Beware of color, size, shape changes and bleeding in moles against melanoma!

Melanoma, which originates from cells called melanocytes that give color to the skin, can be successfully treated if detected at an early stage. According to Globocan 2012 data, it is among the top ten most common cancers in men and women. Although the prevalence of melanoma has increased worldwide in recent years, it is still very rare when compared to breast, lung or colon cancer. However, the fact that melanoma is a malignant type of cancer makes it one of the most important cancer types. Providing important information about melanoma, Marmara University Pendik Training and Research Hospital Medical Oncology Specialist Assoc. Dr. Nalan Akgül Babacan gave comprehensive information about melanoma: Those with intense sun exposure, fair-skinned people, people with a family history of cancer and atypical moles, and people over the age of fifty have a higher risk of developing melanoma.

What is melanoma? It is a skin tumor originating from melanocytes that give the skin its color. Melanocytes make the pigment melanin, which gives the skin its color. The more exposure to sunlight, the more melanin pigment is produced and the skin color darkens. Melanoma progresses quite aggressively, it can be cured with treatment in the early stages, but if it is not caught in the early stages, it tends to spread. Melanoma is rare but more serious than other skin cancers. See: >>>

Fair-skinned people, the elderly, and those who spend too much time in the sun are at risk.

Ultraviolet rays are one of the main risk factors for melanoma. Although exposure to the sun’s ultraviolet rays is a triggering factor, melanoma can also develop in areas such as mucous membranes that are not exposed to these rays. Exposure to ultraviolet B rays is more closely associated with the development of melanoma, but Ultraviolet A rays (tanning beds used for tanning) have also been shown to play a role in the etiology of melanoma.

Beware of the cancer before our eyes: MELANOM

Those with intense sun exposure, fair-skinned people, those with a family history of cancer, people with dysplastic nevi (atypical moles), and those over the age of fifty are more prone to melanoma. People with more than 100 moles on their body, fair-eyed people, and people who had severe sunburns in childhood and were exposed to intense sun or solarium are also at higher risk of developing melanoma.

These people should have a dermatology examination at least 1-2 times a year. In addition, it is learned that one out of every 10 patients diagnosed with melanoma has similar cases in the family, but less than half of them are ‘familial cancer syndrome’. For this reason, the families of people with such a diagnosis should also be followed in terms of possible melanoma risk.

Pay attention to color, size, shape changes and bleeding in moles

Nevi (moles) are actually benign structures consisting of melanocyte collections. Changes in color, size, shape and bleeding that may be observed in these skin spots should raise suspicion and a doctor should be consulted. Often the first physician to go to is the family physician, and if the mole is found suspicious after the first evaluation, the patient is sent to the dermatologist.

To distinguish moles on the skin
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In dermatological examination, the lesion is examined with a dermatoscope, which we can define as a kind of advanced magnifying glass, and if melanoma is still suspected, a biopsy is taken. Pathological examination reveals whether this lesion is melanoma.

Early diagnosis is very important in the treatment of melanoma.

Patients diagnosed with melanoma are often referred to plastic surgery clinics for surgical treatment. Depending on the size of the lesion, the lesion is completely excised with a safe area of ​​intact tissue. Depending on the depth of the lesion, an additional surgical intervention may be required, including examination/removal of the lymph nodes involved in the surgical procedure. After this stage, the patient is directed to the medical oncology department. If there is melanoma spread in the lymph nodes or if there are some risk factors, an additional treatment plan (interferon, radiotherapy) is made.

Otherwise, the patient continues both dermatological (in terms of following other skin lesions) and oncological follow-ups with a certain frequency. However, some patients are not so lucky and the disease may spread to other organs. The main method of treatment in this case is drug therapy. In some special cases, surgical intervention and radiotherapy can also be used.

New generation treatments give hope to advanced melanoma patients

Compared to other cancer types, melanoma does not respond well to chemotherapy. Since 2011, new treatment options for patients with advanced melanoma have been on the agenda. These treatments can be grouped into two main groups.

If moles have darkening, bleeding and redness, beware: It may be skin cancer!

The treatments in the first group, which we can call ‘targeted therapy’, target certain specific mutations in the tumor and deprive the tumor of this growth pathway, causing the death of cancerous cells. For these treatments, the BRAF mutation must be detected after the pathology examination. The incidence of this mutation in patients is around 40%. Rapid and effective responses can be obtained to these treatments.

Another form of treatment is immunotherapy. Here, the target is not the tumor cell, but the immune system. The immunosuppressive effect of the tumor in the tissue is tried to be eliminated with these treatments. Thus, the activated immune system can go and neutralize the tumor cells. Although the rate of patients benefiting from this method is relatively low, the long-term nature of some of the responses is promising.

We, oncologists, choose the treatment according to the prevalence of the disease, the general condition of the patient, and mutation analysis when the patient applies to us. In this case, we choose one of the treatment methods I mentioned and in case of treatment failure, we are directed to other suitable options. In some cases, if there are international clinical studies ongoing in our center for new treatments, we inform our appropriate patients.

Take precautions against sun rays to prevent melanoma

As a country, we need to learn and practice sunbathing correctly. Unprotected sun exposure between 10:00 and 16:00, when the sun’s rays descend perpendicularly and intensely to the earth, is inconvenient. Since light-colored clothing can reflect the sun’s rays on our exposed skin, dark and tightly woven clothing, hats and glasses should be used. In addition, sunscreen products should be used for exposed body parts. The most common mistake is to use products in insufficient quantities.

Watch out for large moles with irregular edges.

For example, for the face, approximately 3 cc (1 teaspoon = 2.5 cc) of preservative should be applied each time. Preferably, sunscreens that provide 30 or more protection should be used for 15-20 minutes before going out in the sun. It should be applied first and reapplied in case of sweating, taking a shower or swimming in the sea. Solarium should also be avoided. Another precaution is that each individual examines his/her own skin at regular intervals and consults a dermatologist immediately if he/she notices a rapidly growing mole-like formation or a mole that changes.”

The belief that a knife is not worth the tumor is completely wrong

Stating that suspicious lesions should be removed by biopsy or surgical intervention, Assoc. Dr. Nalan Akgül Babacan said: “There is still a belief among the people that ‘cancer spreads when the knife touches’, but after the examination findings, all lesions that are likely to be melanoma should definitely be surgically removed. The belief that the touch of a knife will spread the disease is completely unfounded and wrong. Unfortunately, this false belief can cause patients to lose their chance for early treatment and cure.”

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