Melanoma Treatment in Mumbai, India

Overview

Melanoma is the most dangerous form of skin cancer in specialised cells called melanocytes. Melanocytes secrete excess melanin in patches, which leads to the disease manifesting itself in the form of blackish or brownish patches. Thus the condition is known as "black tumour". However, it can also be pink, red, purple or skin-coloured. It proliferates quickly and can spread to any organ.

About 30% of melanomas also start as moles, changing their form as the condition progresses. The moles range from 1/4 inch (about 6 millimetres) in diameter. However, many people with no risk factor may also have moles in their bodies. This is not a reason to panic. If you get moles very frequently and have existing risk factors, you can get yourself checked regularly to prevent severe cases. 99% of cases of melanoma can be cured if caught in the earliest stages.

Causes of Melanoma?

One of the major causes of melanoma is overexposure to sunlight. Sunburns are caused among younger people due to excess ultraviolet (UV)-light exposure, which leads to 86% cases of melanomas.

Excess UV exposure tends to damage the cell’s DNA irreversibly, leading to crucial gene mutations that may cause unrestrained growth and division of cells.

Another source of UV radiation is tanning beds, which have also been referred to as carcinogens (cancer-causing) agents by the World Health Organization (WHO).

Different Stages/Types of Melanomas

The moles in melanomas can be of different types and can be categorised as per their shape/orientation, and can be classified as ABCDE,

A stands for an asymmetrical shape with irregular borders or two very different-looking halves.
B stands for borders like irregular, notched or scalloped
C stands for changes in colour patterns
D stands for diameters larger than 1/4 inch (about 6millimetress).
E is for evolving in size, colour or shape, or any other discomfort like itchiness or bleeding.

Melanoma is staged using the Roman numerals 0 through IV. Until stage I, melanomas can be treated and cured successfully. But higher stages are more challenging to treat, indicating spread towards or beyond lymph nodes (stage II and III respectively). Stage IV denotes the spread of cancer into internal organs like the lungs or liver.

Prevention of Melanoma

Simple methods can act as preventive measures against skin cancer-

using sunscreen with an appropriate sun protection factor (SPF)
reducing exposure to carcinogens because of lifestyle or professional reasons
whenever possible, keep oneself hydrated
preventing exposure to the intense sun rays by using appropriate clothing

Diagnosis of Melanoma

Physical exam: The doctor normally conducts a thorough medical check and collects family history and past medical records.
Biopsy: Analyzing a specimen from the skin (mole) to conduct specialised histological examinations in the laboratory. It can be done in different ways and can involve on-site inspection and can be done after scalping out a thin section from the mole/blackened skin patch.

A common technique for doing biopsies is punched biopsy. It is conducted with a circular blade pressed into the skin around the suspicious mole.

Following the primary examination, the cancer is staged using a combination of techniques. These include determining the thickness of the sample under the microscope and assessing the spread of the melanoma to the lymph nodes. If there is a spread towards the lymph node, a specialist conducts a sentinel node biopsy, using a dye that spreads to the lymph nodes from the site of the excisional biopsy.

Imaging tests including X-rays, CT scans and positron emission tomography (PET) scans are used for further examination in case there is a risk of advanced disease that has spread to other organs (metastasis). One may also find ulcerated open sore in the skin.

Different Treatment Methods for Melanoma

Treatment for early-stage melanomas usually includes surgery. Once detected in the early stages, melanomas can be removed either through biopsies or by removing the entire section of the skin along with a part of the surrounding skin to ensure no metastasis in future.

Treating melanomas that have spread beyond the skin include,

Surgery to remove affected lymph nodes if the melanoma spreads towards lymph nodes
Immunotherapy targets the immune system that can help fight the cancer-causing cells and boost the immune system.
Targeted therapy focuses on specific weaknesses in cancer cells when cancer has spread towards or beyond the lymph nodes.
Radiation therapy uses a high-powered energy beam to kill cancer cells, like X-rays and protons. It is typically given along with surgery for severe cases of melanoma.
Chemotherapy targets specific cancer cells with the help of oral or intravenous injections. However, chemotherapy and radiotherapy have the inherent risk of killing normal cells along with cancer cells. Hence patients suffer from adverse effects during such therapies.

Risk Factors of Melanoma

People can develop melanoma when they have one or more risk factors, including

Previous medical history or genetic predisposition
Lack of melanin pigmentation in the skin (mainly Caucasian or white-skinned people), those with freckles, blond or red hair and blue eyes
Excess exposure to UV light and the sun owing to lifestyle and professional commitments or inhabiting tropical countries
Abnormal appearance of moles in the body, especially by the age of 40 years
A weak or compromised immune system

Certain atypical presentations of melanoma appear in people’s palms, soles, mouth, digestive tract, urinary tract, vagina, and nails.

Other Conditions & Treatments

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