Melanoma on the leg treatment. Diagnosis of melanoma at the initial stage, symptoms and treatment of malignant neoplasm

Melanoma is a type of cancer that affects melanocytes—pigment cells located in human skin.

Melanoma is different high risk rapid metastasis, which leads to the development severe complications and, in severe cases, death of the patient. Every year, about 50 thousand new cases of melanoma are registered in the United States.

The first link in timely diagnosis diseases are the patients themselves, since melanomas usually occur on open, visible areas of the skin. This is important because early detection and diagnosis of melanoma ensures rapid cure with minimal surgery.

Disease statistics

Skin cancer is the most common cancer in the United States and Australia. In other countries this group diseases is in the top three. Melanoma is the leader among skin cancers in terms of the number of deaths. Every hour in the world from of this disease one person dies. In 2013, there were 77 thousand confirmed melanoma diagnoses and 9,500 deaths from it. The share of melanoma in the structure of cancer is only 2.3%, while at the same time being the cause of 75% of deaths from skin cancer.

This form of cancer is not exclusively skin cancer and can affect the eyes, scalp, nails, feet, mucous membranes oral cavity(regardless of gender and age). The risk of developing melanoma among Caucasians is 2%, 0.5% among Europeans and 0.1% among Africans.

Causes

• Prolonged exposure to the sun. Exposure to ultraviolet radiation, including solariums, can cause the development of melanoma. Excessive sun exposure in childhood significantly increase the risk of disease. Residents of regions with increased solar activity (Florida, Hawaii and Australia) are more susceptible to developing skin cancer.

Burns caused by prolonged exposure to the sun more than double the risk of developing melanoma. A visit to the solarium increases this indicator by 75%. The WHO Cancer Research Agency classifies tanning equipment as an "increased risk factor for skin cancer" and classifies tanning equipment as carcinogenic.

• Moles. There are two types of moles: normal and atypical. The presence of atypical (asymmetrical, raised above the skin) moles increases the risk of developing melanoma. Also, regardless of the type of moles, the more there are, the higher the risk of degeneration into a cancerous tumor;
• Type skin . People with more delicate skin (they are characterized by light color hair and eyes) are at high risk.
• Anamnesis. If you have previously had melanoma or another type of skin cancer and are cured, your risk of developing the disease again increases significantly.
• Weakened immunity. Negative Impact on immune system various factors, including chemotherapy, organ transplantation, HIV/AIDS and other immunodeficiency conditions increase the likelihood of developing melanoma.

Heredity plays an important role in the development of cancer, including melanoma. Approximately one in ten patients with melanoma has a close relative who has or has had the disease. A strong family history includes melanoma in parents, siblings, and children. IN in this case the risk of melanoma increases by 50%.

Types of melanomas

Based on the type of melanoma, they are divided into 4 categories. Three of them are characterized by a gradual onset with the development of changes in only the superficial layer of the skin. Such forms very rarely become invasive. The fourth type is characterized by a tendency to quickly grow deep into the skin and spread to other parts of the body and internal organs of the patient.

Superficial (superficial) melanoma

is the most common variant of the disease (70% of cases). This is a melanoma of the skin, the symptoms of which are characterized by the long-term persistence of relatively benign growth in the upper (outer) layer of the skin. Only after long period over time, superficial melanoma grows into deeper layers.

The first sign of this type of melanoma is the appearance of a flat, asymmetrical spot with uneven borders. The color of the affected area changes to brown (like a tan), black, red, blue, or white. Such melanomas can occur at the site of moles. Although the disease can occur anywhere on the skin, symptoms are more likely to develop on the torso (men) and legs (women), as well as the upper back (regardless of gender).

Lentigo maligna

the course is similar to superficial melanoma, since long time develops into upper layers skin. Visually, lentigo appears as a flat or slightly raised unevenly colored area of ​​skin. The color of the spot is variegated with brown and dark brown elements. This type of “in situ” melanoma is more often recorded in elderly patients due to constant chronic exposure solar radiation and usually develops on the face, ears, arms and upper body. This is the most common form of melanoma in Hawaii. When it enters the invasive stage, the disease is called lentigo melanoma.

Acral lentiginous melanoma

also develops superficially before continuing to grow deeper into the skin. This form differs from the others in that it appears as black or brown spots under the nails, on the palms of the hands or on the soles of the feet. The disease progresses faster than previous forms and is more likely to affect dark-skinned people. It is the most common form among Africans and Asians, while Caucasians and Europeans are least susceptible to it.

Nodular melanoma

is an invasive variant of the course. Usually, by the time it is detected, it has already grown quite deeply into the skin. Outwardly, this melanoma resembles a lump. It is usually black in color, but there are other variations (blue, grey, white, brown, red or even unaltered skin colours). It is most often localized on the torso, legs and arms. Mainly affects older people. This is the most aggressive variant of melanoma. It is diagnosed in 10-15% of cases.

Melanoma symptoms

Melanoma can develop from an existing mole or as a result of another skin disease, but it often occurs on normal skin. The most common locations for melanoma are the legs and upper back. Due to the continued production of melanin by the altered cells, the tumor is black or Brown color, but colorless melanomas are also found.

Less commonly, melanomas occur on the palms, nails, and mucous membranes. In older people, melanomas are more likely to appear on the face, as well as on the neck, scalp and ears.

Early symptoms of melanoma

The main signs of melanoma are changes in the size, shape, color of existing moles or “birthmarks” or the appearance of discomfort in this area. The development of these symptoms may take a long time (several weeks or months). In addition, melanoma may initially be perceived as new mole, but at the same time have an unpleasant appearance. The appearance of such subjective symptom should serve as an alarming sign and a reason to visit a doctor.

