Melanoma - what is it? Symptoms, stages, treatment. Skin melanoma: life forecasts, photos of the initial stage, symptoms and signs, diagnosis and treatment Initial signs of melanoma

Until about 40 years ago, skin melanoma was a relatively rare disease. However, in recent decades, its frequency has increased significantly, and the annual growth rate is up to 5%. Why is melanoma dangerous?

Causes of development and risk factors

Melanoma is one of the types of skin malignant neoplasms that develops from pigment cells - melanocytes that produce melanins, and is characterized by an aggressive, often unpredictable and variable clinical course.

Its most frequent localization is the skin, much less often the mucous membrane of the eyes, nasal cavity, mouth, larynx, skin of the external auditory canal, anus, and female external genitalia. This tumor is one of the most severe forms of cancer that disproportionately affects young people (15-40 years old) and ranks 6th among all malignant tumors in men and 2nd in women (after cervical cancer) .

It can develop on its own, but more often it “masks” against the background of birthmarks, which does not cause concern in people and creates significant difficulties for doctors in terms of its earliest diagnosis. In how quickly this neoplasm develops and is difficult to detect in the initial stages, there is another danger that often interferes with timely diagnosis. Already within 1 year, it spreads (metastasizes) to the lymph nodes, and soon through the lymphatic and blood vessels, in almost all organs - bones, brain, liver, lungs.

Video: The simplest test for skin cancer

The reasons

The main modern theory of the origin and mechanism of development of melanoma is molecular genetic. In accordance with it, DNA damage occurs in normal cells by the type of gene mutations, changes in the number of genes, chromosomal rearrangements (aberrations), violations of chromosomal integrity, and the DNA enzyme system. Such cells become capable of tumor growth, unlimited reproduction and rapid metastasis.

Such disorders are caused or provoked by damaging risk factors of an exogenous or endogenous nature, as well as their combined effects.

Exogenous risk factors

These include chemical, physical or biological environmental agents that have a direct effect on the skin.

Physical risk factors:

1. Ultraviolet spectrum of solar radiation. Its connection with the occurrence of melanoma is paradoxical: the latter occurs mainly on areas of the body covered by clothing. This indicates the development of a neoplasm not so much as a result of a direct, but rather an indirect effect of UV radiation on the body as a whole. In addition, it is not so much the duration as the intensity of exposure that matters. In recent years, the scientific literature has drawn attention to the particularly high risk of sunburn - even received in childhood and adolescence, at an older age they can play a significant role in the development of the disease.
2. Increased background of ionizing radiation.
3. Electromagnetic radiation - the tumor is more common among people professionally associated with telecommunications equipment and the electronics industry.
4. Mechanical trauma to birthmarks, regardless of its multiplicity, is a high risk. It is not completely clear whether it is the cause or the trigger, but this factor accompanies 30-85% of melanoma cases.

Chemical Factors

They are important mainly among those working in the petrochemical, coal or pharmaceutical industries, as well as in the production of rubber, plastics, vinyl and polyvinyl chloride, aromatic dyes.

Of the biological factors, the most important are:

1. Features of nutrition. High daily intake of animal proteins and fats, low consumption of fresh fruits and vegetables high in vitamins “A” and “C” and some other bioactive substances are a risk in terms of developing superficially spreading and nodular (nodular) forms of melanoma, and also tumors of unclassified type of growth.

   With regard to the systematic use of alcoholic beverages, the possibility of provoking the growth of melanomas is theoretically assumed, but there is no practical evidence for this. The absence of a connection between the use of drinks containing caffeine (strong tea, coffee) and malignant neoplasms has been accurately proven. Therefore, nutrition for skin melanoma should be balanced mainly due to plant products, especially fruits and vegetables, and contain a rich amount of vitamins and antioxidants (blueberries, green tea, apricots, etc.).

2. Taking oral contraceptives, as well as estrogenic drugs prescribed to treat menstrual disorders and autonomic disorders associated with menopause. Their influence on the development of melanoma is still only an assumption, since there is no clear relationship.

Video: How melanoma develops

Endogenous risk factors

They are divided into two groups, one of which is made up of factors that are a biological feature of the body:

• low degree of pigmentation - white skin, blue and light eyes, red or light hair color, a large number of freckles, especially pink ones, or a tendency to their occurrence;
• hereditary (family) predisposition - it is mainly the disease of melanoma in parents that matters; the risk increases if the mother was sick or there were more than two people with melanoma in the family;
• anthropometric data - a higher risk of its development in people with a skin area of ​​more than 1.86 m 2;
• endocrine disorders - a high content of sex hormones, especially estrogen, and melanostimulating hormone (melatonin), produced in the middle and intermediate lobes of the pituitary gland; a decrease in their production after the age of 50 coincides with a decrease in the incidence of melanoma, although some authors, on the contrary, indicate an increase in its frequency at an older age;
• state of immunodeficiency;
• pregnancy and lactation, stimulating the transformation of pigmented nevi into melanoma; this is predominantly for women with a late first pregnancy (after the age of 31), and pregnancy with a large fetus.

The second group is nevi, which are skin changes of a pathological nature and are characterized by the maximum degree of probability of degeneration into melanoma, as well as being its precursors. These are benign formations consisting of pigment cells (melanocytes) of varying degrees of maturity (differentiation), located in different numbers in different layers of the skin. A congenital nevus is called a birthmark, but in everyday life all formations of this type (congenital and acquired) are called birthmarks. The greatest risks are:

• black or dark brown pigmented nevi measuring 15 mm or more;
• the presence of 50 or more of these formations of any size;
• Dubreuil's melanosis - is a small, slowly increasing over the years, brown spot with irregular contours, which is usually localized on the face, hands, on the skin of the chest, less often on the oral mucosa;
• skin pigment xeroderma, characterized by high sensitivity to sunlight; this is a hereditary disease that is transmitted to children only if there are specific DNA changes in both parents; these changes lead to a lack of cells' ability to recover from damage by ultraviolet radiation.

