatologist may perform surgery. A skin graft might be needed in some cases to replace skin that has been removed. Nearby lymph nodes may also be removed surgically if they have also been affected by the melanoma. For people with early-stage melanoma that has not yet spread to the lymph nodes surgery is typically the only treatment necessary.To make certain that the melanoma has not returned and that additional moles do not need biopsies regular follow-up visits to the doctor are imperative. The risk of melanoma returning is higher once a person has already had it.

For later-stage melanomas that have spread to the lymph nodes additional adjuvant treatments such as radiation therapy, chemotherapy, or immunotherapy are vital. Melanoma that has spread to organs such as the lungs or liver, or to other isolated locations inside the body is identified as Stage IV. Treatment options such as clinical trials may be available for these patients.Talking to a Physician Once a person has been diagnosed with melanoma they will have a great number of questions and consternations. It is essential for them to seek a healthcare team with whom they can openly discuss their concerns, take the time to clarify things that they do not comprehend, and articulate in a way that they can understand. There are a few things that a person can do that may be of assistance when going to a doctor’s appointment for the first time. It is very helpful to bring a trusted family member or friend along to help take note of what the doctor says so that they don’t have to be oncerned with trying to remember details after the fact.

Take a tape recorder and ask the doctor if the conversation may be recorded to help remember key concerns later. Also, put any questions in writing before going to the doctor’s office to take along. Preventing Melanoma Making certain that skin is well protected when out in the sun as well as reducing the amount of time spent in the sun are the best ways to prevent melanoma. Be cautious of specific times of the day that the skin is exposed as the sun’s ultraviolet rays can be more intense at certain times.Childhood is a significant time for sun protection. Some types of skin cancer can be reduced by protecting the skin during the first eighteen years of life. Performing skin self-examinations every six to eight weeks is another important step in melanoma prevention. This makes certain that suspicious moles will be detected early on.

Can The Prevention of Melanoma cause Vitamin D-Deficiency? While UV protection is important to prevent melanoma skin cancer it also has to be noted that according to Reichrath’s article (2009) vitamin D-mediated positive effects of UV light are not adequately considered.Most public health campaigns propose a strict “no sun policy” without giving recommendations about how to prevent vitamin D-deficiency. Approximately 90% of all vitamin D needed by the human body has to be formed in the skin through the action of UV-B radiation and it has been shown that strict sun protection causes vitamin D-deficiency. This dilemma represents a considerable problem for a group of vitamin D-deficiency and multiple independent diseases such as various types of cancer, bone diseases, autoimmune disease, infectious diseases, cardiovascular disease, and hypertension.Although further work is necessary, it is at present mandatory that guidelines for UV-exposure (e.

g. skin cancer prevention campaigns) take into account these facts and give recommendations how to prevent vitamin D-deficiency. These recommendations will hopefully protect us against vitamin D-deficiency without increasing the risk to develop UV-induced skin cancer. Childhood is a significant time for sun protection. Some types of skin cancer can be reduced by protecting the skin during the first eighteen years of life. Performing skin self-examinations every six to eight weeks is another important step in melanoma prevention.This makes certain that suspicious moles will be detected early on. The North vs.

The South It is common knowledge that sun exposure is known to cause melanoma, but what is not known is whether patients from the Southern United States have a different profile of clinicopathologic factors and outcomes than those from the Northern United States in Woodall et al. ’s (2009) article reviewing the differences in melanoma according to geographic location. In Information from a probable, randomized trial on surgery for cutaneous melanoma was analyzed. The patients were put into two groups: Northern or Southern depending on their state of residence.A total of 2,025 patients were included in the analysis; 1,214 (60%) from the Southern states. It was determined that significant differences exist between primary melanoma based on geographic regions, but there was no difference in survival. It is thought that cumulative versus sporadic sun exposure may play a role in these differences.

Living with Melanoma Most people living with melanoma find that it is a challenge. Many find that they need help dealing with the side effects of treatment, the after-effects of surgery and the fear of the cancer returning.Anyone that is having difficulty with these types of issues and concerns should consider talking with one of their health care experts about joining a support group. There are cancer support groups available for those people who have overcome cancer and need to talk with other people who understand what they are going through. These groups help survivors learn how to cope with melanoma and its treatments from others.

A member of the clergy, a counselor, or a social worker could also be of help. Fears and concerns about such things as caring for family members, keeping a job, or continuing with daily activities is expected.For example, a social worker might recommend a few resources for emotional support, home care, transportation, of financial aid. Each individual has a setting that is comfortable for communication needs. The key in the aid of confronting the challenges of melanoma is knowledge. Information is beneficial to know what to expect before, during, and after treatment, and how to tackle it. ? References Diffey, B.

(2007, August). Sunbeds, beauty and melanoma. British Journal of Dermatology, pp.

215-216. doi:10. 1111/j. 1365-2133. 2007.

07960. x. Oliveria, S. , Saraiya, M. , Geller, A. , Heneghan, M. , & Jorgensen, C. (2006).

Sun exposure and risk of melanoma. Archives of Disease in Childhood, 91(2), 131-138 Reichrath, J. (2009). Skin cancer prevention and UV-protection: how to avoid vitamin D- defiency? British Journal of Dermatology,16154-6, doi:10. 1111/j. 1365-2133. 2009. 09450.

x Thompson, J. F. , Morton, D. L.

(Eds. ). (2004).

Textbook of Melanoma: Pathology, Diagnosis and Management. Kentucky: Independence. Woodall, C. , Martin, R. , Stromberg, A. , Ginter, B.

, Burton, A. , Ross, M. , et al. (2009). Do Melanoma Patients from Southern Climates Have a Worse Outcome Than Those from Northern Climates?.

American Surgeon, 75(8), 687-692.



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