Early signs of melanoma include:

• Bleeding
• Burning feeling
• Crust formation
• Change in the height of the spots (thickening or raising a mole that was previously flat above the skin)
• Ulceration
• Change in consistency (mole becomes soft)
• The appearance of any discharge in the tumor area
• Increase in the size of the altered lesion
• Redness or swelling of surrounding tissues
• The appearance of new small areas of pigmentation around the main lesion

Late symptoms of melanoma

Further development is characterized by the following symptoms of melanoma:

• Violation of the integrity of the skin
• Bleeding from a mole
• Bleeding from other pigmented areas of the skin
• Pain in the affected area

Symptoms of metastatic melanoma

These symptoms develop when exposed to cancer cells melanomas into the bloodstream and their spread to other organs:

• Chronic cough
• Lump under the skin
• Gray skin tone
• Constant headache
• Convulsions
• Enlarged lymph nodes
• Unexplained weight loss, exhaustion

You should immediately consult a doctor if you experience:

• Bleeding from moles or areas of pigmentation
• Discoloration of fingernails and toenails not caused by injury
• Asymmetry in the growth of moles or individual areas of skin
• Darkening of the skin not associated with tanning
• The appearance of areas of pigmentation with uneven edges
• The appearance of moles with areas of different colors (the spread of pigmentation from a mole to surrounding tissues is early sign melanoma)
• Increase in diameter more than 6mm

Stages of melanoma

According to the new approved international classification, when determining the stage of melanoma, diagnostic criteria are the thickness of the tumor (Breslow thickness), the presence of microscopic ulcerations and the rate of division of cancer cells. Thanks to new system It became possible to make a more accurate diagnosis and plan the most effective treatment.

Breslow thickness is measured in millimeters and characterizes the distance from the upper layer of the epidermis to the deepest point of tumor invasion. The thinner the melanoma, the higher the chance of cure. This indicator is the most important aspect in predicting the course and effectiveness of treatment measures.

• Stages 1 and 2

melanomas are characterized by limited swelling. This means that cancer cells have not yet metastasized to lymph nodes or other organs. At this stage, the risk of recurrence of melanoma or further spread of the tumor is quite low.

Depending on the thickness there are:

• Melanoma “in situ” (“in place”). This is the initial stage, when the tumor has not yet grown deep into the epidermis. This form is still referred to as the zero stage;
• Thin tumors (less than 1 mm). The development of a tumor indicates the initial (first) stage of melanoma;
• Medium thickness (1 – 4 mm). From this moment on, the course of melanoma enters the second stage;
• Thick melanomas (more than 4 mm in thickness).

The presence of microscopic ulcerations aggravates the severity of the disease and means a transition to later stages. The rate of cell division is also an important criterion in determining the prognosis of the course. Even a single confirmed process of dividing a cancer cell culture by one square millimeter characterizes the transition to more severe stages course of melanoma and increases the risk of metastasis. In this case, the method of choice is a more aggressive treatment tactic to achieve the desired effect. At the first and second stages, melanoma is characterized by an asymptomatic increase in the size of areas of pigmentation, their elevation above the skin level without bleeding or pain.

• Stage 3

At this stage, important changes in the course of the disease are observed. At this stage, the Breslow thickness is no longer taken into account, but the identification of ulcerations becomes indicative.

The third stage is characterized by the spread of tumor cells to the lymph nodes and surrounding areas of the skin. Any spread of tumor beyond the borders primary focus characterized. As a transition to the third stage. This is confirmed by a biopsy of the lymph node closest to the tumor. Now this diagnostic method is indicated when the tumor size increases by more than 1 mm or if there are signs of ulceration. The third stage is characterized by the late symptoms of melanoma described above (pain, bleeding, etc.).

• Stage 4

means that tumor cells metastasize to distant organs. Metastases in melanoma spread in (according to the time of involvement in the pathological process):

• Lungs
• Liver
• Bones
• Gastrointestinal tract

At this stage, symptoms of metastatic melanoma appear, which depend on the damage to a particular organ. At stage 4, melanoma has a very unfavorable prognosis, the effectiveness of treatment is only 10%.

What does melanoma look like - photo

Malignant melanoma is not always characterized by dark pigmentation. Because of this, it is often difficult to make a correct diagnosis.	Photographs taken at some time interval help to assess the degree of tumor growth and changes in the size of the lesion.
Left - Plain Right - Color changes within one element	Left - Smooth edges Right - No clear border
Left - Common mole Right - Change shape, size and color	Left - Normal mole (symmetrical) Right - Melanoma (asymmetric)
A brown or dark line along the nail should be considered malignant melanoma, especially if the edges become uneven and gradually thicken.

Diagnostics

Diagnosing melanoma is quite a difficult task even for an experienced dermatologist. Because they don’t always come first characteristic symptoms, then it is necessary to pay great attention to self-diagnosis and notify the doctor immediately after discovering a suspicious mole or spot. This is especially important if your close relatives have had a similar disease. After an examination, your doctor may order a skin biopsy as well as a lymph node biopsy to confirm the diagnosis. The final diagnosis of melanoma is confirmed only after histological examination of the biopsy specimen. Obtained from a pathological focus.

Early detection of melanoma can save the patient's life. To do this, it is recommended to perform a monthly self-examination for timely detection. skin changes. You don't need any special equipment for this. All you need is a bright lamp, large mirror, hand mirror, two chairs and hairdryer.