How to distinguish a mole from melanoma?

The real frequency of development of the last of the nevus has not been elucidated. The types of nevus with the highest risk were established: complex type - 45%, borderline - 34%, intradermal - 16%, blue nevus - 3.2%; giant pigmented - 2-13%. At the same time, congenital formations account for 70%, acquired - 30%.

melanoma symptoms

At the initial stages of the development of a malignant tumor on healthy skin, and even more so against the background of a nevus, there are few obvious visual differences between them. Benign birthmarks are characterized by:

1. Symmetrical shape.
2. Smooth smooth outlines.
3. Uniform pigmentation, giving the formation a color from yellow to brown and even sometimes black.
4. A flat surface that is flush with the surface of the surrounding skin or slightly evenly elevated above it.
5. No increase in size or little growth for a long time.

Each "birthmark" goes through the following stages of development:

1. Border nevus, which is a spotted formation, the nests of cells of which are located in the epidermal layer.
2. Mixed nevus - cell nests migrate into the dermis over the entire spot area; clinically, such an element is a papular formation.
3. Intradermal nevus - formation cells completely disappear from the epidermal layer and remain only in the dermis; Gradually, the formation loses pigmentation and undergoes reverse development (involution).

What does melanoma look like?

It may have the form of a flat pigmented or non-pigmented spot with a slight elevation, rounded, polygonal, oval or irregular in shape with a diameter of more than 6 mm. It can maintain a smooth, shiny surface for a long time, on which small ulcerations, irregularities, and bleeding occur in the future with minor trauma.

Pigmentation is often uneven, but more intense in the central part, sometimes with a characteristic black rim around the base. The color of the entire neoplasm can be brown, black with a bluish tint, purple, motley in the form of individual unevenly distributed spots.

In some cases, it takes the form of overgrown papillomas, resembling a "cauliflower", or the shape of a mushroom on a wide base or on a stalk. Near the melanoma sometimes there are additional separate or merging with the main tumor foci (“satellites”). Occasionally, the tumor is manifested by limited redness, which turns into a permanent ulcer, the bottom of which is filled with growths. When developing against the background of a birthmark, a malignant tumor can develop on its periphery, forming an asymmetric formation.

A sufficient understanding of the population about what are the initial signs of melanoma, to a large extent contributes to its timely (in the initial stages) and effective treatment.

Video: How to recognize melanoma?

Stages of development of a malignant tumor:

• Initial, or local (in situ), limited;
• I - melanoma 1 mm thick with a damaged surface (ulceration) or 2 mm - with an undamaged one;
• II - thickness up to 2 mm with a damaged surface or more than 2 mm (up to 4 mm) with a smooth surface;
• III - a tumor with any surface and thickness, but with nearby foci or metastases to at least one "on duty" (closely located) lymph node;
• IV - germination of the tumor in the underlying tissues, distant skin areas, metastases to distant lymph nodes, lungs or other organs - the brain, bones, liver, etc.

Of great importance is the knowledge of reliable and significant symptoms of the transition of benign formations into an active state. How to recognize a malignant formation and the moment of transformation of a birthmark into it? The early signs are:

1. An increase in planar dimensions to that unchanged or very slowly growing mole, or the rapid growth of a newly emerging nevus.
2. Changing the shape or outline of an already existing formation. The occurrence in any of its areas of seals or asymmetry of contours.
3. Change in color or the disappearance of the uniformity of color of an existing or acquired "birthmark" spot.
4. Change in intensity (increase or decrease) of pigmentation.
5. The appearance of unusual sensations - itching, tingling, burning, "bursting".
6. The appearance of redness around the birthmark in the form of a corolla.
7. The disappearance of hair from the surface of the formation, if any, the disappearance of the skin pattern.
8. The appearance of cracks, peeling and bleeding with minor injuries (light friction with clothing) or even without them, as well as growths by type.

The presence of one of these symptoms, and even more so their combination, is a reason for the patient to contact a specialized oncological treatment and preventive institution for differential diagnosis and the solution of the question of how to treat melanoma, which depends on its type and stage of development.

Diagnostics

Diagnosis of a malignant tumor is carried out mainly through:

1. Familiarization with the patient's complaints, clarification of the nature of the changes in the "suspicious" formation, its visual examination, examination of the entire patient in order to count the number of birthmarks, highlight the different ones among them and further study them.
2. Conducting general clinical blood and urine tests.
3. , allowing to examine in the skin layers, enlarged several tens of times (from 10 to 40), a neoplasm and make a fairly accurate conclusion about its nature and boundaries according to the relevant diagnostic criteria.
4. Ultrasound examination of the abdominal organs, computed and magnetic resonance imaging of the spinal cord and brain, X-ray of the chest organs, which allow to determine the spread and presence of metastases in other organs.
5. Cytological examination of a smear (in the presence of ulceration) and/or material obtained by puncture of the lymph node (in rare cases). Sometimes a study of punctate from an enlarged lymph node makes it possible to diagnose the presence of a disease in the apparent absence of a primary tumor.
6. Excisional biopsy, the meaning of which is to excise a formation that is "suspicious" for a malignant tumor (within 0.2-1 cm outward from the edges) with subsequent urgent histological examination. Upon confirmation of the diagnosis of melanoma, its further radical removal is immediately carried out. Such diagnosis is carried out in cases where all other results of preliminary studies have remained doubtful.

