Big melanoma. Symptoms of melanoma (photo), treatment and prognosis

Melanoma is a malignant tumor of the skin, mucous membranes and uveal tract (choroid) of the eye. It grows from pigmented skin cells, the so-called melanocytes, has a high tendency to early metastasis and low sensitivity to treatment.

There are several varieties of the disease, each of which has its own symptoms, developmental dynamics and prognosis.

Localization and prevalence

More than 90 percent of all melanomas develop on the skin, but this type of cancer can attack any tissue that contains melanocytes (pigment cells) - the eyes, the mucous membrane of the genitals, oral cavity, larynx, esophagus, intestines, stomach. Most often, it occurs on the site of age spots and moles (nevi), but can also develop on unchanged skin.

Melanoma is a very common problem. It accounts for 5% -7% of all human malignant skin neoplasms. About 130,000 cases of the disease are diagnosed each year. Most patients are Caucasian, living in countries with high solar activity. The peak incidence occurs in the seventh and eighth decade of life, people under the age of 40 practically do not suffer from it.

Causes

The main factor causing malignant melanoma is UV radiation. In melanocytes, as in most cells of the human body, there is genetic material in the form of DNA. Under the influence of negative factors, DNA undergoes irreversible damage (mutation). Under normal conditions, when mutations are detected, the mechanism of death of pathological cells (apoptosis) is triggered. However, if the genes responsible for this mechanism are damaged, the mutated cells do not die, but continue to divide. Normal melanocytes present in the tissues of every healthy person degenerate into cancerous melanocytes.
  A person with fair skin, blue eyes, blond or red hair is predisposed to such a process. However, there are other provoking factors:

• prolonged exposure to sunlight - sunburn is especially dangerous at a young age. The use of a solarium also causes great harm;
• individual sensitivity of the patient to sunlight;
• the presence of numerous age spots and moles;
• xeroderma pigmentosa (an inherited disorder associated with the work of pigments);
• conditions accompanied by a decrease in immunity - chronic use of immunosuppressive drugs in patients after organ transplantation, administration of glucocorticoids by carriers of the human immunodeficiency virus (HIV), congenital immunodeficiency;
• genetic factors (scientists have identified a family predisposition to this cancer);
• hormonal factors - puberty, pregnancy and childbirth, prolonged use of oral contraceptives and hormone replacement therapy.

Varieties

There are 5 main varieties of skin melanomas:

• lentious - a relatively mild type, which is localized mainly on the face and other open areas of the body, often in contact with sunlight; develops slowly over many years, has a favorable prognosis;
• acrolentious - a rare form that is placed on the tips of the fingers and toes, slowly develops and can completely destroy the nail plate on the affected finger;
• superficially spreading - the most common type of cancer that develops from pigmented moles, including atypical ones (that is, those that showed a predisposition to oncology on microscopic examination). Neoplasms often occur in the middle and lower body (trunk and lower extremities), they develop relatively slowly;
• nodular - a rare dangerous species that is usually localized in the head, neck and back. The nodular form shows rapid growth and an abundance of metastases;
• achromatic (pigmentless) - the most dangerous of all types of melanomas. It is characterized by a decrease in the production of melanin in cancer cells.

As for tumors of other organs, then in medicine there are:

• retinal melanoma;
• lentiginous melanoma of the mucous membranes (vagina, anus, nasopharynx);
• malignant melanoma of soft tissues (localized on ligaments and aponeuroses).

Symptoms and stages

The tumor grows either on the site of an existing mole, or on unchanged skin. Here are some features of malignant neoplasms:

• a change in the shape of the spot - the more it is characterized by asymmetry, the greater the suspicion of the development of cancer;
• uneven edges;
• itching and burning;
• uneven or atypical color - new, previously unnoticed places with black, blue, brown, red or pink spots with possible interspersed with other colors;
• increase in the size of changes - nevi with a diameter of more than 6 mm, or fast-growing spots should alert;
• the appearance of a red or pink rim around inflammatory changes - this indicates the activity of immune cells and the development of a local inflammatory response in response to contact with foreign antigens (obtained from cancer cells);
• the neoplasm and surrounding tissues may swell or harden.

There are 5 stages of melanoma, depending on the depth of its germination:

• stage I - pathological cells affect only the upper layer (epidermis);
• stage II - the papillary layer of the dermis is affected;
• stage III: the cancer has reached the border between the papillary and reticular layers;
• stage IV: the mesh layer is affected;
• stage V: changes reached adipose tissue.

In the last stages, the changes are covered with ulcers, from which the serous-bloody contents flow.
  Melanoma gives metastases to the lymph nodes, lungs, liver, brain, bones. In this case, symptoms from damaged organs appear:

• swollen and tender lymph nodes;
• hemoptysis, shortness of breath, symptoms of pneumonia;
• gastrointestinal bleeding, bleeding disorders, edema of the lower extremities, fluid in the abdominal cavity;
• headache, nausea, vomiting, temporary impaired consciousness;
• bone pain, frequent fractures.

It should be noted that each of the above general symptoms may indicate other nosological problems.

Diagnostics

The most important diagnostic element is a self-examination of the body - if you notice one of the above signs, inform your doctor. Early diagnosis is the key to successful treatment.

The specialist makes a preliminary assessment using a dermatoscope - an optical device through which you can consider the profound changes in the mole. If there is a suspicion of malignancy, the doctor cuts out the entire neoplasm with a supply of healthy skin, and part of the tissue poisons for histopathological examination. This analysis allows you to determine the type and severity of the disease.

Since melanoma initially gives metastases only to the lymph nodes, the doctor will definitely prescribe an ultrasound of the regional absorption zone (closely located lymph nodes). It will show if there are metastases. When the study does not give a clear answer, the doctor removes the so-called sentinel lymph node - the first lymph node along the path of the lymph vessels coming from the tumor.

At developed stages of the disease, analyzes of internal organs are prescribed to assess the degree of damage.

Treatment

Doctors use 3 main methods: surgery, chemotherapy and radiation therapy. In the early stages, surgical resection (removal of pathological tissues with a supply of healthy skin) can be dispensed with. This is done in a traditional or laser way. Necessarily removed surrounding lymph nodes.

At later stages and in the presence of metastases, chemotherapy is prescribed. This is the main treatment when there is diffuse proliferation, not amenable to resection. With extensive and multiple metastases, treatment is limited only to symptom relief and support of affected internal organs - painkillers (potent analgesics, morphine and its derivatives), metoclopramide, diuretics, and diet food are prescribed.

With lesions located on the limbs, a special type of chemotherapy is used - isolated perfusion. It includes the introduction into the artery of high doses of cytostatic when heating the limbs to 41/42 ºC. These two factors interact with each other, destroying mutated cells.

Radiation therapy is usually used in extreme cases, in the absence of consent to treatment or the inability to perform an operation.

A breakthrough in the treatment of melanoma has occurred in recent years. Scientists have identified a relationship between the BRAF gene mutation and disease progression. Such knowledge has helped develop molecular targeted therapy that works by blocking the abnormal protein encoded by the mutated BRAF gene. This gene is present in more than half of patients with melanoma. The effect of the new drug (vemurafenib) is that it blocks access to tumor cells - they do not receive nutrition, as a result of which they die (the tumor stops growing). Such therapy is effective in 90% of patients.