• Examine the head and face using one or both mirrors. Use a hair dryer to check the scalp;
• Check the skin of your hands, including your nails. Using mirrors, examine your elbows, shoulders, and armpits;
• Carefully assess the condition of the skin on the neck, chest and torso. For women, it is mandatory to check the skin under the mammary glands;
• Using a mirror, examine your back, buttocks, and the back of your neck, shoulders, and legs;
• Carefully evaluate the condition of the skin on your legs and feet, including your nails. Be sure to examine your knees;
• Using a mirror, inspect the skin on the genitals.

If you find suspicious pigmentation elements, compare them with the photos of melanomas below.

Forecast

The prognosis of the disease depends on the time of detection and the degree of tumor progression. When detected early, most melanomas respond well to treatment.

Melanoma that has grown deeply or has spread to the lymph nodes increases the risk of recurrence after treatment. If the depth of the lesion exceeds 4 mm or there is a lesion in the lymph node, then there is a high probability of metastasis to other organs and tissues. When secondary lesions appear (stages 3 and 4), treatment of melanoma becomes ineffective.

If you have had melanoma and recovered, it is very important to conduct self-examination regularly, since for this category of patients the risk of recurrence of the disease is very high. Melanoma can recur even after several years.

Survival rates for melanoma vary widely depending on the stage of the disease and the treatment provided. In the first stage, cure is most likely. Also, cure can occur in almost all cases of stage 2 melanoma. Patients treated in the first stage have a 95 percent five-year survival rate and 88 percent ten-year survival rate. For the second stage, these figures are 79% and 64%, respectively.

In stages 3 and 4, the cancer has spread to distant organs, resulting in a significantly reduced survival rate. The five-year survival rate of patients with stage 3 melanoma ranges (according to various sources) from 29% to 69%. Ten-year survival is achieved in only 15 percent of patients.

If the disease has progressed to stage 4, then the chance of five-year survival is reduced to 7-19%. There are no 10-year survival statistics for patients with stage 4.

The risk of melanoma recurrence increases in patients with a large tumor thickness, as well as in the presence of ulcerations of melanoma and nearby metastatic skin lesions. Repeated melanoma can occur both in the immediate vicinity of the previous location and in significant distance From him.

Despite the fact that this form of cancer looks frightening, the prognosis for its treatment is not always unfavorable. Even if it reoccurs, early treatment leads to cure and ensures long-term survival of patients.

Melanoma is a malignant tumor that develops from pigment cells (melanocytes) in human skin. The tumor is localized in the skin, less often - on the retina and mucous membranes. Melanoma on the leg is a common disease among people of different ages, but more common after 45 years. Preventing a disease is much easier than stopping an advanced cancer process.

Melanoblastoma is an outdated name for a malignant tumor. The tumor is a type of skin cancer and appears as a dark brown spot. The process begins with damage to melanocytes, the skin particles responsible for pigmentation. The source of the disease can be just one cell. The tumor changes from a benign state to a malignant one. If the pathology is not stopped in time, there is a high probability of the disease spreading to other parts of the body.

Statistics point to skin cancer leading the way. The peculiarity is the rapid growth of metastases and the occurrence of complications leading to increased mortality.

The disease appears for the following reasons:

• Under the influence of ultraviolet radiation, when a person is exposed to direct rays of the sun for a long time, melanin production occurs at this moment.
• Various injuries, burns, and poor environmental conditions provoke the appearance of the disease.
• No less important is the genetic factor due to the presence of similar diseases in the family. The risk of disease increases by 50%.
• The period of menopause and pregnancy can be dangerous, as it triggers the degeneration of moles into melanoma.
• When depilating legs and cleaning feet, pay attention to new growths so as not to damage the skin.
• Weak immunity provokes the formation of melanomas on the legs. Surgical interventions, transplantations, chemotherapy lead to a decrease in immunity and the development of pathology.

Features of localization on the leg

Approximately 50% of malignant tumors appear on the legs and develop from melanocytic cells. Nodular forms of the disease are more aggressive and occur in 15% of affected people.

Let's look at the common types of melanomas on the legs.

On the toe

Melanoma on the toe – most often affects the big and little toes. At the initial stage, the tumor looks like a bruise, and a dark pigmented formation appears under the nail. The surface of the nail plate becomes deformed and becomes lumpy. Metastases rapidly spread in the diseased area. Over time, cracks appear on the surface of the nail, from which ichor and blood leak out, and tumor growth reaches the lateral edges of the plate.

Subungual melanoma is diagnosed in 3% of women and 4% of men, when considered cutaneous species diseases. At the beginning of the development of the disease, in 20% of cases there are no pronounced symptoms, which leads to late detection at stages 3–4.

On the foot

Melanoma on the foot occurs when melanin production increases. The affected area appears as a dark brown spot and is malignant in nature. A dangerous growth, located on the foot, causes discomfort and can spread throughout the body.

Melanoma of the foot is the most aggressive malignant neoplasm that can develop metastases that cannot be cured. Even in small sizes, this form of cancer is extremely life-threatening. In just a few months, a progressive disease can affect a person’s internal organs.

In the early stages of the affected area, it is quite easy to remove. If the size of the area exceeds 1 cm, is unevenly colored and asymmetrically outlined, complex treatment is carried out. IN mandatory procedures, except surgical operation, includes chemotherapy sessions. You can prevent the oncological process if you constantly monitor the condition of moles and pigmented areas on your legs.

Main features

An experienced dermatologist will help diagnose melanoma on the leg in a timely manner. The patient can independently track the first signs of the disease. Self-diagnosis is of great importance.