Some types of melanoma

There are many types of melanoma, depending on the cellular composition and pattern of growth. This classification is explained by the fact that different forms have a different tendency to local spread and metastasis rate. It allows the oncologist to navigate the choice of treatment tactics.

Achromatic or pigmentless melanoma

It occurs much less frequently than other species and is difficult to diagnose due to the fact that it has the color of normal skin and is noticed by patients already in the later stages of development. Its formation begins with a small compaction, which, as it increases, is covered with small-lamellar epithelial scales and acquires a rough surface.

Sometimes this neoplasm looks like a scar with uneven edges, sometimes it is scalloped, pink or whitish in color. The appearance of an inflammatory corolla is accompanied by swelling, itching, sometimes hair loss and sores. Can non-pigmented melanoma be cured? This form of the disease is very dangerous due to late detection, a tendency to aggressive growth and very rapid, in the early stages, metastasis. Therefore, at stage I, effective treatment is still possible; at later stages of the disease, even after intensive radical treatment, tumor recurrence or metastasis occurs.

Spindle cell melanoma

Received such a name in connection with the characteristic shape of cells, determined by histological or cytological examination. They look like a spindle and are located separately from each other. Intertwined with cytoplasmic processes of various lengths, which sometimes extend over considerable distances, tumor cells form strands, clusters, and bundles.

The shape of the nuclei and their number in different cells are not the same: there may be cells with two or more elongated, oval, rounded nuclei. Melanin is concentrated mainly in the processes, due to which they acquire a granular, mottled appearance, which distinguishes them from a sarcoma or a tumor of the nervous tissue (neurinoma).

Due to the significant similarity with the cells of moles, cytological diagnosis often presents considerable difficulties.

Nodular or nodular melanoma

It occupies the 2nd place among those diagnosed and ranges from 15 to 30%. It occurs more often after the age of 50 in any part of the body, but usually on the lower extremities in women and on the trunk in men, often against the background of a nevus. In connection with vertical growth, it is one of the most aggressive and is characterized by a rapid course - 0.5-1.5 years.

This tumor is oval or round in shape and by the time the patient sees a doctor, as a rule, it already takes on the appearance of a plaque with clear boundaries and raised edges, black or unusually blue-black in color. Sometimes nodular melanoma reaches a considerable size or has the form of a polyp with a hyperkeratic or ulcerative surface.

subungual melanoma

A form of acral lentiginous tumor that affects the skin of the palms and feet. It accounts for 8-15% of all melanomas and is most often localized on the first finger or toe. The tumor often lacks a radial growth phase, which makes it difficult to diagnose in the early stages. Within 1-2 years, it spreads to the nail matrix and part or all of the nail plate, which becomes brown or black. Appearing papules and nodes are often devoid of pigment, so the disease at first does not attract the attention of the patient and lasts for months. In the future, ulcerations and growths of the mushroom type occur.

melanoma metastases

A malignant tumor resulting from atypical degeneration and reproduction of pigment cells (melanocytes). Most often affects the skin, but can also occur on the mucous membranes. It is characterized by the rapid spread of tumor cells throughout the body. Melanoma is diagnosed according to the study of a smear-imprint made from its surface. Histological confirmation of the diagnosis is made after removal of the formation. Treatment is carried out depending on the stage of melanoma and may consist of surgical excision of the formation, removal of lymph nodes, immunotherapy, radiation therapy and chemotherapy.

General information

Melanoma is a type of skin cancer. Melanoma accounts for 1-1.5% of all malignant neoplasms. According to the World Health Organization, about 48,000 people die of melanoma every year and the incidence is increasing. Most often, melanoma is diagnosed in patients living in southern countries in conditions of increased natural insolation. Mostly people over 30 years of age are susceptible to the disease, but individual cases of melanoma are also found in children. In various countries of the world, the incidence of skin melanoma varies from 5 to 30 people per 100,000 population.

Causes of melanoma

The risk of developing melanoma is increased in individuals with skin phototypes I and II. The development of the disease is most unlikely in people with dark skin and people of the Negroid race. The likelihood of melanoma is increased by a history of (even in early childhood) sunburn, excessive ultraviolet radiation, both natural and obtained in a solarium. There is a hereditary predisposition - the occurrence of the disease in persons with a family history of cases of melanoma. Scientists suggest that this is due to a genetically transmitted disruption in the work of suppressors that suppress tumor growth.

About 70% of cases of melanoma development occur as a result of malignant degeneration of pigmented nevi, which include: giant pigmented nevus, blue nevus, nevus of Ota, complex pigmented nevus, borderline nevus. With a high probability, xeroderma pigmentosa and Dubreuil's melanosis can also transform into melanoma. The factors that trigger the process of malignancy of a nevus or pigment formation include its trauma and increased insolation, hereditary and endocrine factors.

melanoma classification

When examining the formation, its edges, density, displacement relative to the surrounding tissues are evaluated. Dermoscopy of the formation and the surrounding skin is carried out. To detect melanoma metastases, other areas of the skin, as well as regional lymph nodes, are also examined. It is possible to conduct a radioisotope study. The patient takes the radiopharmaceutical on an empty stomach. Then, using radiometry, the accumulation of the isotope in the area of ​​education and in a healthy area of ​​​​the skin is assessed.