Folk remedies

Naturopaths recommend treating growing moles with celandine juice, milkweed, Kalanchoe, gum, or even burn with matches. However, these methods cause skepticism among doctors. Oncological diseases require immediate medical attention, therefore it is better not to risk your own life and trust in the hands of a competent specialist.

Traditional medicine will be useful during rehabilitation after chemotherapy. Regular intake of tea from wild rose, chamomile, lemon balm, prickly thistle and echinacea will help restore immunity faster and strengthen the body as a whole.

Prognosis and complications

If the disease is detected at an early stage, the chances of recovery are very high (95% of patients live longer than five years). The third and fourth stages are successfully cured in 40-60% of cases, but the chance for treatment of the fifth stage is only 25%. The most favorable prognosis is for lentiological and superficially propagating varieties. The most dangerous forms are nodular and achromatic, as well as neoplasms that develop during pregnancy and childbirth. Thus, prevention and early diagnosis play an extremely important role in the fight against melanoma.

Death occurs as a result of complications caused by metastases (liver failure, respiratory arrest, internal hemorrhage, etc.).

Prevention

Prevention includes:

• safe tan (it is forbidden to stay on the beach between 10:00 and 15:00);
• the use of sunscreens;
• regular examination of the skin for signs of suspicious elements;
• regular visits to a dermatologist (every six months).

Prevention is especially important for people who have a lot of nevi on their bodies.

Photo

To begin with, let's define the concepts of blood leukemia and cancer of melanoma, as well as determine the fundamental differences between these diseases.
  So, blood leukemia and cancer of melanoma are oncological diseases. Both are called cancer, but differ in the type of affected organ or area of \u200b\u200bthe skin. Blood leukemia is a cancer of the blood, also called anemia or bleeding, because a lot of immature blood cells, white blood cells, appear in the blood. And melanoma cancer is the same cancer, but it does not affect the blood, but the skin.

Blood cancer

Consider blood cancer in more detail. Oddly enough, but on the occurrence of the disease affects the geographical location of the patient and belonging to certain races. Also affected by hereditary signs and age of the patient, children aged 3-4 years and adults after 50 years are more likely to be affected. The course of the disease is more complicated and its treatment takes place in adults.
  Symptoms of this disease include fatigue, low immunity, pain in the limbs, complex bleeding, lack of appetite, and others. But nevertheless, to determine this disease, it is necessary to conduct a series of examinations and analyzes.
  When a disease occurs, the bone marrow is affected and therefore the degree of this disease is not determined. Often in the early stages of the disease is not determined.
To monitor the patient's condition and determine the disease of blood cancer itself, they take a normal blood test, a biochemical blood test and bone marrow analysis, for this they take a puncture.
  If nevertheless the disease is detected, then it will remind of itself for the rest of his life. One will either have to be treated all his life, or, with a favorable outcome, be observed to prevent relapses.
  Treatment is determined by the attending physician, which takes into account the stage of development of the disease and the patient's condition, which is evaluated according to the results of the analyzes.

Melanoma cancer

Not every skin cancer is called melanoma. Melanoma is a malignant tumor on the skin. It affects both areas of the skin and internal organs.
  The cause of this pigmented disease has not yet been determined, but it is known for sure that people with a fair color of skin, hair and eyes are more likely to be affected. And in black races, this disease occurs extremely rarely, and it is more difficult to diagnose it. This disease is also affected by people who have ever had professional burns with chemicals or metals.
  Melanomas are different, they vary in shape, color, size, type of surface. The largest melanomas approximately reach 3 mm. Very often, melanomas are extremely difficult to determine, since they are first considered benign pigment spots.
  For the treatment of this disease, surgery, radiation therapy, chemotherapy are mainly used. Melanoma vaccines have also been invented, but their effectiveness has not been confirmed and is an experimental treatment.
  But at the same time, a favorable outcome is not guaranteed, since the disease can kill a person in a matter of days due to the impossibility of predicting the course of the disease. The disease can have a calm course, or it can behave very aggressively and treatment can be useless and all efforts are in vain.
  It is not recommended to use self-medication and refer to traditional medicine for a disease, because some herbs can create the opposite effect. Constant monitoring by a doctor is necessary.
  To prevent this disease, a rarer stay in the open sun is recommended.

Skin melanoma is a malignant disease that develops from the pigment cells of melanocytes. Cancer of this type manifests itself regardless of the age and country of origin of the person, and the number of fatal outcomes of the disease is statistically large, despite the intensive care. Melanoma of the skin is diagnosed in 3% of all epithelial tumors.

The appearance of melanoma is explained by a defect in the DNA molecule that the pigment cell contains. In medical practice, the following causes are distinguished for the occurrence of one of the most dangerous human oncological tumors, characterized by constant relapses and lymphogenous and hematogenous metastases in all organs:

1. Abuse of ultraviolet rays is especially dangerous when exposed to the sun at its zenith. A malignant tumor can also occur as a result of prolonged exposure to artificial sources of ultraviolet radiation, which include a solarium and bactericidal lamps. According to statistics, melanoma is most common among residents of countries with increased solar activity, such as Florida, Australia and Hawaii.
2. Cancerous skin lesions often manifest as relapse.
3. Overgrowing moles is common in medical practice. In 60% of cases, skin cancer develops from nevi and atypical moles. The main places of localization are the head, legs, arms, back, neck, palms, scrotum, sole and thoracic region. The more moles throughout the body, the higher the risk of their degeneration into a malignant tumor.
4. Skin diseases of a precancerous nature. Similar diseases include pigmentosa xeroderma and Dubei melanosis.

In addition to the direct causes of skin cancer, there are so-called risk factors:

• weakened immunity, unable to independently destroy cells with altered DNA;
• overweight;
• the predominance of fats and proteins in the daily diet;
• age - the older the person, the higher the risk of getting sick;
• genetic inheritance;
• fair skin, the presence of freckles and red hair pigment;
• a history of sunburn.

A person belonging to one of the risk groups should carefully monitor his health in order to prevent the development of the disease at the initial stage.

Symptoms of Melanoma

Often, melanoma occurs on unchanged skin, however, manifestations of a tumor from moles and against a background of a skin disease that is precancerous are common. The main symptoms of tumor lesions of the skin include a modification of the color and shape of existing moles, as well as the occurrence of unpleasant sensations in this area. Often, melanoma is perceived as a new mole with an unpleasant appearance, but only a doctor will be able to recognize it when examined.

Primary symptoms

What the initial stage looks like can only be understood by the changes and sensations that appear in the area of \u200b\u200bthe mole:

• burning sensation;
• bleeding
• itching of the skin;
• a change in the appearance of a mole, its thickening and elevation;
• a change in consistency, the mole becomes soft;
• severe swelling and redness of nearby tissues;
• the appearance of secretions;
• the main tumor focus is surrounded by new pigmentation.

