MELANOMA
Cutaneous Melanoma: Causes, Symptoms, and Treatment
What is 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, which are cells responsible for producing melanin—the pigment that gives skin its colour and enables tanning. Melanin helps protect the skin from sun damage. Normally, melanocytes can form moles (nevi), which vary in colour from reddish to dark brown.
In recent years, the incidence of melanoma has risen significantly, with over 12,000 new cases diagnosed annually in Italy, around 60% of which are among men. Melanoma can develop anywhere on the body, often appearing as an irregularly shaped and unevenly coloured lesion. It is essential to monitor any changes in moles and report them to your healthcare provider.
Symptoms of Melanoma
The first warning sign of melanoma is the appearance of a new mole or changes to an existing one. Since melanoma can develop in less visible areas, it is crucial to regularly check the entire surface of your skin. Key features to look out for include:
A: Asymmetry – one half of the mole is unlike the other.
B: Border – irregular, notched, or blurred edges.
C: Colour – uneven or varied shades.
D: Diameter – changes in size.
E: Evolution – rapid changes in shape or colour.
Other signs may include bleeding, itching, or the development of a lump or red area around a mole.
Causes of Melanoma
Most skin cancers are caused by ultraviolet (UV) rays that damage the DNA in skin cells. The primary source of UV rays is sunlight, but sunbeds and tanning lamps also increase the risk. Frequent sunburn, especially in childhood, significantly raises the risk of melanoma. People with numerous or large moles, or those with a family history of melanoma, are at higher risk.
Other risk factors include:
Fair skin with freckles and a tendency to burn.
Red or blonde hair.
Blue eyes.
Advanced age.
A weakened immune system (e.g., HIV infection or immunosuppressive therapy).
Exposure to chemicals like creosote and arsenic.
Diagnosis of Melanoma
It is advisable for all adults to undergo regular medical check-ups to monitor their moles. If changes are noticed, it is essential to consult your healthcare provider and, if necessary, a specialist. A dermatologist or oncologist may recommend removing a suspicious mole for 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 common).
Melanoma Treatment
The primary treatment for melanoma is surgery. If the melanoma recurs, new therapies are available. The choice of treatment depends on the type of cancer, the stage of the tumour, and the patient’s overall health.
Staging melanoma is crucial for determining the course of treatment. The stages include:
Stage I and II: No metastasis.
Stage III: Regional lymph node metastasis.
Stage IV: Distant metastasis.
Active Surveillance and Innovative Therapies
For early-stage melanoma, active surveillance involves careful monitoring without immediate post-surgical treatment. For advanced stages, new therapies such as targeted therapy and immunotherapy are available, which have shown significant benefits, although they can also have serious side effects.
Gender Considerations
Gender differences impact the incidence, prognosis, and response to melanoma treatments. Men are at higher risk of disease progression and mortality. However, men with advanced melanoma tend to respond better to immunotherapy than women, who may experience more frequent side effects.
Conclusion
Overall, gender is a critical factor to consider in melanoma prevention and treatment choices.
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