In the diagnosis of melanoma, a skin biopsy is categorically not used, since it can cause tumor growth and metastasis. The main diagnostic method is the detection of atypical melanocytes during a cytological examination of a smear-imprint taken from the surface of the formation. However, the final diagnosis of melanoma can only be made after a histological examination of the removed tumor.

Melanoma treatment

The choice of treatment for melanoma depends on the phase of its development, the prevalence of the process and the presence of metastasis. If treatment is started in the phase of horizontal growth of melanoma, then its surgical excision within healthy tissues is sufficient. When deep tumor invasion is detected, surgical treatment is combined with immunochemotherapy with alpha-interferon to prevent recurrence. Metastasis of melanoma to regional lymph nodes is an indication for their removal.

Identification of several melanomas requires the removal of all of them and additional chemotherapy, irradiation of affected skin areas, or a combination of these methods with immunotherapy. Patients with distant metastases of melanoma undergo palliative treatment: excision of large tumor foci that cause severe discomfort to the patient. In some cases, it is possible to perform operations to remove metastases from the internal organs. Radiation and chemotherapy are also performed.

Prediction and prevention of melanoma

Unfortunately, even with the current level of development of medicine, every third case of melanoma ends in a quick death. Approximately half of patients fail to prolong life beyond 5 years.

Prevention of melanoma consists in avoiding exposure to provoking factors and oncological alertness in relation to existing pigmented nevi. People with fair skin, especially those with phototypes I and II, should avoid excessive insolation and sunburn. It is important to limit exposure to ultraviolet rays on those areas of the skin where pigmented nevi are located. If there are sharp changes in the size, color or consistency of the nevus, you should consult a dermatologist or oncologist. Timely diagnosis and surgical excision of melanoma-dangerous skin formations and frequently injured nevi prevents their transformation into melanoma.

Melanoma is the most aggressive course. Signs of melanoma must be recognized at an early stage of their development, since in 73% of cases in advanced cases of this disease, a fatal outcome occurs.

What is skin melanoma?

This tumor develops from melanocyte pigment cells, which, under the influence of provoking factors, degenerate into cancerous ones. A neoplasm may well begin to form in fairly young people.

The main localization of melanoma is the skin, but this neoplasm can also grow in the mucous membranes - in the structures of the eye, in the vagina, rectum, and oral cavity. In most cases, a cancerous tumor of melanocytes is found on the limbs and face, and often it forms at the site of moles.

The picture shows the difference between melanoma and other benign neoplasms of the skin surface.

Melanoma is characterized by rapid germination deep into the skin and the development of metastases. under the influence of the spread of cancer cells by the hematogenous and lymphogenous pathways. Due to these features, melanoma is an aggressive malignant skin neoplasm.

Clinical types

Oncologists distinguish five types of melanomas, of which four are most common.

• Surface-propagating melanoma. This type of tumor begins to form on a nevus (mole) or against the background of the skin that has not been changed before. You can pay attention to the towering pigmented area with uneven edges and mostly irregular shape. The color of this type of melanoma is from light brown to black and blue. Sometimes in the center you can see blotches that differ in color. Gradually, the tumor thickens, transforms into a plaque, and then into a node, on the surface of which ulcerations appear. More women are diagnosed with this form of the disease, metastasis occurs in almost half of the cases.
• nodal melanoma is characterized by the most aggressive growth, on average, this form of the disease lasts from six months to 18 months. There is no horizontal formation of melanoma, it immediately begins to grow vertically. The surface of the resulting node quickly becomes thinner, easily injured and bleeding occurs. Ulcers gradually appear on the node, from which a yellowish exudate comes out, sometimes blood may be present in it. The color of the node varies from light pink to dark blue.
• Lentiginous melanoma. This form of the disease is also known as lentigo maligna or Hutchinson's freckle. Most often it is formed from a senile pigment spot, a birthmark, less often from an ordinary mole. This type of tumor is prone to formation in those parts of the body that are most exposed to solar ultraviolet radiation, such as the face, ears, neck, and hands. This melanoma develops in most ill people very slowly, sometimes it can take up to 30 years to the last stage of its development. Metastasis is rare, and there is evidence of resorption of this formation, so lentiginous melanoma is considered the most favorable skin cancer in terms of prognosis.
• Acral-lentiginous melanoma occurs predominantly in people with a dark skin tone. The formation is located on the palms, genitals, feet, eyelids, nail beds. This form of melanoma develops very quickly, characterized by the rapid spread of metastases. The tumor at the beginning is a spot with a brownish color, under the nail such a spot has a purple or bluish-red color. As the neoplasm progresses, it ulcerates, and if the nail is touched, it collapses.
• Pigmentless type of melanoma is very rare. The formation received a similar name due to the lack of color in it, which is due to the fact that a pathological disorder in melanocytes also leads to the destruction of the pigment. The growing tumor is pinkish or flesh-colored.

Reasons for the appearance

The main reason for the development of melanoma is a defect that develops in melanocytes. This defect leads to a change in the structure of cells and to their cancerous degeneration.

A variety of factors can provoke such a pathology, they are divided into exogenous and endogenous.

Exogenous risk factors

Exogenous provocative causes include those that have a damaging effect on skin cells from the external environment.

Physical reasons

Physical triggers:

• The most likely causes in this group include ultraviolet solar radiation. And more important is not the duration of exposure, but its intensity. There is evidence that even a sunburn received in childhood can later provoke a cancerous degeneration of melanocytes.
• Ionizing radiation.
• Electromagnetic radiation. It is noted that among patients with this disease there are many who, by virtue of their profession, are associated with electrical communications.
• Mechanical injury. Constant scratching, compression or other unfavorable change in moles contributes to their malignancy.

