General characteristics of the disease
Melanoma - a particular tumor on human skin cells which, malanotsity, produce the pigment melanin. And since it affects the color of the skin, hair and human retina, one of the main signs of melanoma it is the dark color of the tumor.
Melanoma - only one type of skin cancer pathologies. It is quite rare compared to other types of skin cancer, basal cell or squamous tumors. Melanoma is not more than 15% of all cases of skin cancer.
The most common symptoms of melanoma are diagnosed in the limbs and body of people with Eastern European skin type. Her feature - the pale white color and increased susceptibility to erosion at sunburn. Patients with signs of melanoma most often red or blond hair, blue, gray or green eyes.
Precipitating factor in the development of melanoma may serve of severe sunburn, the presence of venous ulcers or scars in places fold limbs. The symptoms of melanoma are diagnosed more often in the elderly, in patients with skin cancer in the family history, as well as the men and women whose skin is prone to moles. Melanoma is a particular danger for patients with congenital xeroderma pigmentosum, Paget's disease, or Bowen.
Melanoma - the extremely aggressive and dangerous disease. Timely diagnosis and successful treatment of melanoma - one of the most difficult problems of modern oncology. Each year, the disease is diagnosed in about 4 per 100 thousand. Population. Guaranteed healing of disease is achieved only when the regional prevalence during the early stages of melanoma.
Symptoms of melanoma
Melanoma is not necessarily developed on the site of a mole or birthmark (nevus). Dark-colored asymmetrical forms of education may appear on the site with clean skin, devoid of any dark spots.
However, most often to malignancy (malignancy process) tend to nevi is almost black, dark gray or dark brown. An important sign of melanoma - the lack of vegetation in the hair nevus. Initially, it is also almost never rises above the surface of the skin. Over time, lentigo is beginning to change color, and the first symptom is the appearance of melanoma skin at the site of the tumor pink-red, gray or white color.
Signs of melanoma in the late stages of development include bleeding, itching, pain, expression of, as well as the emergence and spread of the tumor near numerous pigmented spots. The average size of 6 melanoma mm in diameter. Behavior in terms of speed melanoma growth and metastasis unpredictable.
Symptom melanoma surface type - slow growth for several years. The rapid growth - especially cancers of the skin nodular. Symptoms of this type of melanoma include friability and a tendency to ulceration of the skin at the site of the tumor.
Malignant lentigo and freckles Hutchinson more typical for the elderly. Another type of melanoma, lentigo peripheral, usually occurs in people with darker skin color and are diagnosed at later stages of melanoma in connection with localization in remote places look, for example, on the sole.
Diagnosis of melanoma
Any appearance of suspicious lesions on the skin requires a careful attitude. At the first sign of melanoma diagnosis of the disease begins with a survey of the patient's timing of the appearance and behavior of the suspicious spot. After anamnesis and inspection neoplasms comes the turn of laboratory tests for the diagnosis of melanoma. The first of them - a skin biopsy, study under a microscope scraping the surface layers of the skin, performed under local anesthesia.
For the diagnosis of metastatic melanoma tumors used needle aspiration biopsy, surgical biopsy of lymph nodes, chest X-ray, CT (computed tomography) and MRI (magnetic resonance imaging) of the entire body. Indications for this type of diagnosis is confirmed diagnosis of "melanoma" on the results of local tumors and biopsy poschupyvaemye tumor nodules in the lymph nodes.
Staging of melanoma - one of the most important prognostic factors in treatment. A sign of melanoma stage I and II is the localization of the tumor in the primary focus. In this case a positive outcome of the treatment of melanoma up to 99%. Metastases to the regional lymph nodes - a symptom of melanoma stage III - positive results in the treatment of skin cancer is possible to achieve only 50% of cases.
Patients with stage IV melanoma prognosis sounds less optimistic, but, fortunately, skin cancer - one of the rare cancer, signs of which in most cases are diagnosed at stages I and II. To date, more than 40% of patients with symptoms of melanoma of the skin disease start treatment when the tumor thickness of less than 0, 75 mm. At this stage, surgical treatment of melanoma skin cancer successful in 97-99% of cases.
Treatment of Melanoma
At the initial stage melanoma necessarily performed surgical excision of the tumor. It may be economical, removing not more than 2 cm from the edge of the skin melanoma or wide resection skin 5 cm around the boundary of the neoplasm. Common standard in the surgical treatment of melanoma stage I and II in this respect there. Wide excision of melanoma ensures a more complete removal of the tumor focus, but at the same time can be a cause of cancer recurrence at the site of the formed scar or transplanted skin flap. The type of surgical treatment of melanoma depends on the type and location of the tumor, as well as the solutions of the patient.
As part of a combined treatment of melanoma is ppedopepatsionnaya tepapii radiation. It is appointed in the presence of ulcerated tumors, bleeding and inflammation in the region of tumors. Local radiation therapy inhibits the biological activity of cancer cells and creates favorable conditions for the surgical treatment of melanoma.
As an independent method of treatment of melanoma Radiation therapy is rarely used. And in the preoperative period of treatment of melanoma its use has become common practice, as excision can be performed the next day after the end of radiotherapy. The interval for recovery between the two types of treatment for the symptoms of melanoma is usually not maintained.
The question at issue in the treatment of melanoma - prophylactic lymphadenectomy or removal of regional lymph nodes. When postoperative histological study they are struck by only 30% of cases. But since there is no reliable method of determining the state of the lymph nodes before surgery, usually with melanoma of the lower limbs removed pahobedpennye lymph nodes. When melanoma upper limbs performed excision of axillary lymph nodes.
The results of the application of chemotherapy in the treatment of metastatic melanoma are unsatisfactory, so this type of treatment for skin cancer almost never used.