Primary signs:

1. The area of ​​skin becomes convex and increases in size, and yellow-gray nodules appear.
2. A birthmark or mole on the leg acquires a dark color with splashes.
3. The affected area changes shape, acquiring an irregular shape with jagged edges.
4. Unpleasant sensations and itching occur for more late stages. A bleeding and crusty ulcer forms in the center of the tumor.
5. The tissue around the affected area thickens, which is noticeable upon palpation.
6. On later stages Metastases characteristic of cancer develop. Symptoms appear in the form of bone pain, exhaustion, and weakness.

As soon as primary signs are noticed, you should immediately visit a doctor. The type of cancer presented quickly stops the lymph nodes, penetrating deeper and metastasizing. The more time has passed since the disease, the more difficult it is to cure it, and in the later stages it is impossible.

Diagnostic stages

The first is self-assessment of the skin of the legs, including the feet and nails. If changes in birthmarks are noticed, you should consult a doctor.

The second is an examination by a specialist to identify a malignant tumor.

The third is the dermatoscopy method. Using optics, the affected area is enlarged several times, which makes it possible to identify the disease at an early stage.

The fourth is the biopsy method. Excision of the tumor is performed under general anesthesia. The tissue is sent for analysis.

Fifth – diagnosis using ultrasound.

Stages of development

1. At the first stage, the area affected is no more than 2 mm, the formation is localized on the surface of the skin, there are no depressions or metastases. The risk of recurrence is low.
2. At the second stage, the thickness of the formation reaches a size of over 2 mm, ingrowth into soft fabrics, without the formation of metastases.
3. In the third stage, the lymph nodes are affected. Extension beyond the primary focus is characterized by the third stage, which is confirmed by a biopsy of the closest lymph node to the diseased area.
4. At the fourth stage, metastasis develops in tissues, damage to bones and internal organs. The prognosis for cure is low and ranges around 10%.

The diagnostic criterion is the thickness of the tumor, called the Breslow thickness, the rate of division of cancer cells and microscopic lesions. The combination of all criteria allows us to determine the degree of damage and plan effective treatment. The thinner the Breslow thickness, the greater the chance of recovery.

Treatment methods

Melanoma develops rapidly and forms metastases in just a few months. It is difficult to cure the pathology; several stages are required, let’s consider the main ones.

Stage	Basic treatment
1	Removal of the tumor through surgery. Healthy tissues are affected.
2	A biopsy is performed. Removal of lymph nodes if they are damaged. Taking alpha-interferon drugs to reduce relapse.
3	Removal of formations and lymph nodes located nearby. This stage does not involve effective treatment. Immunotherapy, radiation, and chemotherapy are used. Let's take interferon and similar pharmaceutical drugs.
4	Difficult to treat. New growths are cut out, fingers are amputated, pain is relieved with the help of medications. Chemotherapy, drugs dacarbazine, temozolomide are used. To reduce the tumor and improve well-being, joint reception immuno- and chemotherapy drugs. The fourth stage has been little studied and involves participation in clinical trials to identify new treatments.

Forecast and prevention of occurrence

Depends on the stage of the disease further forecast. At the initial stage, most melanomas can be cured. In the advanced version, when ingrowth into the tissue and spread to the lymph nodes has occurred, the risk of re-development after treatment greatly increases.

Here are the survival statistics:

With the right approach to treatment, survival will depend on the initial thickness of the lesion. If the lesion is less than 0.75 mm in size, people live five years in 95–100% of cases. A tumor that has grown to 1.5 mm has a survival rate of 85%, and when it grows to 4 mm, the five-year survival rate drops to 47%. Recurrence at the site of the previous tumor is possible. Treatment will depend on the stage of development, location and previous performance of the operation.

For preventive purposes against the formation of melanoma on the leg, it is recommended to avoid prolonged exposure to the sun. Wear closed cotton clothing on sunny days. Carry out regular examination of your feet to detect changes in moles and age spots. Try not to injure areas with age spots. Visit an oncologist year-round to detect pathology on your leg in time.

A tumor on the leg is life-threatening. Its development depends on lifestyle, environmental conditions, genetics, etc. It is difficult to detect pathology in the early stages, and treatment may be accompanied by relapse. Although the prognosis looks scary, the outcome of treatment may well be positive. Even in the case of repeated neoplasm, timely measures increase the patient’s life expectancy.

The most dangerous form of skin cancer, which develops rapidly and can metastasize to other organs, is called melanoma; the initial stage of the disease is difficult to diagnose. And, unfortunately, it very quickly turns into more severe and dangerous ones. The earlier melanoma is diagnosed, the better the prognosis for treatment.

Human skin performs a number of essential functions: barrier, thermoregulatory, respiratory, metabolic, secretory. May be present on the skin various neoplasms benign in nature, which can degenerate into malignant. Melanoma is considered a dangerous type of cancer, as it develops rapidly and can affect not only the skin, but also the skeletal system, internal organs and the brain.

Usually the disease develops from birthmarks, so it is very important to know what skin cancer looks like in order to be able to identify it in the initial stage. It is during this period that treatment of melanoma can end successfully.

Skin melanoma - what is it?

Melanoblastoma, melanocytoma, neocarcinoma are all names for melanoma.

Between the epidermis and dermis there are melanocytes, in which melanin, the brown-black pigment of the skin, is formed. It is melanin that determines the color of skin and hair and helps protect the body from aggressive radiation from the sun. With the proliferation of melanocyte cells, benign moles are formed, which, under the influence of risk factors, can degenerate into melanoma.