Chemical

The degeneration of melanocytes can be affected by external conditions detected in industries associated with the processing of oil, plastics, polyvinyl chloride, coal, dyes and paints. There is also an adverse effect of the pharmaceutical industry.

Biological

Biological triggers include:

• Certain diet. The risk of forming a melanocyte defect is increased in those people who constantly eat meals containing a large amount of animal fats and proteins. At the same time, there is not enough plant food in the diet of such people, which reduces the intake of vitamin A, which is so necessary for the skin.
• Use of oral contraceptives and medications needed to normalize the menstrual cycle. This provoking factor is just an assumption, since the exact relationship between skin cancer and hormonal drugs has not yet been established.

Endogenous

Melanoma is most often detected in people with certain biological characteristics, these include:

• Racial affiliation. Representatives of the Negroid race practically do not suffer from melanoma.
• The amount of pigment in the skin. People with light eyes, hair and correspondingly fair skin are most susceptible to ultraviolet rays. Most often, melanoma occurs in redheads, followed by blondes, and in third place is just all other people with a light skin tone.
• immune factors. Immunodeficiency states increase the risk of malignant neoplasms.
• endocrine factors. Hormonal imbalance can provoke the degeneration of melanocytes. That is why malignancy of nevi is often noted during pregnancy.
• Gender and age. Among patients with melanoma, there are more females, the peak of the disease occurs between the ages of 40 and 50 years.
• Precancerous skin diseases- Dubreu's melanosis, xeroderma, blue or giant nevus.

There is also a hereditary predisposition to the disease and a large number of patients with melanoma, prone to overweight.

Symptoms

The symptoms of the disease depend on the type of melanoma and its stage.

In the last stages, in addition to external signs, symptoms of a violation of the general condition of the body are also added, which is associated with its intoxication.

What does a malignant tumor look like?

Melanoma of the skin can manifest itself as a spot, nodule, plaque. At first, this is a small area, which is alarming only for its formation and color.

Melanoma often begins with moles or nevi. Its locations are mainly legs, arms, face, then comes the surface of the body, back. Melanoma grows not only upwards, but also in depth, its external dimensions can be more than 10 cm in diameter in some types of neoplasms.

What are the first signs of malignant transformation?

It is possible to understand that an abnormal degeneration of cells occurs in a mole or nevus by self-examination. The following changes most often indicate a malignant process:

• Rapid growth of a mole.
• Discoloration, the nevus may become discolored or darken to black.
• Tingling, burning in the area of ​​pigmentation, internal itching. These signs are signs of increased cell division.
• The appearance of an inflamed (red) rim around the spot.
• Ulceration of the surface of the mole, the appearance of exudate in it.
• The formation next to the primary spot of daughters, which indicates metastasis.
• Compaction of the mole and the appearance of uneven, jagged edges.

The photo clearly shows what the initial stage of a cancerous tumor on the skin looks like - melanoma

Even the fixation of one of the listed types of changes should be the reason for a quick appeal to an oncologist. Currently, all examinations are carried out instantly, and therefore the treatment in the early stages of melanoma is very effective.

Skin cancer stages and life prognosis

The stages of melanoma are of great importance in predicting the outcome of treatment. In total, there are five stages of such an oncological formation:

• initial stage exhibited when the process is organic only by the epidermis.
• First stage it is a melanoma having a thickness of 1 mm and an ulcerated surface. This stage also includes melanoma 2 mm thick, but without ulcers on the surface.
• Second stage- a tumor up to 2 mm with ulcers, or a tumor from 2 to 4 mm without damage.
• Third stage Any melanoma with metastasis to a lymph node.
• At the fourth stage melanoma grows into distant parts of the body, metastasizes not only to the lymph nodes, but also to the lungs, brain, bones.

The photo shows the late stage of malignant melanoma of the skin.

A positive outcome of treatment is possible in almost 99% of cases if melanoma is established at stages 1-2. In the third stage, recovery is noted only in half of the cases.

Methods of diagnostic examination

A doctor can suspect melanoma based on the patient's complaints and visual examination of the altered skin. To confirm the diagnosis is carried out:

• - Examination of the skin area under a special device. This examination helps to examine the edges of the spot, its germination in the epidermis, internal inclusions.
• – taking a sample of the tumor for histological examination.
• Ultrasound and are prescribed to detect metastases and to determine the stage of cancer.

If necessary, and to exclude other skin diseases, the doctor may prescribe a number of diagnostic procedures and blood tests. The effectiveness of their elimination largely depends on the accuracy of diagnosing melanomas.

How is it treated?

Identified melanoma is removed surgically. The most effective treatment is where the operation is combined with radiation exposure, which is necessary to prevent further metastasis.

Initially, several sessions of radiation therapy are usually prescribed, then an operation is performed, and after that several sessions are also used. During the operation, the tumor is removed with the capture of the surrounding tissue.

When melanoma is located on the fingers of the extremities, according to indications, their complete amputation is possible. With a generalized process, a systemic or regional one is assigned. Currently, immunotherapy is often additionally prescribed.

The most favorable outcome of combined treatment is observed if the patient seeks help in the early stages of the disease. Dispensary observation allows timely detection of a recurrence of the disease and a new course of therapy.

Diet food

A certain importance in the recovery of a person and the absence of relapses of the disease is also given to nutrition. The diet must be complete with a large amount of proteins, vitamins, and with the lowest content of animal fats. Minimize the need for dishes with flavorings and food additives.

