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Melanoma

Melanoma is a type of cancer that starts in cells called melanocytes. These cells produce a substance called melanin, which is responsible for giving our hair, eyes and skin its unique pigmentation (color). You may mostly think of melanoma in regards to skin cancer, but it’s important to be aware of how it can affect your eyes, too.

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Rejuvenating your body’s largest organ

Your skin is your body’s largest organ. It has a natural cycle called regeneration where it sheds dead skin cells to reveal new ones underneath. Because of regeneration, it’s important to be aware of the skin you’re in and how it changes with time.

Melanoma has been on the rise in the United States. It’s widely accepted that ultraviolet (UV) light exposure from the sun can cause melanocytes to start growing abnormally and forming tumors in your skin or eyes. That’s why it’s so important to care for your skin with protective clothing, sunscreen and routine skin checks for changing moles or skin pigments. And don't forget a pair of sunglasses when leaving the house to protect your eyes.

While melanoma is the most dangerous and malignant form of skin cancer, it’s highly curable when caught and removed early on.

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Conditions

Melanoma is form of cancer that develops anywhere on the body as moles, bumps, scaly patches of skin or open sores. The difference between melanoma and other types of skin cancers is that it's considered malignant, meaning that it can spread to other parts of the body.

Melanoma often surfaces on areas that have the most exposure to sun, like your back, legs, arms and face. However, melanoma can also develop in other areas like your eyes, head, fingernail beds or even genitals.

Knowing how to identify melanoma red flags is very important. Melanoma can develop very quickly, but it’s also highly curable with early detection. Keep your ABC’s top of mind when doing an at-home skin check:

  • A for asymmetry: Is one side of the spot different from the other side?  
  • B for border irregularities: Does your spot look jagged or have uneven edges?  
  • C for color variegation: Does this spot have a different color compared to others in the same area?
  • D for diameter: Is this spot larger than a pencil eraser (about 6 mm)?
  • E for evolution: Has this spot changed in color, shape or symptoms over time?

Melanoma can also lead to symptoms like:

  • Bleeding 
  • “Crust” forming on the skin 
  • Inflammation
  • Ulceration (open sores)

If you notice any of these abnormalities, talk to your doctor as soon as possible. They may refer you to a dermatologist for more evaluation.

Ocular melanoma

While melanoma is oftentimes linked to skin cancer, it can affect the eyes, too. Ocular melanoma comes in several forms, with each one developing from the pigmented cells in your eye:

  • Conjunctival melanoma: This affects the thin, transparent layer that covers the white part of your eye.
  • Iris melanoma: This affects the colored part of your eye.
  • Choroidal melanoma: This affects the thin layer of blood vessels that sit behind the white part of your eye.
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Testing

Early detection is the name of the game when it comes to treating melanoma. Our word of advice is to schedule regular skin and eye exams with your primary care doctor, dermatologist or eye doctor so they can keep a detailed record of your skin and eye health.

Meeting with your doctor to undergo a routine skin exam is an excellent way to stay on top of your health. That's because your doctor can note when an existing mole changes or a new, unusual growth on the skin forms. If your doctor suspects anything unusual on your skin, they may take a small skin sample, or biopsy, to examine the skin cells more closely.

The earlier these changes are discovered, the more likely your treatment will be successful.

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Treatments

Have you ever wondered what gives our hair, eyes and skin their unique pigment (color)? It's all thanks to our bodily substance known as melanin. Melanoma develops when pigment-producing cells, called melanocytes, start to grow out of control.

Curing very early stages of melanoma can be as simple as an excision surgery to ensure your doctor removed the damaged melanocytes. Advanced stages of melanoma are more invasive and can spread to other parts of the body. It can grow deep into the skin, then to lymph nodes and blood vessels that can take the melanoma into different areas of the body.

Surgery

Most melanoma surgeries can be achieved with local anesthesia and will have you return home the same day. Our goal is to surgically remove the damaged skin cells so that the margins come back clean, meaning that the edges of the affected tissue are completely cleared.

Moh's surgery

Depending on the type of cancer and its location, we may turn to Moh’s surgery to treat your condition. A Moh's surgery involves removing one thin layer of tissue at a time and evaluating its cells on the spot.

This layered surgical approach limits the amount of tissue removed during surgery by signaling to your doctor when the margins are clear. Moh's surgery is especially helpful for people with melanoma located on the head, neck, hands or feet.

Wide local excision

Another common surgical approach for treating skin cancer is with a wide local excision. This is a go-to treatment route for when the melanoma is localized (contained to one area) and in an easy-to-treat area that doesn't require a Moh's surgery. During a wide local excision, your doctor numbs the surrounding skin with local anesthesia and removes the damaged tissue.

Different from Moh's surgery that only takes out the damaged tissue, a wide local excision errs on the safe side and removes a wider margin (2 cm) around the melanoma to ensure all damaged tissue is gone. The size of the excision will depend on the margins and depth of the cancer.

Melanoma adjuvant therapy

Adjuvant therapy is any anticancer treatment that is given after a cancer is surgically removed. Treatment begins after surgery and continues for up to 1 year. This helps stop or slow the growth of any remaining cancer cells that were not removed during surgery.

Interferon alpha (IFNa) is the most common adjuvant therapy for melanoma. IFNa is designed to boost your immune system so that it can more effectively treat cancer.

Treatments for when a melanoma has spread

When melanoma metastasizes, it usually moves to other parts of the skin, lymph nodes, lungs, liver, brain or bones. Learning that your melanoma has spread can be a heavy weight to bear. You don’t have to carry it alone.

We’ll create a treatment path that prioritizes your comfort and quality of life. Depending on where and how big the metastases are, those treatments may include:

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FAQs

Who's at risk for melanoma?

Melanoma occurs more frequently in young and middle-aged people. People with fair skin, red or blonde hair and blue eyes may be at higher risk.

How can I prevent melanoma?

Studies suggest that melanoma is tied to sun exposure. You can protect yourself from the melanoma by:

  • Avoiding tanning beds and sunlamps
  • Using sunscreen with a high Sun Protection Factor (SPF)
  • Wearing clothing that covers your skin when going outdoors
  • Wear UV-blocking sunglasses
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