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Melanoma

Melanoma is a serious skin cancer, which is curable if detected early. Melanoma grows from pigment cells (melanocytes) in the outer layer of the skin (epidermis). Melanomas usually start as a skin lesion and tend to spread out within the epidermis before moving into the deeper layer of the skin (the dermis).

 

As many as 90% of melanomas are estimated to be caused by UV exposure. In its early stages, melanoma can be successfully removed and monitored by regular skin screenings. In fact, survival rates can exceed 90 to 95 percent in early stage melanoma.

Prevention, protection and early detection are absolutely essential.

✓ PREVENTION means limiting exposure to UV radiation. This includes UV from sunlight and artificial sources, such as tanning beds.

✓ PROTECTION means wearing sun protective clothing and a broadband sunscreen with an SPF of 30 or higher, while also seeking shade when possible.

✓ EARLY DETECTION means doing self-screenings and visiting your doctor for your annual skin check. Who Can Get Melanoma? Melanoma can occur in adults of any age. Anyone can get it. Early detection is key, so it is important to take time to look at the moles on your skin. When checking your skin, you should know the signs and symptoms of melanoma.

 

The most common early signs of melanoma are:

  • A mole that is growing
  • An Unusual looking mole (one that does not look like any other mole on your skin)
  • A mole with an uneven border, blurred border, odd shape and different colors

 

In the early stages, melanoma may not cause any symptoms, however, you may develop

  • Itching
  • Bleeding
  • Pain

 

These characteristics are used by dermatologists to classify melanomas. Look for these signs: Asymmetry, irregular Borders, more than one or uneven distribution of Color, or a large (greater than 6mm) Diameter. Finally, pay attention to the Evolution of your moles – know what’s normal for your skin and check it regularly for changes. The Evolution of your mole(s) has become the most important factor to consider when it comes to diagnosing a melanoma. If you see one or more of these signs, make an appointment with your dermatologist immediately.

The first signs can appear in one or more atypical moles and not all melanomas fall within the ABCDE melanoma guidelines. All suspicious moles or lesions should be brought to the attention of your dermatologist immediately. (insert pictures) It is important to note that these pictures should only be used as a guide/reference point.

A – Asymmetrical Shape
Melanoma lesions are often irregular, or not symmetrical, in shape. Benign moles are usually symmetrical.

B – Border
Typically, non-cancerous moles have smooth, even borders. Melanoma lesions usually have irregular borders that are difficult to define.

C – Color
The presence of more than one color (blue, black, brown, tan, etc.) or the uneven distribution of color can sometimes be a warning sign of melanoma. Benign moles are usually a single shade of brown or tan.

D – Diameter
Melanoma lesions are often greater than 6 millimeters in diameter (approximately the size of a pencil eraser).

 

These are examples of they types of treatment available for melanoma. Based on your personal history, pathology report, and stage at diagnosis, your doctor may recommend one or more of the following:

  • Surgery-Surgery is the mainstay of therapy for early stage melanoma and for the resection of an isolated metastatic melanoma site. There are several different types of surgeries. READ ON to learn about MOHS Surgery and additional surgical options.
  • Clinical Trials-Clinical trials are research studies to test promising new or experimental cancer treatments. There are hundreds of clinical trials happening at any given time, and most experts agree that for a late-stage diagnosis, clinical trials are the best treatment option.
  • Immunotherapy-Immunotherapy is a type of systemic therapy used in the treatment of melanoma at high risk for recurrence and metastases.
  • Targeted Therapy-Targeted therapy is a type of therapy where drugs (or other substances) “target” the abnormal aspects of tumor cells without harming normal cells. Several targeted therapies have been approved for use in treating various cancers, and this approach is now being evaluated in melanoma.
  • Chemotherapy-Chemotherapy is a type of systemic therapy intended to destroy melanoma cells throughout the body. Chemotherapy has shown limited success in the treatment of melanoma. Each case is unique – your doctor will want to review your full pathology report and your medical history with you when discussing treatment, to determine the best course of action.

 

Surgery is the mainstay of therapy for early- stage melanoma and for the removal, or resection, of a diagnosed melanoma. Skin biopsy techniques and sentinel lymph node biopsies are first-line surgical procedures used in diagnosing melanoma; once diagnosed, many other types of surgery are employed when appropriate.

Types of Surgery: The initial biopsy may be performed by a dermatologist or dermatologic surgeon. Surgery to remove melanoma may be performed by a surgical oncologist, a plastic surgeon, a head-and-neck surgeon or by a combination of these specialists, using the following techniques:

  • Simple Excision: thin melanomas are removed along with a small amount of non-cancerous skin at the edges.
  • Mohs Surgery: a small section of apparently normal skin beyond the visible melanoma is removed and looked at under a microscope. If abnormal cells are identified, another small section is removed and this process continues until the cells removed no longer look abnormal. Dr. Richard Asarch and Dr. Adam Asarch have successfully performed over 30,000 Mohs Surgery Procedures for skin cancer removal.
  • Wide Local Excision: this excision is used to decrease the chance of local recurrence. A wide excision, usually 1-2 cm, is made around the original melanoma site, and the tissue is sent to the pathologist for evaluation.
  • Sentinel Lymph Node Biopsy: a radioactive tracer and dye are injected into the site of the primary melanoma to “drain” the lymph node basin. They are then examined under a microscope to determine if there are any melanoma cells detected.

The Asarch Center values each and every patient. Our team of medical experts receive specialized training in their respective fields to provide our patients with the most up to date treatments, procedures and the highest standard of care.

 

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