• Fish rich in omega acids.
• Vegetables, fruits and juices from them.
• Foods with selenium - turkey, chicken breast, lamb and pork kidneys, lobsters, mussels, squid, low-fat homemade cheese.
• natural dairy products.
• Of the additives, kelp, wasabi sauce, turmeric, saffron, rosemary are recommended.
• Fresh herbs and fresh tomato dishes.
• Green tea, coffee is not prohibited, but no more than two cups per day.

It is necessary to eat in small portions, but often, and it is definitely recommended to monitor the regularity of bowel movements.

Preventive actions

Preventive measures to prevent cancerous growths on the skin consist in the least exposure to direct sunlight, especially for people with a light skin tone. It is also necessary to avoid injury to the skin and exposure to the body of chemicals, salts of heavy metals.

A healthy diet and the absence of bad habits are also of some importance in reducing the likelihood of cancerous tumors.

Video about the treatment of melanoma of the skin:

Skin cancer is a malignant tumor that develops from the cells of the epidermis (integumentary) skin cells.
Melanoma is an extremely malignant tumor of skin pigment cells.

Causes of Skin Cancer

The causes of skin cancer development can be divided into: exogenous and endogenous.

1. Exogenous factors (external).

Exposure to UV radiation (in particular, the UV spectrum of sunlight) is considered one of the most important exogenous factors in skin cancer. While chronic UV damage to the skin is important for the development of basal cell and squamous cell skin cancers, the risk of developing melanoma is greatest with occasional (perhaps even single) intense sun exposure. This position is confirmed by the fact that melanoma of the skin often occurs on areas of the body protected by clothing. It has been established that skin melanoma is more likely to occur in people who spend most of their time indoors, but are periodically exposed to intense UV exposure (outdoor recreation under the sun). While skin cancer occurs in unprotected areas. It is believed that the increase in the incidence of skin cancer to a certain extent
is associated with the destruction of the ozone layer, located in the stratosphere and retaining most of the UV rays.

An important and very common etiological factor in skin melanoma is trauma to pigmented nevi (bruises, abrasions and cuts).

There are reports of the possible etiological role of the rays of fluorescent lighting devices, chemical carcinogens, in particular hair dyes, as well as ionizing radiation and strong electromagnetic fields.

2. Endogenous factors.

Ethnic factors influence the incidence of skin cancer. The tumor is more common among fair-skinned people, and it occurs less frequently in blacks.

Most often, skin cancer and melanoma occur in individuals with a small amount of pigment in the tissues (ie, with fair skin, hair, eyes), which is combined with increased sensitivity to UV rays. When skin and hair color are adjusted, the risk of developing cancer is 1.6 times higher for blondes, 2 times for fair-skinned people, and 3 times for redheads.

In recent years, more and more importance in the occurrence of skin cancer is attached to the immune factors of the body. Immunosuppression and immunodeficiency states of the body increase the risk of the disease. In addition, endocrine factors play a role. In particular, it has been found that pregnancy can
have a stimulating effect on the degeneration of pigmented nevi.

Influence on the disease of gender, age and anatomical localization of the tumor. These factors are closely interrelated. Skin melanoma is 2 times more common in women, with the peak incidence occurring at the age of 41-50 years; most often affects people in the 5th decade of life; the most frequent localizations of the tumor are the skin of the extremities and torso; in women, primary melanoma is localized more often on the face, buttocks and legs, in men - on the skin of the anterior and lateral surfaces of the chest wall, thighs, hands, heel region and toes.

In addition, there are a number of hereditary skin diseases that predispose to the development of cancer (xeroderma pigmentosa, Bowen's disease, Paget's disease, and others).

Types of skin cancer:

1. Basal cell carcinoma (basalioma)- a tumor from the upper layer of the epidermis, bearing the same name, it is characterized by growth in the depth of tissues with their destruction, is not capable of metastasizing, does not give relapses.

It may appear as confluent nodules 2-5 mm in size, prone to ulceration, or as a large node up to 2 cm or more in size.
It is not dangerous, except in cases where it is located on the face or auricles, in which case it can reach a large size, germinate the organs of the face: nose, eyeball, auricle with their destruction and the development of infection up to brain damage.
More common in older people. Maybe in combination with tumors of internal organs: intestines, stomach and others.

2. - arises from the cells of the deeper layers of the skin, has aggressive growth, is able to reach large sizes and metastasize to the lymph nodes and internal organs. The tumor has the appearance of a nodule or knot, or the appearance of a "cauliflower".

3. - a malignant tumor from the sebaceous, sweat glands or hair follicles.

4. - does not apply to skin cancer, is an extremely aggressive malignant pigmented tumor of the skin, quickly metastasizes, practically untreatable. It has the appearance of a pigment spot (mole), bright black or pink, a rapidly growing spot (non-pigmented melanoma, less common).

Often, an ordinary mole degenerates into melanoma.

Skin Cancer Symptoms

There are several signs of a malignant degeneration of a mole (nevus):

1) Horizontal growth;
2) Vertical growth over surrounding tissues;
3) The appearance of asymmetry or irregular outlines (scalloped) edges, that is, a change in its shape;
4) Complete or partial (uneven) discoloration, the appearance of areas of associated depigmentation;
5) The appearance of a feeling of itching and burning;
6) Ulceration of the epidermis above the mole;
7) Wetting of the surface and bleeding from its surface;
8) Absence or loss of hairline on the surface of the nevus;
9) Inflammation in the area of ​​the nevus and in the tissues surrounding it;
10) Peeling of the surface of the nevus with the formation of "dry" crusts;
11) The appearance of small dot nodules on the surface of the mole;
12) The appearance of child pigmented or pink formations (satellites) in the skin around the nevus;
13) Change in the consistency of the nevus, that is, its softening or loosening;
14) The appearance of a shiny glossy surface;
15) Disappearance of the skin pattern on the surface of the mole.