Late symptoms

Rapidly developing melanoma is characterized by the following symptoms:

• constant bleeding of a mole;
• palpable pain discomfort in the lesion;
• noticeable violation of the integrity of the skin;
• the appearance of blood from pigmented areas located elsewhere.

Symptoms of Metastases

When cancer cells enter the bloodstream and spread to other organs, signs of metastatic melanoma are observed:

• palpable seal under the skin;
• the skin becomes grayish;
• a causeless cough of a chronic nature appears;
• severe headaches, accompanied by convulsions throughout the body;
• weight loss, or complete exhaustion;
• lymph nodes acquire a pronounced increase.

Immediate medical attention is required if there is severe bleeding from age spots, with a strong change in skin color, asymmetry of moles and an increase in diameter of more than 6 mm.

Medical practice recognizes the various types of melanomas that develop in different parts of the body.

The most common types of cancerous lesions:

1. Noduryany, better known as nodular. It ranks second in popularity among those diagnosed with melanomas, according to statistics it is 15-30% of cases. The average age of education is from 50 years and older, the localization of the nodular has no clear places, can occur throughout the body: from the scalp to the formations on the foot or palm. It is noteworthy that this type of tumor in men occurs on any part of the skin, and in women mainly on the lower extremities. The appearance of nodular melanoma is characterized by aggressive development and vertical growth of nevus. The average duration of tumor development is from six months to one and a half years. Diagnosis of the formation of a nodal type at an early stage is extremely rare, usually patients seek help when the tumor takes the form of a dark-colored plaque with high edges and clear dimensions. In advanced stages, melanoma can take the form of an aggressively developing polyp.
2. Superficial, called in medical practice as super-official. This version of the tumor of the skin occurs in 70% of cancerous lesions. The source of development are previous moles and nevi. Growth begins with a benign tumor located in the subcutaneous layer. The development of the super-official type takes place over a long time. Characteristic features are the appearance of a spot with uneven edges, which is characterized by a change in color pigment. A mole can take on different shades from tan to black or white. Superficial melanoma is usually treatable and has a favorable prognosis when compared with other types of skin cancer.
3. Lentiotic melanoma is also called malignant lentigo and melatonic freckles. It appears mainly in old age against the background of senile skin pigmentation, in rare cases, the appearance of a simple mole is possible. The average percentage of incidence is 10% of the total number of cancerous lesions of the skin. Diagnosed malignant lentigo in those parts of the body that are most exposed to ultraviolet radiation - ears, face, neck. Development is slow, the period between its initial manifestation and the final stage can be up to 30 years. Malignant lentigo has a rather favorable prognosis: metastasis is rare. There are cases when the disease resolves on its own without consequences for the patient.
4. Lentigo is peripheral, the proportion of the disease is about 10%, mainly in representatives of the black race. The main place of localization of peripheral melanoma are the palms of the hands and the nail bed. Often, skin lesions in the form of a dark spot with uneven edges are diagnosed on the foot. Lentigo growth is very slow, a tumor grows in the upper layers of the skin, without spreading inward. The prognosis depends on the depth of the tumor.
5. Pigment melanoma. It is characterized by the presence of the pigment melatonin, which gives the tumor a specific color. The main advantage is a clear cosmetic manifestation, since the cosmetic effect is immediately noticeable, which makes patients seek medical help on time. A feature of pigmented melanoma is the presence of flowers unusual for a simple mole. The range of colors can vary from pink to black as the disease spreads. At the same time, one tumor can gradually become mottled from monophonic. Over time, pigmented melanoma loses its color and becomes colorless.
6. Amelanotic, is colorless and the most dangerous. The main risk of such a tumor lies not only in its invisibility at the initial stage, but also in the rapid growth rate. With this diagnosis, the predictions are the worst, compared with other types. Cases of the transition of a non-pigmented neoplasm to a pigmented are possible.

Any melanoma is initially a malignant, benign type of such a tumor in medical practice does not exist. Signs of cancer education are rapid growth, a tendency to germinate in the deeper layers of the skin and metastasis.

External representation of melanoma

Giving a description of the appearance of the tumor of the skin, it is necessary to take into account its type, stage of development and location. Melanoma is a neoplasm characterized by the greatest variability among other malignant phenomena. With the development of a tumor from a mole, it is localized either in the center or along the edges. The following melanoma options are available:

• proliferation of papillomatous type;
• a pigment spot of a flat shape;
• protrusion of a minor nature;
• the shape of the fungus, the tumor is located either on a wide base or on a stalk.

Mostly, single oval or round tumors are found. Often there is multiple melanoma, when around the main focus there are several additional ones. Gradually, they can merge into one common.

At the initial stage of development of melanoma, it has a smooth surface, however, as the disease progresses, it becomes covered with small manifestations and irregularities. The main danger of this stage of the disease is high trauma, bleeding from the tumor can begin with the slightest impact.

With the collapse of the tumor node, the neoplasm can take the form of cauliflower with multiple formations on the surface. According to the consistency of melanoma, it can vary from fairly dense and hard to soft, or combine hard and soft areas.

The hue is always individual and depends on the amount of pigment present in it, if there is no place to be a pigmentless tumor. The most common are brown, gray, purple, crimson and black shades.

Pigmentation of melanoma is most often heterogeneous with a higher concentration of color in the central part. An alarm is the change in color of the neoplasm, which indicates the progression of a malignant disease.

Locations

Melanoma can occur on any part of the skin. According to statistics, the favorite places of her education in women is the lower leg, in men - the face and back.

Face

The most dangerous malignant melanomas appear on the face. They are a pigmented spot of various shapes, but in some cases, the pigment may be absent. The primary stage of malignant skin lesions of the face is characterized by a clear oval shape with possible symmetry. With the progression of the disease, melanoma acquires a blurry outline and variegated color. The shape itself is also gradually changing - it can become convex, take the form of a mushroom or a node.

Back

Melanoma on the back does not differ in its course from tumors localized in other parts of the body. The shape of the neoplasm has rounded outlines, and the color scheme varies from dark blue to reddish. The main danger of melanoma that forms along the spine is its late detection.

An aesthetic defect on the face or leg will be noticed faster than on the back, which leads to too late seeking medical help.

Eye melanoma

A tumor of the eye occurs quite often and entails a significant loss of vision. Development occurs more often from the optic choroid and has an aggressive course. The following types of melanoma of the organs of vision are distinguished:

• choroid;
• conjunctiva;
• iris;
• century.

Less commonly, tumors of the eyelid and conjunctiva are found. It is not possible to identify this type of tumor at the initial stage due to insufficient symptomatic picture. The main primary sign is a slight clouding in the retina. Only an ophthalmologist can conduct an accurate diagnosis of this stage.

The second stage is characterized by painful discomfort in the mucosa, redness of the eyelid and swelling. In the third stage, ocular melanoma goes beyond the apple, the eye begins to shift due to a growing tumor, and in the fourth stage, symptoms of bleeding and clouding of the lens are noticeable.

Nail

The neoplasm in this case is localized directly on the skin around the nail plate or the nail itself. The manifestation is possible at any age, and the tumor can grow on the nails of the hands and feet.