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Most often, the tumor forms on the back, on the skin of the face, chest, and leg. Slightly less often, cancer begins on the hands and phalanges of the fingers. Very rare, but even melanoma of the eyelid occurs. Melanoma can develop in such rare places as the cervix, ovaries, vagina, urethra, bladder, ureters.

The disease is characterized by the very rapid penetration of abnormal cells into the layers of the skin and the development of metastases. Melanoma in the initial stage does not have severe symptoms and has a poor prognosis.

In 85% of cases, the disease cannot be treated.

It should be noted that melanoma and skin cancer are still slightly different concepts. Skin cancer also includes diseases such as basal cell and squamous cell carcinoma.

Risk factors

The disease most often affects women aged 30-50 years. People at risk for melanoma are fair-skinned people, as well as those who like to sunbathe or go to a solarium. An important factor is heredity: if one of your close relatives has already had skin cancer, then the likelihood of getting sick increases by 30%. Melasma (a pathology in which excess melanin accumulates in the skin) is a pre-melanoma disease.

Dubreuil's melanosis (lentigo maligna), if left untreated, develops into melanoma in 75% of cases. The chances of getting sick also increase several times for those with more than a hundred moles on their body. The disease also occurs in children.

Causes of melanoma

The exact cause of the development of malignant pathology is unknown. In 70% of patients, a skin tumor developed at the site of a birthmark or pigmented nevus.

An important place in the development of the disease is occupied by risk factors that contribute to the degeneration of a benign formation into oncology:

• Solar radiation and ultraviolet radiation;
• Constant mechanical irritation of the skin;
• Heredity;
• Injury to moles;
• Large moles;
• Bright skin;
• Malfunctions of the endocrine system;
• Presence of HPV;
• Autoimmune pathologies;
• Chronic inflammatory processes on the skin.

Video on the topic - Melanoma

Types of melanomas

There are 4 types of skin melanoma:

1. Superficial spreading melanoma occurs in 40% of all skin cancers. Externally, it looks like a slightly raised spot with clear contours. Nodules or highly pigmented areas appear on the formation. Typically the disease is localized on the back, neck and hips. The mortality rate from this type of cancer is 35% of all melanomas.
2. The nodular form of melanoma occurs in 15% of all cases. Typically this form is localized on the chest or back. The nodular form refers mainly to deeply penetrating cancer. Externally, it looks like a nodule on a stalk of black or dark blue color. When a nevus is injured, it bleeds. Mortality from the nodular form is 60% of all cases.
3. Lentiginous melanoma takes a long time to develop, over several years. This form appears as black or brown spots different sizes with blurred edges. Occurs in 10% of all cases, mainly in the elderly. Most often observed on the limbs, feet, and fingers.
4. The acral lentiginous form is localized on the sole of the feet (can be found on the heel), on the palms and near the nail bed. The survival rate for this form is low because it is diagnosed very late.

How to recognize the early stage of skin melanoma

The particular danger of melanoma is that the onset of the disease is extremely difficult to recognize.

At the 1st stage, the thickness of the formation does not exceed 1 mm. A mole that has just begun to degenerate is practically indistinguishable from an ordinary one. An already developing malignant neoplasm can have any size and shape, be weeping, covered with nodes, and bleed. The tumor has a dense consistency and often rises above the skin. The color can be black, brown, blue, gray. Not often, but there are cases when a melanoma lesion does not change color and remains light, similar to ordinary hypomelanosis.

Melanoma can occur in any area of ​​the body. However, most often in women it is diagnosed on the lower leg, and in men - on the back. In older people, the tumor is more often localized on the face. In half of the cases, education develops at healthy skin, and in other cases - at the site of pigmented nevi.

Melanoma on the iris of the eye looks like a dark spot of irregular shape; the subungual formation looks like a strip located under the nail plate on the cuticle.

Superficial forms tend to grow slowly, while nodular forms can go through several stages of development in a few weeks.

When a mole becomes malignant, changes can be observed:

• Increased pigmentation;
• Uneven color (presence of several shades);
• Shiny surface of the formation;
• Redness of the surrounding area;
• Blurred edges of the mole, jagged borders;
• Lack of hair;
• The lesion may exceed 5 mm;
• The appearance of nodular small papillomatous elements in the area of ​​the nevus;
• Itching and burning.

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As the formation grows and the stage moves to a more serious stage, a more pronounced clinical picture develops.

The most important thing for a person regularly exposed to risk factors is to conduct a self-examination. Where to start and how to conduct a self-examination:

• It is necessary to conduct a detailed examination of the head, look in the mirror at the mouth and nose. You can ask relatives to look carefully at the head under the hair;
• Examine your neck, chest and back in front of a mirror;
• Examine the abdomen and genitals;
• Use your fingers to feel the axillary lymph nodes for tenderness or enlargement.

Symptoms of melanoma at an early stage

At the initial stage, Melanoma is no different from an ordinary mole. The main symptoms of the onset of the disease include the following:

• The mole began to grow and bleed and became darker;
• The mole began to itch (

It is worth noting that it is quite difficult to remove tumors of this kind, especially due to age-related changes.

Causes

The main reasons for the appearance of tumors include poor ecology and poor lifestyle. Melanoma is a dark brown malignant tumor. From the legs it can spread to the rest of the body, and the pain will be very severe.

Typically, melanoma develops from benign formations. In this case, even one melanocyte can be the focus. The causes of the disease can also be the effect of ultraviolet radiation, injuries and burns.

Basically, a tumor on the leg is a genetically determined disease. There is an opinion that during menopause and during pregnancy, the mechanism for the degeneration of a mole into melanoma is triggered. A tumor on the leg is one of the most dangerous diseases. Once metastases appear, it will be very difficult to cure the disease. In order to protect yourself, it is necessary to periodically examine your legs to detect any damage to moles.