Diagnosis of skin cancer

The diagnosis of skin cancer is established on the basis of a number of examinations:

Visual examination: the appearance of the tumor, size, condition of nearby lymph nodes are assessed;

A smear or scraping from a tumor is made by a doctor with a special tool, the material taken is sent to a cytological laboratory for examination under a microscope; by the appearance of the cells, one or another skin tumor can be accurately determined or suspected. In no case should you scrape or injure tumors that are suspicious of melanoma on your own, as this can cause the development of metastases.

Biopsy: taking a piece or the entire tumor for examination (total biopsy) for examination under a microscope;

Ultrasound examination of the tumor and nearby lymph nodes is used to more accurately diagnose the tumor and the presence of metastases;

Ultrasound examination of the abdominal organs is performed in order to exclude distant metastases in the abdominal organs;

X-ray of the lungs: to rule out lung metastases.

Stages of skin cancer:

Stage 1: tumor size does not exceed 2 cm;
stage 2: tumor size from 2 to 5 cm;
stage 3: the size of the tumor is more than 5 cm or there is a metastatic lesion of nearby lymph nodes (for example, for tumors of the skin of the shoulder - damage to the axillary lymph nodes);
Stage 4: the tumor grows into nearby organs (muscles, bones, cartilage) or distant metastases are detected.

This classification is not applicable for melanoma; staging is used for it according to the depth of germination into the skin and underlying tissues.

Survival for skin cancer is certainly different at different stages: at the first 2 stages, the prognosis is much better and the survival rate reaches 100%, at 3-4 stages, the survival rate drops sharply to 70% or less. As for melanoma, even in the initial stages, the prognosis is not always positive, this tumor can quickly metastasize to any internal organs and brain.

Skin Cancer Treatment

In the treatment of skin cancer, like any malignant tumor, the leading role belongs to the surgical method. Removal of the tumor within healthy tissues is the key to long-term survival and the absence of relapses.

For the treatment of skin basaliomas, especially on the face, where there is not much skin and it is difficult to achieve a good cosmetic effect, radiation therapy at a dose of 40-50 Gy is successfully used. In addition, radiation therapy can be used to treat squamous cell skin cancer. In debilitated, elderly patients, chemotherapeutic ointments used to be used, now they have been replaced by more effective methods, such as surgery and radiation.

In the presence of metastases of skin cancer, if it is impossible to completely remove them, chemotherapy is used, and it is also used in the presence of metastases to nearby lymph nodes to prevent recurrence of the disease.

In the treatment of melanomas of the skin, a surgical method is also used, in the presence of metastases, various chemotherapy regimens are possible, but the effect of them is insignificant, since the tumor is practically not sensitive to any of the modern chemotherapy drugs. Radiation treatment for melanoma is not used, since the tumor is not sensitive to it.

Treatment with folk remedies is unacceptable, especially in the case of melanoma, since any compresses and lotions can dramatically increase tumor growth.

Complications of skin cancer

Complications of skin cancer can be: the development of infection (suppuration); bleeding from the tumor, tumor germination of vital organs (large vessels, eyeball, meninges and brain tissues in case of localization of the tumor on the head and in advanced cases).

Prevention of skin cancer

Prevention of skin cancer and melanomas mainly consists in reducing sun exposure, especially in fair-skinned people, and in hot countries with a scorching and unaccustomed climate. Occupational injuries and skin lesions (chemicals, metals, arsenic) should also be avoided.

Skin cancer and melanoma consultation:

Q: How common is skin cancer?
Answer: This is the most common tumor, especially basalioma. These tumors are found everywhere after the age of 60, many patients do not pay attention to them, since the growth of the tumor is slow and does not cause concern.

Question: What is melanoma and why is it dangerous?
Answer: Melanoma is an extremely malignant pigmented tumor of the skin and mucous membranes. Dangerous aggressive growth and rapid metastasis to nearby lymph nodes and internal organs. Melanoma metastases can lead to exhaustion and death of patients in a short time, even if the entire arsenal of modern medical means is used.

The diagnosis of "melanoma" often sounds like a sentence, frightening not only the patient himself, but also his loved ones. It is no secret that the predisposition to the development of this type of malignant tumors is hereditary.

The success of the treatment of this disease (as well as many others) is highly dependent on the stage at which the disease was diagnosed. This means that each of us needs to clearly understand how to recognize melanoma at an early stage in order to prevent its dangerous growth.

What is melanoma

Melanoma is a variety. It is considered the most aggressive, since it actively metastasizes to all human organs with the lymph flow. Moreover, the process can develop quite rapidly, literally in a matter of days, and even a minor injury can provoke it.

Melanoma is formed from melanin-producing cells called melanocytes. It is diagnosed in 4% of cancer patients, but it is perhaps the only tumor whose development can be seen at an early stage.

By the way, when thinking about how to recognize melanoma (a photo of which you can see in this article), remember that these neoplasms only in 30% of cases begin their development from existing moles (nevi). And in 70% it appears on the spot of the skin where there were no spots. In addition, be aware that melanoma can also occur on the mucous membrane and even under the nails.