The primary symptom of the disease is a change in the color of the nail plate, but at this stage it is not always possible to diagnose the disease. The dark spot formed under the nail begins to grow and increase in size. The nail begins to gradually rise, and a nodule with erosion forms near the nail plate.

Stages of the disease

Assess the course of melanoma and predict the chances of a favorable outcome based on the stage at which the disease is. In medical practice, it is customary to distinguish 5 main stages of the course of the disease:

1. Zero stage, to determine the presence of cancer cells in which it is possible only on the extracellular layer. This stage does not have a deep growth of the tumor inward.
2. The first stage, also called initial. The thickness of the tumor in this period is from 1 to 2 mm, metastasis is not observed. Localization occurs at the level of the dermis, but distribution at the level of the lymph nodes does not occur. According to the clinical classification of melanomas, this tumor formation is not yet dangerous, since it is a local stage.
3. In the second stage, the thickness of the melanoma is in the range of 2-4 mm, but metastases in the lymph nodes and other organs are still not diagnosed. The tumor spreads to the thickest skin layer - the dermis.
4. The third stage is different in size over 4 mm, there are no metastases. A lesion of 2-3 lymph nodes is diagnosed without spreading to other organs. Tumor growth occurs already in the subcutaneous fat layer. According to the clinical classification, generalized damage to the internal organs is added.
5. The fourth stage is characterized by metastasis of internal organs and lymph nodes. Melanoma grows deep in the subcutaneous layer and has a thickness of more than 4 mm. Complete cure at this stage is almost impossible.

Infant melanoma

A malignant tumor of the skin can manifest itself in childhood, mainly in the period from 4 to 6 years and from 11 to 15 years. It is located most often on the neck, head and limbs. In 70% of cases, the appearance of melanoma in a child is observed on unchanged skin against the background of moles and nevuses already present. More than 10% of cases of malignant neoplasms are genetic hereditary. The main symptoms are:

• an increase and change in the shape of a previously calm nevus;
• discoloration of a mole;
• burning, the appearance of cracks and tingling in the area of \u200b\u200bskin lesions;
• bleeding manifestation;
• noticeable elevation of moles and age spots;
• loss of vegetation in and around the nevus.

Infantile melanoma is characterized by unpredictability of development, can occur both rapidly and gradually, when periods of remission are replaced by exacerbation. Treatment of a childhood tumor of the skin is carried out without using the usual means of chemical therapy, since the main feature of such melanoma is resistance to radiation and chemical therapy. The children's version of the disease and rapid metastasis are distinguished.

The study of melanoma is a set of activities that are standard for all diseases. Previously, the doctor conducts a visual examination of the tumor and interviews the patient about the nature and prescription of the changes. An important point is the presence of heredity: whether there are cancerous lesions of the skin in other family members.

General examination with palpation, during which the doctor determines the pain and density of melanoma, as well as its fusion with other tissues. During a general examination, attention is also paid to the lymph nodes. Even with an obvious diagnostic picture, the doctor prescribes a series of studies that will confirm the diagnosis. This is necessary to exclude or confirm metastases in other organs. The main diagnostic measures for melanoma:

• scanning bones and an x-ray of the organs of the breast of the cell in order to detect metastases;
• sampling of a blood test for a biochemical study, where the indications of LDH and alkaline phosphatase are important, high values \u200b\u200bof these indicators indicate the process of metastasis and the resistance of the tumor to treatment already underway;
• Ultrasound of the abdominal cavity, with which the state of the lymph nodes and organs is determined, the study is shown if the thickness of the melanoma exceeds 1 mm;
• dermatoscopy, when using a special device with an enlargement function, a close examination of melanoma is performed.

Therapies

Treatment of melanoma directly depends on the stage of development of the disease:

1. Zero stage - surgical excision of the tumor with the capture of tissue around the focus for 1 cm.
2. First stage. A biopsy is preliminarily performed, after which the tumor is removed with a tissue capture of 2 cm. If there are signs of metastasis in the lymph nodes, they are also removed.
3. The third stage shows chemotherapy, raising immunity and removing the tumor. Capture of healthy tissue during resection of melanoma reaches 3 cm. Mandatory continuation is the removal of lymph nodes and subsequent chemotherapy.
4. The fourth stage does not have a standard treatment regimen; usually, the therapy includes the combined effects of chemicals and radiation medicine.

Chemotherapy

Treatment of melanoma involves the use of several drugs at once, the most common among them:

• Roncoleukin,
• Cisplatin
• Reaferon,
• Vincristine.

If there is a disseminated form, the medicine Mustoforan, indicated for brain metastases, is used. With standard therapy, Roncoleukin is administered intravenously at 1.5 mg in combination with other drugs. The average duration of chemotherapeutic exposure is 6 cycles with 4 week intervals.

Radiation therapy

This method of exposure is optional and is used in combination with other therapeutic measures. Independent use of radiation treatment is possible only if the patient refuses surgery.

Cancer cells are markedly resistant to ionization, so this method is used as a recovery therapy after surgery or in combination with chemotherapy.

Operation

The method of surgical treatment involves a wide excision of the tumor with the capture of nearby tissues. The main goal of surgical intervention is the prevention of metastases. The defect resulting from surgery is eliminated with the help of plastic.

The area of \u200b\u200bthe removed area depends on the initial size of the tumor. In case of nodular type melanoma or superficial neoplasm, the indent from the edge of the focus is no more than 1-2 cm. The excision is carried out in the form of an ellipse, and the block of excised tissues takes an ellipsoidal shape.

Surgery is contraindicated in case of lentigo melanoma. This type of cancerous lesion of the skin is subjected to laser destruction or exposure using cryogenic technologies using low temperatures.

Prevention

Measures to prevent the development of cancerous lesions of the skin:

1. Limit exposure to ultraviolet radiation. This includes not only a ban on prolonged exposure to the sun at its zenith, but also a visit to tanning salons. UV rays are dangerous even on a cloudy day. Sunscreens will help protect you.
2. Limit skin from exposure to chemicals as much as possible. This is especially true for workers in the field of hazardous industries.
3. It is necessary to take care of nevuses and moles, not to allow them to be injured and not to try to independently eliminate a cosmetic defect, regardless of its location.
4. Compliance with a balanced diet and maintaining a healthy lifestyle. It is scientifically proven that people who prefer fatty junk food and have bad habits suffer from skin cancer more often than others.
5. Take any medication only under the supervision of a doctor in the dosage strictly specified by him.

Skin melanoma affects the skin of people, regardless of age and gender. A timely visit to a doctor if there is a suspicion of a cancerous tumor gives an excellent chance of getting rid of the disease.

Melanoma is a skin cancer that develops from a mole very quickly and gives metastases to the lymph nodes and other organs and systems. It is not easy to detect melanoma at the initial stage, the tumor is almost imperceptible and, nevertheless, very dangerous.

Modern medicine is faced with many diseases. Some of them have been known to mankind for a long time, and some have not even been investigated. That is why problems with diagnosis and treatment often arise. Oncological diseases are one of the most dangerous. They carry a great danger to human life, and at the moment there is no medicine that guarantees 100% cure. This article is about melanoma. We will find out what kind of disease it is, what statistics knows about it, we will analyze treatment and diagnosis. Be sure to read all the information provided. Today's pace of life requires such awareness not only from specialized specialists, but also from the person himself.

