Understanding Skin Melanoma: How to Treat

Skin Disease

In order to understand melanoma it is first necessary to understand the skin and certain cells involved in pigmentation. Skin is actually an organ and has a great number of responsibilities including protection, regulation, storage and production. There are two main layers including the outer layer known as the epidermis and the inner layer known as the dermis. Making up the majority of the epidermis are flat cells called squamous cells and beneath them are round cells called basal cells. Also located in the epidermis are melanocytes.

Melanocytes are responsible for the production of melanin which gives color to the skin. Whenever the skin is exposed to sun, the production is increased which increases pigmentation (darkening) of the skin. Melanoma takes place when these cells become malignant. When melanoma begins in the skin it is referred to as cutaneous melanoma. It can occur anywhere on the skin, but is most likely to be seen on the trunk area between the head and neck or hips and shoulders. It is rare in people that have dark skin and when it does appear it tends to be in places like under the toenails and fingernails or on the palms of the hands and soles of the feet.

Treatment will depend on which stage the condition is in upon diagnosis. In the early stages, called stage 0; surgery will most likely be performed to remove any cells that are abnormal and some tissue that surrounds the area which is still normal.

Stage I may indicate the possibility of a spread to the lymph nodes and surgery will require removal of abnormal cells, surrounding area and possible mapping of the lymph nodes and lymphadenectomy; follow up therapy will most likely include chemotherapy or radiation therapy as part of treatment.

Stage II will be treated in the same manner as stage I depending on the spread to lymph nodes and including biological therapy along with chemotherapy and radiation.

With stage III, cancer has spread to the lymph nodes and surgery is required to remove the cancer with possible skin grafting being necessary. Follow up treatments may include biological, chemo and radiation therapy, hyperthermic and isolated limb perfusion.

Stage IV treatment follows the same guidelines as those for stage III, but includes possible palliative and targeted therapies to relieve symptoms. Clinical trials are also available in particular cases including recurring ones so there is always the possibility to participate in new and advanced forms of treatment.

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