Malignant melanomas are aggressive and life-threatening cancers that affect the skin. It often arises from the skin producing cells called melanocytes. It is life-threatening and dangerous because of its ability to metastasize and spread to other parts of the body. The prognosis of these cancerous conditions depends on the time of detection and stage of the malignant melanoma. It occurs in different age and ethical groups. The frequency of this cancerous disease is often influenced by a lot of factors such as skin color, geographical zone, and exposure to sunlight. And lifestyle choices. 1 out of every 10,000 people with dark skin has malignant melanoma, compared to 50 people in Caucasians and light skinned people. Queensland in Australia has been discovered to have the highest prevalence of malignant melanoma, with 56 and 43 new cases per year per 10,000 people in men and women respectively.

In America, the current frequency of malignant melanoma among whites is smaller compared to Australia and some other countries. It was recorded that about 14 and 11 new cases per year per 10,000 people in men and women respectively. Cutaneous malignant melanoma is the most common type of melanoma in the world. It is interesting to know that, 1 out of every 105 American born in 1993 will develop malignant melanoma in his or her lifetime. It is the 7th most common cancer in America. This cancer is not gendered specific in America and occurs equally in men and women, irrespective of their age group and profession.

Causes of Malignant melanoma

There are different etiologies and risk factors responsible for causing malignant melanoma. The popular ones, you need to know and be aware of includes:

  1. Environmental factors: There is a common saying that “we are what we eat,” but pardon me to say: we are where we live and how we live.” Environmental factors such as socioeconomic status, sun, and ultra-violet light exposure. |Areas with frequent sunlight exposure have been linked to high risk of malignant melanoma. Indoor workers are at a higher risk of developing this cancer when exposed suddenly to constant Outdoor workers are lucky, and show a low incidence of this disease because their skin adapts to the constant sunlight exposure. Frequent exposure of kids to sunlight for a prolonged period is the most significant risk factors among children. Tanning beds contain a lot of ultra-violet rays, which could predispose the person to malignant melanoma. Rich people that can afford various exotic holidays and outdoor activities are more predisposed to this cancer.
  2. Skin Types: People with type 1 and 2 skin and presence of moles on their skin, are at higher risk of having malignant melanoma.
  3. Genetics: This disease is more common in people with first degree relatives diagnosed with this disease.

Malignant Melanoma Treatment

There are different factors that influence the treatment of malignant melanoma such as stage of cancer and duration.Surgery is the primary treatment for early malignant melanoma, contrary to advanced melanoma treated with conservative and adjuvant therapy. Primary melanoma is often treated with wide local excision with completion lymph node dissection (CLND) in the patient. Based on stages, the treatment of malignant melanoma includes:

  1. Stage 0: This stage is often mild and treated with excision
  2. Stage 1: This is usually treated with Excision, with or without lymph node management
  3. Stage 2: It is often treated the same way as stage 1.
  4. Resectable stage 3: There are different options when it comes to treating resectable malignant melanoma stage 3. The treatment options include: Excision, with or without lymph node management; adjuvant therapy and immunotherapy
  5. Unresectable stage 3, stage 4, and recurrent melanoma: this unique form of malignant melanoma can be treated by Intralesional therapy, immunotherapy, signal transduction inhibitors, chemotherapy, local palliative therapy.

Adjuvant feedbacks are often used for malignant melanoma of stage 3 above. There are different guidelines guiding the use of adjuvants for various stages of malignant melanoma. The guidelines include:

  • Stage 3 Adjuvant Therapy: Adjuvant therapy for stage 3 malignant melanoma includes: Immunotherapy with ipilimumab, Interferon alpha, and pegylated interferon.
  • Stage 3, stage 4, and recurrent melanoma Adjuvant therapy: The adjuvant therapy for this  stage include: Immunotherapy, Signal-transduction inhibitors, Therapies that penetrates between lesions such as talimogene laherparepvec, and  Chemotherapy,

Melanoma Radiation Therapy

Radiation therapy involves the use of different types of high –energy rays to treat malignant melanoma, mainly, when it has spread to other parts of the body. Sometimes, it is used after surgery when excess lymph nodes are is often used to prevent reoccurrence of malignant diseases and prevent them from growing again. It can also be used as a form of palliative therapy

Melanoma Mohs Surgery

Moh’s micrographic surgery is currently considered as the best surgery for treating basal and squamous cell carcinoma. The goal and the primary focus of this surgery is to remove all the tumor and prolong the lifespan of the patient

Wide Excision Melanoma Surgery

This is a type of surgery used for eliminating melanoma and its surrounding normal tissue. It is an effective surgery for treating melanoma. However, this type of surgery has some consequences such as post-operative wounds/ the best way to manage this post-operative complication is skin grafting. Skin grafting is a medical procedure that involves transferring a skin graft from one part of the body to another for medical treatment. It is often used for cosmetic purposes and treatment of various medical conditions.  One of the most important factor when using wide excision melanoma surgery is to detect the presence of distant metastasis to surrounding lymph nodes.

Malignant melanoma is a common cancerous skin disorder that affects s people of different age groups and race. However, the prognosis of this disease depends on early detection and mode of treatment. The stage of the disease determines if  it would be treated conservatively or surgically. Frequent exposure to sunlight, working outdoors, or family history is the most significant risk factor for this disease. Most people do not diagnose this cancerous disease early which could be hazardous to their health. Detecting it early, going for a regular checkup, and seeking help or treatment is the best decision you can make for yourself.



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