What is melanoma?

Melanocytes are certain cells located in the skin of a person that produce melanin (the so-called coloring pigment). Melanoma is a skin cancerous formation that arises and develops precisely from these cells (melanocytes). This tumor disease is now very common everywhere. Unfortunately, people of different ages, sexes and nationalities are exposed to it. The first stages of the disease in question in most cases have a positive trend in treatment, while neglected forms very often do not respond to interference and as a result lead to death.

Modern medicine knows many pathologies of the skin of an oncological nature, and melanoma is one of them. According to statistics, in the countries of central Europe 10 cases per 100,000 people are annually. Austria and America have 37-45 cases per year for the same number of people in the country, which makes melanoma the most dangerous cancer, even in developed countries, what can we say about those where the level of medicine is not so developed.

Scientists in Berlin concluded that women are faced with this disease much more often than men. Statistics show that 6 thousand men and 8 thousand women are affected by the disease. Mortality due to melanoma is determined by 2 thousand men and women. From official data it is clear that about 14 thousand Germans fall ill with this type of cancer annually. It is also worth knowing that out of all the deaths in the world from cancer, 1% of them are due to melanoma.

The disease is considered to be of different ages, but the majority of patients are in the elderly, after 70 years. Over the past half century, the incidence of the disease has increased by 600%. However, do not relax if you are still very far from this age. Unfortunately, melanoma is often diagnosed in middle-aged people, youth, and even children.

Many moles: maybe melanoma?

Since melanoma develops from a mole, it would be logical to ask: are people with many moles on their body susceptible to cancer? Oncologists answer: yes. People with nevus, papillomas and skin prone to pigmentation should be careful not to expose the skin to solar radiation and mechanical damage.

Years of medical research have shown that people with East European skin types have melanoma on their limbs and trunk. More exposed to her face, having blond, red hair, eyes green, gray, blue shades. The risk group consists primarily of people with pink freckles, congenital age spots (nevuses) and atypical moles located in open areas of the body, forearm, foot and back. Injury to the nevus in some cases leads to skin cancer. In older people, age-related pigmentation on the skin is a signal for concern, which in no case can be ignored, since melanoma develops well against this background. The following factors affect the appearance of such a pathology:

• hereditary predisposition;
• regular exposure to ultraviolet rays;
• dubreus melanosis;
• pigment xeroderma;
• the presence on the body of a large number of moles (more than 50 pieces) and freckles.

Thus, if there was at least one case of cancer in the family, then all subsequent generations automatically fall into the risk group, and if a person is constantly exposed to ultraviolet rays, and additionally also has fair body skin, strewn with freckles, then he needs to be especially careful refers to his health. These people also need to know about factors that can provoke the rapid development of cancer cells (which are in the body of every person, only for the time being dozing). In addition to environmental influences, cancer can be provoked by severe stress, prolonged illness, alcohol, smoking, drugs.

The rapid formation of moles and freckles on the skin is also a cause for concern.

Where does melanoma grow

However, melanoma occurs in people with any skin color. People in different countries meet with this skin pathology.

A tumor will not be recognized as malignant if hair growth is detected on the skin. In the area affected by melanoma, this does not happen. However, even if there is no hair on the neoplasm, do not panic, remember - if you take appropriate measures in time, the disease can be defeated.

Melanoma develops on age spots and healthy skin as well. In women, it is found, most often, in the region of the lower extremities, and in men on the entire surface of the trunk. Parts of the body exposed to ultraviolet rays are more often affected by this formation. However, areas of the body where the rays penetrate little and do not penetrate at all are not excluded. This tumor also occurs in people between the fingers, on the soles of the feet, even on the internal organs. Infant morbidity is extremely rare. Scary, but even minimal getting a sunburn or heat stroke is conducive to the disease.

Everyone develops a different disease.

The disease in different patients proceeds at different speeds. There is a period of several months, when the disease proceeds very rapidly and leads to death. Some people have been suffering melanoma for more than 5 years, thanks to ongoing supportive care.

Another danger is that metastases appear very early, a person may not even suspect a disease for a long time. The lesion occurs in the bones, brain, liver, lungs, skin, heart. Metastases may not appear if melanoma has not spread shallowly, i.e. not further than the basement membrane.

Types of Melanoma and Symptoms

Modern medicine differentiates the disease considered in today's article into types and defines in this distinction a set of symptoms arising from this disease. Symptoms of melanoma are quite diverse. Thanks to her and high-quality diagnosis, you can detect the disease at an early stage.

The types of this tumor are as follows:

This formation is growing very slowly, but it is considered the most common and occurs, according to statistics, in 47% of cases. It grows in the horizontal direction, has an uneven shape and is slightly convex to the touch. Reaching a peak, she begins to resemble in appearance a black glossy plaque. Only then it gradually grows vertically and then grows deeper into the skin;

2. Nodular or nodular melanoma grows quite rapidly and is the second most common, according to statistics, it occurs in 39% of cases. This type is more aggressive and rather rapid;

3. Peripheral or malignant lentigo changes the tissues of the skin, which later turn into cancer, and this type occurs in 6% of cases. He is considered a precancerous condition. The lesion on the skin is flat, not convex;

4. Amelanotic melanoma or acral melanoma occurs on the soles of the feet and on the palms of the hands. Occurs extremely rarely in medical practice.

Initial melanoma: how to determine

Very often, an oncologist is consulted by people with an already advanced stage of melanoma, when the tumor has already begun to metastasize to various organs. Due to the painlessness of this type of skin cancer and the speed of its development, the symptoms of melanoma must be known. A person can be saved if melanoma is detected at its very initial stage. Melanoma can be identified by:

1. The appearance of a skin formation with an irregular shape;

2. Distinctive color education;

3. The edges of the tumor with a jagged or arched shape;

4. A dark spot from 5 mm in size;

5. A stain that looks like a mole that is located above the skin level.

From the foregoing, one can draw the following conclusion: it can be melanoma if a mole suddenly appeared that had not existed before. At the same time, it is irregular and heterogeneous in shape, has blurry edges. It can itch and hurt. It completely lacks hair. It may have ulcers, oozing blood or an anemone (but this only happens in some cases).

Sometimes melanoma is reborn from an existing mole. Be careful if:

• there used to be hair on a mole, but now it has fallen out;
• mole has increased in size;
• the mole has changed color (for example, it used to be light brown, but now it has become very dark, almost black);
• nevus increased volume - significantly increased above the skin;
• keratosis became noticeable on the nevus - dark dry pimples appeared;
• dark spots appeared around the mole.

Symptoms of Melanoma

Skin melanoma is formed from a mole (nevus) in 70% of cases and is located in the trunk, limbs, head and cervical region. In women, as a rule, the lower limbs, chest, and in men, chest and back suffer. In addition, men are prone to epidermal nevus. The defeat occurs on the palms, feet and scrotum. The skin changes color, the structure appears bleeding area. These signs, which determine the most important ones in the preliminary diagnosis.