Factors that can trigger the development of melanoma

Speaking about how to recognize melanoma and what it is, first of all, it should be said that it is either a nodule or a spot that has a dark color (although there are also non-pigmented types) and an irregular shape.

Risk factors that can spur or provoke the development of melanoma include the following:

• the effect on the skin of ultraviolet radiation (this applies both to the sun's rays and to artificial sources - solariums or bactericidal lamps);
• previous precedents for the occurrence of melanomas, both in the patient himself and in his close relatives;
• the presence on the human body of a large number of moles (we are talking about fifty or more);
• female;
• old age (however, melanomas also occur in young people);
• red hair and a large number of rapidly appearing freckles.

The first signs of melanoma

Additional signs that will tell you how to recognize melanoma will be the changes that occur with the mole. If the nevus thickens, rising above the skin, increases in size and at the same time changes pigmentation, then it should be shown to a dermatologist.

Especially obvious signs of a dangerous situation are reddening of the tissues around the nevus, the appearance of cracks on it, sores covered with a crust, and bleeding. In such cases, the mole causes concern - it itches or burns. In this case, the patient may have enlarged lymph nodes.

How does melanoma grow?

Most often, melanoma develops on the lower extremities, on the trunk and arms, only in 10% of patients it can occur on the head or neck.

The described tumor, as a rule, grows in three directions - into the deep layers of the skin, along its surface, or through the skin into nearby tissues. By the way, the deeper the tumor spreads, the worse the forecasts for specialists.

Answering questions about how to recognize melanoma and how it manifests itself, oncologists note its rapid metastasis and damage to nearby lymph nodes. It spreads not only through the skin, but also by the hematogenous or, as already mentioned, lymphogenous route. By the way, hematogenous metastases have the ability to penetrate into any organ, but most often they affect the kidneys, adrenal glands, liver, brain and lungs.

They look like peculiar small rashes that slightly rise above it and have a brown or black color.

How to recognize melanoma: signs and symptoms of the disease

The first sign that a person develops melanoma at the site of a mole, as a rule, are changes that suddenly begin in it. Take a look at your birthmarks.

1. Ordinary moles are always symmetrical. If you mentally draw a line through their middle, then both halves of a normal mole will completely match in shape and size. Any violation of this symmetry should make you suspicious.
2. Pay attention to the borders of the mole. If they are uneven, blurry, fuzzy, then it should be checked.
3. The change in the color of your neoplasm should also alert. If the mole is more than one color or has several shades, check it.
4. The symptoms of the development of melanoma include an increase in the size of the birthmark. Even if your spot has no other deviations (even color, clear boundaries, symmetrical shape), but at the same time it exceeds 6 mm in diameter (this is about the same as that of an elastic band on the tip of a pencil) - this can be attributed to alarming symptoms.

From the above, we can draw an unambiguous conclusion regarding how to recognize melanoma at an early stage. But at the same time, you should remember that you do not need to wait for all of the listed symptoms - just one of them is enough for you to have a serious reason to contact a dermatologist.

Once again about whether to worry if a mole grows

All of the above signs of the development of the disease will surely make you look at your body with fear. But we want to warn you that when thinking about how to recognize melanoma and not miss its symptoms, do not immediately start sounding the alarm as soon as you notice that the mole has grown. After all, an ordinary nevus can change, just like we change with age. It can be flat at first, and then become convex - it's not scary. But if such changes occur, as they say, right before our eyes, you should not delay going to the doctor.

By the way, the presence of hairs on a mole confirms that it is healthy!

Diagnosis of the disease

And yet, if you have doubts about the condition of your mole, do not guess how to recognize melanoma yourself, but consult a doctor. He will clarify the symptoms, find out all the risk factors, and conduct an examination.

Due to the fact that, as already mentioned earlier, melanoma is very aggressive, and even a minor injury can provoke its development, an invasive method of examining it is highly undesirable (it means scraping or histology, when not all of the formation is taken for analysis, but a small part of it ). Therefore, most often the doctor conducts an external examination of the nevus.

He will definitely check the condition of the lymph nodes under the arms, on the neck and in the groin, and will also conduct a radioisotope study, in which phosphorus is used. By its increased accumulation in the tumor, the presence of melanoma is judged.

It is also used in which, if there are ulcerations on the suspected melanoma, an imprint is taken from the surface of the tumor, and then sent for analysis.

To determine the presence of metastases, ultrasound of the internal organs, x-rays and tomography are also performed.

How is melanoma treated?

If the patient managed to turn to an oncologist in time, then at an early stage of development, melanoma is simply excised. Depending on how deep it has penetrated, a small amount of healthy skin is also removed. The doctor may also prescribe additional therapy in the form of drugs that will help reduce the likelihood of relapse.

If lymph nodes are suspected, then after a biopsy of one of them and a positive result, their removal is supposed.

With proven significant benefit of immunotherapy. This is a relatively new method of treatment, which is carried out immediately after surgery to remove the tumor.

In the later stages of the development of the disease, they resort to radiation and chemotherapy, which, by the way, in the fourth stage of the development of a cancerous tumor are ineffective, allowing only to some extent to reduce it.

A few words in conclusion

In the article, we tried to talk in detail about how to recognize skin melanoma. The photos posted in it also probably helped you navigate the situation.

But in the end, I would like to add that it is not at all necessary, having discovered a birthmark of an unusual shape, to immediately fall into despair. Not every mutated mole will turn out to be a cancerous neoplasm, it can be an atypical pigment spot or a benign dysplastic nevus.

But still, a trip to the doctor should not be postponed, since in this case it is better to exercise excessive vigilance, which can subsequently save not only health, but also life.