Basically, a tumor on the leg is a genetically determined disease

Melanoma of the leg often occurs due to exposure to solar radiation.

But there are other factors that influence development. Yes, you should be wary benign neoplasms, the presence of atypical nevi, too light skin, freckles.

Changes in the nails and systemic diseases associated with them

Systemic diseases associated with this finding

Changes in the shape or growth of the nail

Inflammatory bowel diseases (Crohn's disease and ulcerative colitis), malignant lung diseases, asbestosis, Chronical bronchitis, COPD, cirrhosis, birth defects heart, endocarditis, arteriovenous malformations, fistulas

Iron deficiency anemia, hemosiderosis, Raynaud's disease, SLE, trauma, nail-patellar syndrome

Psoriasis, infection, hyperthyroidism, sarcoidosis, trauma, amyloidosis, connective tissue diseases

Psoriasis, Reiter's syndrome, Bloch-Sulzberger pigmentary dermatosis, focal alopecia

Any severe systemic disease affecting nail growth, Raynaud's disease, pemphigus, trauma

Lymphedema, pleural effusion, immunodeficiency, bronchiectasis, sinusitis, rheumatoid arthritis, nephrotic syndrome, thyroiditis, tuberculosis, Raynaud's disease

Terry's nails (white)

Liver failure, cirrhosis, diabetes, congestive heart failure, hyperthyroidism, malnutrition

Crescent azure color

Hepatolenticular degeneration (Wilson's disease), silver poisoning, treatment with quinine

Specific for renal failure

Specific for hypoalbuminemia

Arsenic poisoning, Hodgkin's disease, congestive heart failure, leprosy, malaria, chemotherapy, carbon monoxide poisoning, other systemic lesions

Dark longitudinal stripes

Melanoma, benign nevus, spots due to action chemical substances, a normal variant in people with darkly pigmented skin

Patchy baldness, vitiligo, atopic dermatitis, psoriasis

Subacute bacterial endocarditis, SLE, rheumatoid arthritis, antiphospholipid syndrome, peptic ulcer stomach or duodenum, malignant diseases, taking oral contraceptives, pregnancy, psoriasis, trauma

Rheumatoid arthritis, SLE, dermatomyositis, scleroderma

Abbreviations. COPD - chronic obstructive pulmonary disease; SLE - systemic lupus erythematosus.

Diagnostics

How do you know if you have melanoma on your lower leg? Usually signs of a tumor are clearly visible. Therefore, you should carefully examine the affected area. Early detection of the problem increases the chances of treatment success.

So, you should visit a doctor if you see:

• change in skin color near the nevus;
• the appearance of seals that grow;
• pigment spots appeared;
• the birthmark has changed its color;
• there was an increase in lymph nodes;
• there is itching and burning;
• The nevus is bleeding and cracks have appeared.

If you see these signs, know that you may have melanoma of the lower leg. You should consult a doctor immediately. You can make sure that you have a skin tumor by comparing what you see with the photographs in our article.

Early detection of the problem increases the chances of treatment success

Melanoma can grow in absolutely any direction. The deeper it penetrates, the more difficult the treatment will be. This type of cancer tends to immediately occupy the lymph nodes and penetrate deeper, forming metastases. Therefore, in the later stages it is considered practically incurable.

Treatment of melanoma of the leg

Although the form of cancer is small, it develops quickly. Just a few months are enough for the metastases to go deeper. In the early stages, tumor removal is quite successful. If the size of the lesion reaches 1 cm, and its color is uneven, complex treatment is carried out. In this case, chemotherapy is used in addition to surgery. We recommend that you read the article about treatment methods for different types of melanoma.

The treatment is very difficult and requires several stages.

• The first stage is surgery. The entire tumor and the borders of the tissue next to it are excised. The amount of skin removed will depend on how deep the melanoma has penetrated.
• The next step is to perform a biopsy. It is carried out if there is a suspicion of damage to the lymph nodes. If suspicions are confirmed, all lymph nodes in the area are removed. In this case, you can use drugs such as interferon alpha or the like. They reduce the risk of relapse. The third stage involves removal of the tumor and all lymph nodes that are located next to it. Interferon is used as therapy; it also reduces the risk of relapse. At this stage there is no effective treatment. It is recommended to use immunotherapy radiation therapy and chemistry. Patients suffering from stage 4 are difficult to treat. In their case, the emerging tumors are cut out, and the suffering is alleviated with the help of special means.

The treatment is very difficult, several stages are required

• Ipilimumab is used. This is a modern immunodrug, the purpose of which is to prolong life. It has recently been introduced into practice, but is already showing good results.
• Interleukin-2 and interferon drugs can be used for patients. The effect is achieved by introducing large portions of the drug; the side characteristics are significant.
• At stage 4, the benefit of chemotherapy drugs decreases. Temozolomide and dacarbazine can be used either alone or in combination with others. The effect of chemotherapy is short-lived, only 3-6 months. Then the melanoma grows again.
• A number of experts suggest using immuno- and chemotherapy drugs together. This reduces the tumor and makes the patient feel better.

For patients, drugs interleukin-2, interferon can be used

Since stage 4 has not yet been fully studied, patients are recommended to participate in clinical trials. Some patients feel well after this, and therefore the survival prognosis improves.

Prognosis of recurrent melanoma

Treatment for recurrent melanoma depends on the stage of the tumor, the location of the recurrence, and the results of previous surgery.

Recurrence often occurs near the site where the tumor was previously located. It is also removed surgically.

