CUTANEOUS MELANOMA
Cutaneous melanoma is a type of skin cancer that can spread to other organs in the body. It originates from the malignant transformation of melanocytes, cells that produce melanin, the substance responsible for the color of the skin and its tanning. Melanin protects the skin from sun damage. Normally, melanocytes can form moles (nevi), which range from reddish to dark brown.
In recent years, the incidence of melanoma has increased significantly, with over 12,000 new cases diagnosed annually in Italy, about 60% of which are among men. Melanoma can develop on any part of the body, often presenting with an irregular shape and uneven color. It is essential to monitor changes in moles and report them to your doctor.
Symptoms
The first sign of melanoma is the appearance of a new mole or the change of an existing mole. Since melanoma can develop in areas that are not visible, it is important to periodically check the entire surface of the body. The characteristics to monitor are:
A: Asymmetry - one half of the mole is different from the other
B: Border - irregular, notched or blurred outline
C: Color - non-uniform color
D: Diameter - variation in size
E: Evolution - rapid changes in shape and color
Other signs include bleeding, itching, or the appearance of a lump or a reddened area around a mole.
Causes
Most skin cancers are caused by ultraviolet (UV) rays that damage the DNA of cells. The main source of UV rays is sunlight, but sunlamps and tanning beds also increase the risk. Frequent sunburns, especially in children, significantly increase the risk of melanoma. People with many moles, large or unusually shaped moles, or with family members affected by melanoma, are at higher risk.
Other risk factors include:
Fair complexion, rich in freckles and prone to sunburn
Red or blonde hair
Blue eyes
Advanced age
Weak immune system (for example, HIV infection or immunosuppressive therapies)
Exposure to chemicals such as creosote and arsenic
Diagnosis
It is recommended that every adult undergo a medical examination to monitor moles. In case of changes, it is important to consult your doctor and, if necessary, a specialist. The dermatologist or oncologist may recommend the removal of the suspicious mole for a histological examination.
There are four main types of cutaneous melanoma:
Superficial spreading melanoma (70% of cases)
Lentigo maligna
Acral lentiginous melanoma
Nodular melanoma (more aggressive but less frequent)
Therapy
The initial treatment for melanoma is surgical. If the melanoma recurs, new therapies are available. The choice of treatment depends on the type of cancer, the stage of the tumor, and the patient's health status.
The staging of melanoma is fundamental to determine the treatment. The stages are:
Stage I and II: no metastases are present
Stage III: metastases in regional lymph nodes
Stage IV: distant metastases
Active surveillance and innovative therapies
For early stages, active surveillance consists of careful monitoring without immediate post-surgery treatment. For advanced stages, new therapies such as targeted therapies and immunotherapy are available. These have brought significant benefits, although they may have serious side effects.
Gender aspects
Gender differences influence the incidence, prognosis, and response to therapies for melanoma. Men are at higher risk of disease progression and mortality. However, men with advanced melanoma respond better to immunotherapy compared to women, who may experience side effects more frequently.
Conclusion
In general, sex and gender represent a valid indicator to consider in the prevention and choice of therapies for melanoma.