Melanoma is black, sometimes with a blue tint and looks like a knot. Pigmentless melanomas are found in which there is no particular color, and they are colored pink. The size varies from 0.5 cm to 3 cm. The affected surface may bleed and have a densified structure. Using a magnifying glass at the examination, a preliminary diagnosis can be made.

Determining this disease in the early stages is very difficult. Cancer in stage I may not attract attention. To determine the ailment, the doctor needs to have extensive experience working with similar diseases.

Consider the most common types of melanoma in more detail. We will talk about the surface-distributed, nodular (nodular), malignant lentigo.

Malignant lentigo has a long phase of horizontal growth, which can last up to 20 years or more. In old age, the disease forms against the background of pigmentation on the neck and face.

Superficial melanoma is observed in people whose average age is 44 years. Formation appears both in closed areas of the skin and in open. The upper back is most often affected in men, and in women the lower limbs suffer. When forming, the plaque acquires a chaotic contour, in some places it discolors and stains in a mosaic type, the epidermis undergoes changes and significantly thickens. After a few years, a knot appears on the plaque, then the growth of melanoma occurs already vertically.

Nodular melanoma is the most aggressive of other species. The average age is 53 years. In men, it occurs a little more often than in women. The upper and lower extremities, cervical region, head and back suffer. The node is formed quickly, the skin undergoes changes, reaches a peak of development in several months and already has bleeding.

Improper treatment can lead to recurring relapse. Against its background, distant metastases occur. In most cases, chemotherapy is used. The treatment can be prescribed a combined type, then the patient takes antitumor drugs, which gives a chance of recovery in 40% of cases.

Forms of manifestation of melanoma

Malignant melanoma often sends metastases to the brain, heart, lungs, liver by the hematogenous method and lymphogenous. The nodes begin to spread and are located along the limb, skin, or trunk.

It so happens that a person turns to the doctor with a complaint about enlarged lymph nodes. A competent physician will ask a lot of clarifying questions to the patient to draw up a complete picture of the disease. For example, it may turn out that a patient has recently removed a wart that was melanoma.

Symptoms of eye melanoma

The defeat of tissues by melanoma occurs not only on the skin, but also on the visual organ, eye. The first symptoms include the appearance of a tumor, rapid visual impairment, the appearance of photopsies and progressive scotoma.

Photopsia is accompanied by the appearance of sparks, dots, spots in the field of view. There are two types of scotoma:

1. Positive scotoma (a blind area appears in the field of view, which is perceived by a person as a black spot);

2. Negative scotoma (the blind area is not perceived by a person in any way).

Negative scotoma is determined using certain methods.

Small melanoma can be confused with the pigmented nevus, which is located in the eye membrane. A positive scotoma should be differentiated by an experienced oncologist, as glaucoma has similar symptoms.

It is possible to determine the growth rate of ocular melanoma only with the help of certain studies. The treatment tactics chosen by the doctor after a detailed study. Radiation therapy, local resection or ocular enucleation is prescribed.

Stages of melanoma

The disease has 5 stages, where stage zero is the easiest. Cancer cells are present only at the cellular level. Germination deep into the malignant tumor has not yet occurred.

Stage I has a tumor formation of not more than 1-2 mm in thickness, above the skin level. There may be ulcerations, but this is not necessary. Lymph nodes located near the affected area of \u200b\u200bthe skin are not exposed to negative effects from the tumor.

Stage II has tumor formations from 2 mm thick and characteristic manifestations. Remote and regional metastases are absent.

At the III stage, pathological changes in the skin appear, the nearby lymph node is affected by cancer cells. Sometimes at this stage, melanoma cells spread further along the lymphatic system.

Stage IV always has cancer cells on the lymphatic system and the disease has already spread to other parts of the skin, organs and tissues of the body. Fatal outcome in 100% of cases.

Practice shows that relapses occur even with the right treatment, in addition, the disease returns not only to those places where it was before, but also to those parts of the tissues that were not exposed to melanoma.

Diagnosis of melanoma

A number of manipulations help diagnose melanoma. The doctor uses a special magnifying glass for examination. A radioisotope study helps to make a diagnosis. Thanks to him, you can see a large amount of phosphorus in the tumor, which means that the tumor is malignant.

If skin cancer is suspected, a puncture or biopsy is used, but not with melanoma. The fact is that any damage to the skin can aggravate the situation.

A cytological examination helps to determine the diagnosis finally. On the surface side of the formation, an imprint is taken together with the expression.

A detailed conversation with the patient helps in the diagnosis of melanoma. It is necessary to pay attention to the symptoms that appear in the patient. Often there is weight loss, worsening visual acuity, joint pain, headache and general malaise. X-ray, CT and ultrasound help to accurately determine the presence or absence of metastases on the internal organs of a person.

Melanoma Treatment

The disease is treated in two ways, this is surgery and combination treatment. With combined treatment, the tumor is removed after irradiation.

Combined treatment occurs in two stages. Close-focus x-ray exposure is used in the first stage. Radiation reaction occurs on 2 or 3 days after exposure to the tumor. Therefore, the operation is carried out before or after this point. The malignant lesion is removed with enough healthy tissue around. To restore the skin to its usual appearance, it is necessary to perform plastic surgery, because a wound defect accompanies this kind of procedure.

A patient faced with malignant melanoma needs to remove regional lymph nodes, even if the disease is not detected in them, because melanoma is prone to spread metastases to nearby lymph nodes. Such caution affects the prognosis of the course of the disease and gives a chance for a favorable outcome. Larger lymph nodes indicate a possible metastasis in them. The combined method of treatment involves irradiation with gamma therapy, after which, through surgical intervention, the necessary lymph nodes are removed. In recent years, such combined methods of combating cancer have been used quite often, which indicates a positive effect of the combination of these procedures.

Melanoma prognosis: is it possible to survive?

Melanoma is an extremely dangerous and rapidly developing cancer. Of primary importance is the clinical stage, which was relevant at the time of diagnosis when referring to an oncologist. After all, the sooner the disease is detected, the greater the chance of a favorable outcome. Approximately 85% of patients survive over a five-year period at stage I and II, when the tumor has not yet spread beyond the cancer site. Since stage III metastases spread throughout the lymphatic system, survival is 50% for a five-year period, with only one lymph node affected. If several lymph nodes are affected by the disease, then the ability to recover is reduced to 20%. As mentioned earlier, the fourth or last stage of melanoma has distant metastases, so the survival rate for five years is only 5%.

As a rule, the diagnosis is made at stage I or II, which significantly increases the chances of defeating the disease. Tumor thickness plays an important role in determining prognosis because its mass indicates the presence of metastases.

At 96-99%, five-year survival is due to surgery if the tumor is not 0.75 mm thick or less. Patients with a thickness of not more than 1 mm and about 40% have a low risk. A sharp regression or vertical increase in the tumor indicates the appearance of metastases, but only a histological examination will give the final answer.

In 60% of cases, metastases spread if melanoma has grown to 3.64 mm or higher. Such dimensions are very dangerous because they lead the patient to death. But you can notice the tumor much earlier, because it rises above the level of the skin and significantly changes its color.