If the lymph nodes have not yet been removed, they may be affected. It’s easy to check this fact - a compaction appears. Then lymph node dissection is performed.

Since stage 4 has not yet been fully studied, patients are recommended to participate in clinical trials

Relapse can occur in all organs, even distant ones. The most common sites of injury are the brain, lungs, Bone marrow, liver. Treatment is similar to that for stage 4 melanoma. Isolated limb perfusion may be used. Patients with relapses should also consider participating in clinical trials.

A tumor on the leg represents great danger for human life. It develops due to an incorrect lifestyle, bad ecology. It is difficult to notice it in the first stages; the disease spreads quickly. Prognosis depends on the stage.

Melanoma - how to recognize skin cancer in time?

Melanoma is a malignant skin tumor, one of the most dangerous types of cancer. Of all cancers, this is the most aggressive type. Melanoma must be recognized as early as possible, otherwise its rapid development will lead to death. The exact cause of this disease is unknown. Photos of melanomas help to see the difference between a malignant formation and an ordinary mole.

Melanoma is one of the most dangerous types of cancer

What does melanoma look like?

Most often, the formation of melanoma occurs at the site of a birthmark. This malignant neoplasm is formed from pigment cells, melanocytes, and is therefore characterized by the formation of a pigment spot or subcutaneous node.

Important! If you notice a thickening of the nevus (mole) and raising it above the skin, a change in pigmentation and an increase in size, you should urgently consult a dermatologist.

To understand what melanoma looks like, you should look at the photo. Particular attention should be paid to photos of melanomas at the initial stage - this will help you navigate if a suspicious formation occurs on the skin.

It rarely happens that skin melanoma appears without the formation of melanin and the tumor appears as a light spot. Slow growth and development is observed in the superficial species. The nodular form is characterized by a lightning-fast increase in malignant formation. With this development, the tumor can develop from the first stage to the third or fourth in a short period of time (several weeks).

Note! Melanoma accounts for 2.3% of all cancers, and this is 13% of all skin cancers. Fatal outcomes due to skin cancer, melanoma, reach 75%.

Compared to other types of cancer, melanoma is much easier to recognize and prevent. Its appearance occurs on open areas of the skin or on existing moles or is disguised as them, and therefore can be noticed immediately after the start of development.

Melanoma often forms at the site of a birthmark

Causes

Although the exact reasons for the development of melanoma have not been established, they take into account the following factors risk:

• Long stay under sun rays, especially during lunch hours, artificial exposure to ultraviolet radiation (solarium and bactericidal lamps). The risk of sunburn increases by 2 times, abuse of artificial sources of ultraviolet radiation by 75%.
• Heredity. At the genetic level, a predisposition to cancer can be transmitted. Specifically, melanoma is transmitted in 50% of cases.
• Many moles on the body (more than 50), especially in places prone to injury. The risk category includes those nevi that rise above the skin and are asymmetrical.
• Women aged 40 to 50 years are more at risk.
• Weakened immunity: organ transplantation, HIV/AIDS, chemotherapy.
• Older age, although in at a young age There are also cases of the disease.
• People with white, more delicate skin, prone to freckles, light hair and eyes.

Types of melanomas

Melanoma of the skin appears as a spot, nodule, or plaque. At first, this is a small area that worries only because of its formation and color. It is located primarily on the face (eyebrows, nose, and so on), there is even melanoma of the eye, and can also form on the arms, legs, then on the surface of the body and back. The spread of the tumor occurs both above the skin and deep into it. The external size can reach more than 10 centimeters in diameter.

Melanoma on the foot

Melanoma is divided into 4 types. The first three are characterized by consistent development with changes in the surface of the skin. And here fast growth, metastases of melanoma with penetration into the skin and damage to internal organs are characteristic of the fourth type.

1. Superficial or superficial melanoma. This is the more common type of tumor (70%). The course of the disease is characterized by prolonged, relatively benign growth in the outer layer of the skin. With this type of melanoma, a spot appears with jagged edges, the color of which can change: tan brown, red, black, blue or even white.
2. Lentigo maligna is similar to superficial melanoma. Development is long, in the upper layers of the skin. In this case, the affected area of ​​the skin is flat or slightly raised, unevenly colored. The color of such a spot is patterned with brown and dark brown components. This melanoma often occurs in older people due to constant exposure to sunlight. Lesions appear on the face, ears, arms, and upper torso.
3. Acral lentiginous melanoma. Development occurs superficially, then continues to grow deeper. This type is characterized by the appearance of brown and black spots under the nail beds, on the palms or soles of the feet. The spread of the disease is faster than in previous types and is more common in Africans and Asians.
4. Nodular melanoma looks like a lump. By the time the tumor is discovered, it has grown far deeper. Often black in color, but there are also formations without color, as well as blue, brown, red, white, and gray spots. It occurs most often on the arms, legs and torso. It is diagnosed in 10-15% of cases. Older people are more likely to get it. This is the most aggressive species.

Melanoma on the eye

Symptoms

You need to keep an eye on your moles. Mostly the disease originates from a pre-existing mole or birthmark, although it can appear on intact skin. Arises unpleasant feeling, color changes. Signs of melanoma cannot always be recognized immediately, and the tumor can be mistaken for an ordinary mole, although it may differ in color. The appearance of such a sign should prompt a person to consult a doctor.

• The mole grows quickly (rises above the skin, thickens).
• Ulceration on the surface of the mole, the appearance of exudate in it.
• Bleeding, burning and itching sensation, crust formation. These signs indicate increased cell division.
• Increase in size.
• Redness or swelling of surrounding tissues. The mole thickens and the edges become jagged and jagged.

