It won’t come as any great revelation to learn that fair and pale skinned people with blonde or red hair, are more susceptible to the development of melanoma. But did you know that globally per head of populace, melanoma is the commonest type of cancer in the age range 15-29 and the fifth most prevalent cancer overall across the world? Further, Melanoma is one of the most rapid cancers in terms of aggressive progress and spread.
Interesting and surprising statistics about melanoma
Rather unsurprisingly, melanoma statistics reveal that the sharpest current rise in cases is in the post fifty years age group, a reflection of sun worshipping habits and general ignorance of the dangers of UV rays which younger people are much more in tune with.
This bracket also accounts for the overall percentage rise in melanoma sufferers over the last three decades, as the likely incidence of contracting melanoma increases with age. Most people survive their initial surgery but clinical data on collective survival rates is complicated by multiple factors including the speed of diagnosis, the designated stage or seriousness of the melanoma based on thickness and, the mitotic rate, essentially the rapidity at which the cells subdivide and proliferate.
What are the real facts about the cause of melanoma?
Doctors still maintain that exposure to UV is the greatest trigger of melanoma coupled with genetic factors in terms of skin shade and familial traits. Don’t believe the propaganda that sunbeds and tanning lamps are safe; the scientific evidence and facts from melanoma research demonstrate they cause the same damage as natural sunshine. Where they can be beneficial is in very short controlled windows, accustoming skin to small quantities of UV light which can assist in the prevention of burning. But if you are heading to warmer climes with lily-white North European complexions and wall to wall sunshine, best to stay covered up or use high factor total block sun oil. According to the American Academy of Dermatology, more people develop melanoma from artificial tanning devices than lung cancer from nicotine addiction.
Does a biopsy for melanoma hurt?
The process of biopsy to evaluate a skin abnormality or growth for melanoma status is not painful. Biopsy literally means a gathering of a tiny percentage of tissue. The area is numbed beforehand with a small injection of local anaesthetic. Sometimes the entire lesion is removed because part of its evaluation is thickness and overall size. Patients are left with a small wound which will be managed routinely as any other deliberate or accidental incision. The area is cleaned and dressed to protect it from infection. Any discomfort can be managed with oral painkillers and anti-inflammatory medication.
What information does melanoma histology offer?
A specialist skin pathologist examines the biopsy microscopically with the intention of grading it into one of four categories. The examination conclusion or melanoma histology is based on the depth of the melanoma, the existence of ulceration, consideration as to whether the cells are dividing and finally, confirmation of tumour-infiltrating lymphocytes otherwise known as immune cells. Critically, the report will also describe the presence or absence of melanoma on the edges and bottom of the sample, an essential indicator to the surgical team of their success or otherwise of the removal of all the malignant flesh.
Why is immunotherapy recommended for some melanoma sufferers and not others?
Unless cancer is very far advanced and terminal and care is simply palliative, then removal of the melanoma via operation is standard procedure. Immunotherapy for melanoma is also offered where there is a high possibility of recurrence or cancer has already invaded other areas of the body – metastatic melanoma. Immunotherapy is used in melanoma treatment and other cancers – lung cancer and non-Hodgkin Lymphoma – to stimulate the immune response, encouraging the body to destroy any melanoma cells itself.
At this stage, an oncologist can use agents to boost the immune system and common prescriptions would include antibodies and interleukins, names like Imlygic, Opdivo and Keytruda are all FDA approved. Studies are also investigating the potential benefits of stem cell treatments and vaccine therapy which are undergoing clinical trials.
What to expect from surgery to remove a melanoma?
A small area of skin or abnormal-looking mole can be quickly removed at an outpatient’s clinic and does not necessitate a hospital stay. A wider or deeper excision or removal near a joint e.g. the elbow may need to be conducted under general anaesthesia and you could need a skin graft to repair the incised area. This involves cutting a patch of skin from a discrete area to apply to the wound to promote healing and this cannot be done under local anaesthetic. Follow up appointments and antibiotics are required throughout the healing process. A GA also allows the doctor to inspect your lymph nodes if there is a suggestion that cancer has spread. This applies to those diagnosed with Stage 1B or Stage 2 melanoma. The test is called an SLNB or sentinel lymph node biopsy.
Melanoma surgery depends wholly on your stage of melanoma. For small scale removal under a local numbing agent, there is barely any inconvenience or disruption to daily life. This is why it is always recommended to quickly remove anything that is unusual or odd before it becomes a real problem.
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