The location of the tumor on the body affects the prognosis. Damage to the skin on the forearm or lower leg gives a better chance of recovery than the presence of cancer cells in the area of \u200b\u200bthe hands, feet, mucous membranes and scalp.

Prediction in some way, is determined by belonging to a particular gender. The first two stages often have a better prognosis for women than for men. This is due to the fact that in women the disease develops on the lower extremities, therefore, it is easier to see there at an early stage, and timely detection of a tumor gives great hope for recovery.

A less favorable prognosis is determined for elderly patients. This is due to the fact that tumors are detected quite late and older men are more likely to suffer from another form of melanoma, namely, acutely lentiginous.

Statistics show that after 5 years or more, the tumor returns in 15% of cases after its removal. The fact is that the likelihood of a relapse depends on the thickness of the cancer. Accordingly, the thicker the removed tumor was, the greater the chance that it would return in a few years.

In the first two stages, unfavorable forecasts are sometimes found. There is a high risk of the appearance of increased mitotic activity and satellites (small areas of tumor cells with a minimum size of 0.05 mm and even more) that begin to form in the subcutaneous tissue or the reticular dermis. Often, melanoma spreads satellites and micrometastases simultaneously.

By comparing the histological criteria, Clark makes a prognosis for stage I and II of the disease. The location of the tumor in the epidermis determines the I stage of invasion in accordance with the Clark system. The penetration of a malignant tumor into the layers of the epidermis determines the second stage of invasion. When the tumor enters the space between the papillary and reticular dermis, this indicates the III stage of invasion. The IV stage is characterized by the penetration of the formation into the reticular layer of the dermis. Germination occurs in the subcutaneous tissue at stage V according to Clark’s criteria. The survival rate for each individual criterion is 100% at stage I, 95% at stage II, 82% at stage III, 71% at stage IV, and 49% at stage V.

Everyone should understand that timely treatment at the clinic makes it possible to prevent the serious consequences of diseases. Any changes in the nevus is the reason for a thorough examination. It is necessary to pay attention to changes in its color, size and shape. Expressions and bleeding should not be allowed to drift, because stages III and IV are not amenable to treatment with modern medicine. Even the most advanced technologies and the latest equipment have not yet learned to cope with advanced forms of cancer. Prevention and early diagnosis of the disease help prevent a serious illness and its consequences. Do not forget to independently examine the skin. At the slightest suspicion of melanoma, contact your doctor immediately.

Melanoma or melanoblastoma is a malignant neoplasm (skin cancer) that develops from melanocytes. What is it and what functions does it perform?

Melanocytes are specialized cells that produce melanin, which determines the color of a person’s skin, and its ability to tan. Also, melanocytes perform a protective function, preventing the harmful effects of ultraviolet radiation.

Skin melanoma is considered the most aggressive type of cancer. The tumor process is developing very rapidly. It is a mistake to assume that melanoma appears only from moles.

The percentage of development of this type of cancer from moles is only 30%, the rest falls on clean skin. Melanoma can form even under the nails.

Despite the fact that for the most part melanoma develops on the skin, it can occur in the rectum, vagina, various structures of the eye, and oral cavity.

Causes of Melanoma

There are many theories for the occurrence of cancerous conditions. Science has not yet decided on the reasons for the development of the tumor process, however, for each type of tumor, there are prerequisites and risk factors. For melanoma, this is:

• systematic prolonged exposure to ultraviolet radiation on the skin (sunlight, artificial light in tanning salons);
• chronic burns;
• regular repeated mechanical trauma to moles, age spots, nevi;
• ionizing radiation;
• chronic electromagnetic radiation;
• predisposition of the skin - low pigmentation (white skin, copious amount of freckles);
• heredity (the risk of the disease increases if in the family someone has suffered this type of skin cancer);
• immunodeficiency conditions;
• hormonal disorders (elevated levels of sex and melanocyte-stimulating hormones);
• late pregnancy (after 30);
• use of oral contraceptives.

Symptoms of Melanoma

The initial stage of melanoma

Pictured melanoma on the scalp

Acrolentiological melanoma

Skin cancer on the lip

Skin cancer most often occurs on the lower limbs or back, however, localization can be very diverse. As was said, it can occur at the site of the mole, at the site of injury to the skin, or on normal uninjured clean skin (see photo above).

A malignant neoplasm changes the melanocyte, however, it continues to produce the pigment melanin, so the neoplasm becomes black, brown.

Colorless melanomas are also found.

One symptom of melanoma is a black rim along the edge of the tumor on the skin.

A characteristic feature of melanoma is the asymmetric formation and its large size. At first, skin changes are often not perceived by humans as cancer.

At first, melanoma is similar to a mole, but of an unusual appearance.

Symptoms in melanoblastoma are divided into early and late:

• Early (first) signs of the disease:
  • the elevation of previously flat moles;
  • itching, burning, bleeding, ulceration;
  • density change (a previously firm mole becomes soft);
  • hyperemia and edema of adjacent tissues;
  • growth of the primary focus of neoplasm;
  • new areas of pigmentation around the primary focus of neoplasm;
  • crust formation;
  • discoloration of the nail plate on the arms and legs;
  • darkening of the skin, not associated with prolonged exposure to the sun;
• Melanoma from nevus (a benign tumor of the skin) can be distinguished by the following signs:
  • nevus is a flat formation on the skin;
  • the nevus has a symmetrical shape and smooth smooth outlines;
  • nevus does not have the ability to increase in size.
• The late symptoms of melanoma are:
  • bleeding from the formation and other pigmented areas of the skin;
  • pain syndrome that occurs on the affected skin;
  • violation of the integrity of the skin.

Stages of development of melanoma

The doctor determines the stage of development of melanoma according to the thickness of the neoplasm:

1. Zero stage  - “cancer in place” - at this stage, melanoma has not yet grown into the thickness of the epidermis;
2. initial stage  - the tumor size is less than one millimeter with skin damage or up to two millimeters without damage (see how it looks in the photo below);
3. Second stage  - the thickness of the formation of up to two millimeters with a damaged skin surface or more than two millimeters without damage;
4. Third stage  - the presence of metastasis in one of the regional lymph nodes (lymphatic vessels);
5. Fourth stage  - tumor growth and germination of underlying tissues, the presence of metastases throughout the body.

Metastases of melanoma occur most often on the skin, in the subcutaneous tissues, brain and bones (spine, ribs, cranial and pelvic bones).

Classification

• Superficial spreading melanoma.  Typically, this type of melanoma develops on a mole or intact skin area.

  Lentigo maligna (surface-spreading melanoma)

• Nodular melanoma  is a more malignant type of disease.

• Lentiginous melanoma  (Hutchinson's freckle) develops more often on the face, ears, neck, hands. It is considered the most favorable form of this pathology (slow growth combined with a low risk of metastasis);

How is the diagnosis carried out?

  Dermatoscope

First of all, a specialist examines the affected area of \u200b\u200bthe skin.

A thorough visual inspection is carried out using a special device - a dermatoscope.

This is an instrumental research apparatus, which allows examining a skin neoplasm without surgical intervention.

