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Melanoma matters, what you should know

Sandra Krishnan • Jan 29, 2022

What is melanoma and why is it important?


This screenshot from the Melanoma Institute of Australia shows us why Melanoma matters. The numbers are staggering. 


Melanoma is the most dangerous form of skin cancer; these cancerous growths develop when unrepaired DNA damage to skin cells triggers mutations (genetic defects) that lead the skin cells to multiply rapidly and form malignant tumours.


These tumours originate in the pigment-producing melanocytes in the basal layer of the epidermis. Melanocytes' function is to produce melanin which protects the skin from ultraviolet (UV) radiation. Melanomas often resemble moles; some develop from moles. Most melanomas are black or brown but can also be skin-coloured, pink, red, purple, blue or white. 


Melanoma is a serious form of skin cancer. It grows quickly and can spread to 

  • the deeper layer of skin
  • lymphatic system to spread to the lymph gland
  • bloodstream and go to other parts of the body e.g. lungs, liver, brain or bone.

What does Melanoma mean?

The first recorded descriptions of melanoma (a word derived from the Greek melas, "dark" and oma “tumor”) in history – Hippocrates of Cos in the 5th century, B.C.


Pathological Anatomy: 

Illustrations of the Elementary Forms of Disease  

1831

This beautifully illustrated folio volume consists of forty four coloured lithograph plates with accompanying descriptions of various pathological conditions. The text and the drawings were undertaken by Sir Robert Carswell, who was both a distinguished practitioner of pathology and a skilled artist. Perhaps overshadowed by more well known anatomical atlases, this is a monumental work that deserves further study.Robert Carswell, Public domain, via Wikimedia Commons

What are stages of melanoma ?


The Stage tells us ‘how bad the melanoma is’ which includes a risk profile and an assessment of how much the melanoma has spread. The stages depend on variables noted on a biopsy

  • tumour thickness, 
  • ulceration and the 
  • involvement of lymph nodes or organs. 

Once diagnosed, the stage of melanoma then guides the treatment approach.


What are the ways to stage a melanoma?


Microstaging - Pathologist examines the specimen under a microscope 

Clinical staging - Lymph node groups draining the melanoma are checked to for any evidence of spread

Staging after investigation - Scans may be needed CT, MRI, and PET

What is the role of Surgery and the Surgical Oncologist?

The most likely and initial treatment for melanoma, and the extent and role depends on the progress of the cancer.

  • Early stage melanoma, a biopsy followed by wide local excision is required, where the skin surrounding the melanoma is removed. This is to minimise the risk of recurrence of the melanoma locally. 
  • Later stage melanoma, surgery is a diagnostic tool to assess the spread of the melanoma. You may need invasive surgery to remove lymph nodes.


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