  Dermatoscope Shot

A dermatoscope allows you to see signs of a malignant course of formation that are not visible to the naked eye. Scientific progress has contributed to the creation of a digital dermatoscope, thanks to which you can see a three-dimensional image of the pathology on the screen.

Without fail, a patient with suspected skin cancer donates blood to detect tumor markers .   Oncomarkers are called specific substances that a malignant tumor emits.

A biopsy is a mandatory diagnostic method for suspected cancerous pathology.

The material undergoes a histological and morphological study, which allows you to determine the degree of tumor malignancy, stage and clinical form of melanoma.

Additional research methods are:

• cT scan;
• scintigraphy;
• Ultrasound of the regional lymph node and internal organs.

These methods are used to detect tumor metastases.

Melanoma Treatment

In the early stages of the disease, surgical treatment is carried out, which is the most effective. Perhaps the use of drug therapy. In the later stages of development of melanoblastoma, radiation treatment methods are used.

Medication for melanoma

With skin melanoma, three drug treatment regimens are used:

• before surgical excision of the tumor to reduce the size of melanoma and the defect that remains after (no adjuvant therapy);
• basic therapy when surgery is not possible;
• after surgical removal of the neoplasm in order to prevent relapse (adjuvant therapy).

Medication for melanoma is immunotherapy, radiotherapy and chemotherapy.

Immunotherapy of melanoma is carried out using biological preparations created in the laboratory, but similar to the immunity proteins of the human body.

Applied medicines:

• Interferon alfa  used in adjuvant therapy, preventing relapse of an excised tumor;
• Interleukin-2used to prevent metastasis;
• Peginterferon alfa-2bprovides effective anti-relapse prevention;
• Ipilimumab  - a drug based on monoclonal antibodies; specifically affects the body, increasing the immune response to malignant processes;

Chemotherapy and Radiotherapy

With chemotherapy for melanoma, the drugs spread through the blood vessels, penetrate all organs, tissues and have a systemic effect.

This type of therapy for melanoma is not effective enough, moreover, the destruction of healthy body cells occurs, which makes chemotherapeutic drugs undesirable for use.

Chemotherapy is carried out in conjunction with immunotherapy in order to reduce the possibility of side effects.

Drugs used with this type of therapy: Dacarbazine, Paclitaxel, Carboplatin.

Chemotherapy causes a number of side effects:

• baldness;
• weakness, loss of appetite;
• increased bleeding;
• nausea, vomiting, diarrhea.

Radiotherapy is a treatment method using strong radiation, which lethally affects damaged tumor cells. The method is not applicable for primary melanoma.

Radiotherapy is prescribed after lymphodissection, as a way to prevent relapse.

This type of therapy is accompanied by side effects (hair loss, nausea, vomiting, skin manifestations), however, all undesirable effects from radiotherapy disappear at the end of treatment.

Surgery

Surgery followed by removal of the tumor is the main treatment for melanoma, especially at the initial stage of the disease.

The following surgical methods for removing the tumor are:

• Simple excision- this method is suitable for flat melanomas and involves minimally invasive intervention. Together with the damaged areas, healthy tissues around are removed to prevent relapse;
• Wide tissue excision  - performed after a biopsy, the results of which showed the presence of a tumor process;
• Amputation  - used if melanoma is localized on the finger;
• Lymphatic dissection  - removal of lymph nodes located in the immediate vicinity of the tumor.
• Surgery for metastatic melanoma  - It does not allow the patient to be cured of a tumor, but it improves the quality of his life, by removing the symptoms that metastasis in any organ gives.

Auxiliary treatments

When melanoma is necessarily indicated diet, which suggests proper nutrition to reduce the effects of chemotherapy.

With melanoma, you must follow these rules:

• Reduce fat intake and focus on proteins and carbohydrates;
• It is necessary to cook only steamed or in the oven;
• It is strictly forbidden for a patient with melanoma to go on various diets for weight loss;
• It is necessary to eat every two to three hours in small portions;
• Eliminate alcoholic beverages;
• Increase the number of foods in the diet, which include vitamins E and A and folic acid;
• Increase the intake of foods with antioxidants (broccoli, carrots, pumpkin).

It is forbidden to eat:

• Pork and beef;
• Butter;
• Fast food;
• Baking
• Ice cream;
• Chocolate;
• Sunflower seeds;
• Pine nuts.

Beneficially, the condition of the patient with melanoma will be affected by such products:

• Green tea;
• Fish;
• Vegetables, both raw and boiled (especially pumpkin, radish, tomatoes);
• Fruits or freshly squeezed juices;
• Poultry meat;
• Seafood.

Prevention

People who are predisposed to the development of melanoma need to follow some rules that will reduce the risk of the disease:

• Reducing the duration of exposure to the sun is the main prevention against melanoma;
• It is necessary to protect exposed skin from direct sunlight (wear sweatshirts with sleeves, hats or caps and pants);
• The use of sunscreen is recommended;
• Knowledge of the first signs and symptoms of melanoma is necessary so that if one of them is detected, consult a doctor immediately and begin treatment;
• It is necessary to examine the skin for the presence of new formations or changes in the old ones, so as not to miss the transformation of the mole into melanoma;

How long will the patient live after diagnosis?

The prognosis for this cancer depends on several factors, one of which is tumor metastasis.

If melanoma gave metastases, then the patient's life depends on the number of affected organs:

• one to seven months;
• two - up to four months;
• more than two organs - less than two months.

One of the factors affecting the patient's lifespan is the localization of the tumor process. The prognosis is more favorable with the location of melanoma on the forearm and lower leg, less - the hair of the head, hand, foot and mucous membranes.

Melanoma recurs very often. Scientists have found that the malignant process can start again even ten years after a complete cure.

However, upon detection of melanoma of the first stage, with the timely removal of this formation, the prognosis is more than favorable (97% of patients survive).

For patients who have been able to survive skin cancer, there is a list of mandatory rules that must be followed in order to avoid or promptly detect recurrence of the disease.

First of all, every month the patient should independently or with the help of relatives examine his skin for the presence of suspicious formations and the first alarming symptoms of relapse.

The patient must adhere to the schedule of a visit to a specialist for consultation and examination (if indicated).

Patients with a cured first stage of the disease are recommended to visit a doctor once every three months for the next several years. With the second, third and fourth stages - once a month for four years.

It is also very important to avoid sunlight, to stop visiting tanning salons if the patient used these services before the illness.

Such patients should qualitatively change their lifestyle. Sports activities, proper sleep duration, proper and balanced nutrition are welcome. Refusing bad habits (drinking alcohol, nicotine) is an important measure in the prevention of relapse.

Exercising does not mean intense physical activity. It can be hiking, aerobics, fitness.

This disease is a severe stress for the psyche. And even if the disease managed to defeat unpleasant memories, it can still excite the mind of such a person. Therefore, it is important to apply stress prevention methods (meditation, relaxation). Trips to a psychotherapist are recommended if the patient cannot independently cope with the negative emotional background of the disease.

It is also important that family and loved ones participate in rehabilitation after treatment for melanoma. Regular communication, support, joint pastime will only beneficially affect the psychological state of the patient.

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