In the initial stages of melanoma, the mole begins to grow rapidly

Late symptoms of melanoma:

• Bleeding from a mole.
• Violation of skin integrity.
• Bleeding from other spots near the main mole from which the melanoma developed.
• Painful sensations.

Symptoms of metastatic melanoma, which develops when malignant cells enter the circulatory system and spreading it throughout the body:

1. Lymph nodes enlarge.
2. Persistent headache.
3. Gray skin.
4. Compaction under the skin.
5. Chronic cough.
6. Cramps.
7. Sharp weight loss.

Important! If any of these signs of melanoma occur, you should visit a dermatologist.

One of the symptoms of melanoma is a persistent headache.

Diagnostics

Diagnostics allows you to establish an accurate diagnosis. To do this you need to undergo the following examinations:

1. Dermatoscopy. Examination of the affected skin area using a special device. Allows you to determine the edges of formation, germination and internal inclusions.
2. Biopsy. Collection of a melanoma tissue sample for histological examination.
3. Computed tomography and ultrasound diagnostics determine the presence of metastases and give an idea of ​​the stage of melanoma.

In some cases, the doctor prescribes additional tests.

Stages

There is an international classification that determines the stages of melanoma based on the thickness of the tumor (Breslow thickness), the rate of division of cancer cells, and also takes into account the presence of microscopic ulcerations.

It is customary to distinguish 5 stages:

• The initial stage is diagnosed when the symptoms of melanoma affect only the epidermis.
• Stage 1 melanoma is characterized by an ulcerated surface reaching a thickness of 1 mm, and 2 mm without ulcers. Stage 2 melanoma has an ulcerated surface of 2 mm, and without ulcers the tumor is from 2 to 4 mm. At stages 1 and 2, the spread of melanoma throughout the body is quite low. There are no metastases in the lymphatic system or other organs. At these stages, the formation asymptomatically increases in size in the area of ​​pigmentation, rises above the skin level without bleeding or pain.
• Melanoma of the next stage, stage 3, is characterized by the spread of metastases to the lymph node. At this stage, the Breslow thickness is not taken into account, but the appearance of lesions provides indications for the final diagnosis.
• Stage 4 melanoma is characterized by metastases that penetrate individual organs and areas of the body. Not only is it affected lymphatic system, as well as the brain, lungs, liver, bones, gastrointestinal tract. At this stage, melanoma has a poor prognosis; treatment effectiveness is only 10%.

Initial stage of melanoma

Treatment

Treatment of melanoma with folk remedies is impossible; it is excised surgically, followed by radiation treatment, which prevents further growth of metastases. If the melanoma is located on the fingers, it is possible to completely remove them during surgery. In case of a generalized process, systemic or regional chemotherapy is prescribed. Immunotherapy is also prescribed. Most favorable outcome Treatment may be possible with early diagnosis. Treatment at a dispensary allows for observation and timely detection of recurrence of the disease and a course of treatment. During treatment, a diet with vitamins and plenty of proteins is prescribed. Meals are recommended to be frequent and small.

Forecast

The prognosis of melanoma depends on the moment of detection and the phase of progression of the formation. In the early stages of a tumor, after anticancer therapy, a successful result is observed in 85% of patients.

If the tumor germination was more than 4 mm and there is a focus in the lymph node, this is a guarantee that metastases have penetrated into other organs and tissues of the body. The appearance of foci of grade 3-4 melanoma is secondary and carries an unfavorable prognosis. Treatment is ineffective and survival rate is 20%.

Note! Removing melanoma is an important part of treatment, but monitoring is also necessary after that. It is important to carry out self-examination, since relapse is possible in this category of people. Signs of melanoma may appear again.

Survival for melanoma depends on the stage of the disease and the treatment provided. At stage 1, there is an opportunity to be cured. At stage 2, this probability decreases somewhat, but still remains quite high. But stages 3 and 4, unfortunately, are characterized by a low survival rate.

Melanoma: 40 photos, symptoms and treatment

Melanoma is a skin cancer that develops from a mole very quickly and metastasizes to the lymph nodes and other organs and systems. It is not easy to detect melanoma at the initial stage; the tumor is almost invisible and, nevertheless, very dangerous.

Modern medicine faces many diseases. Some of them have been known to mankind for a long time, and some have not even been explored yet. This is why problems with diagnosis and treatment often arise. One of the most dangerous diseases is cancer. They pose a great danger to human life, and medicines that guarantee 100% cure this moment doesn't exist yet. Today's article will focus on melanoma. Let's find out what kind of disease this is, what statistics know about it, and look at treatment and diagnosis. Be sure to study all the information provided. Today's pace of life requires such awareness not only from specialized specialists, but also from the person himself.

What is melanoma

Melanocytes are certain cells found in human skin that produce melanin (the so-called color pigment). Melanoma is a skin cancer that arises and develops from these cells (melanocytes). This tumor disease is now very common everywhere. Unfortunately, people of different ages, genders and nationalities are susceptible to it. The first stages of the disease in question in most cases have a positive dynamics of treatment, while advanced forms very often do not respond to intervention and, as a result, lead to death.

Modern medicine knows many skin pathologies of an oncological nature, and melanoma is one of them. According to statistics, in the countries of central Europe there are 10 cases per person annually. Austria and America have cases per year for a similar number of residents of the country, which makes melanoma the most dangerous cancer even in developed countries, let alone those where the level of medicine is not so developed.

Berlin scientists have concluded that women experience this disease much more often than men. Statistics show that 6 thousand men and 8 thousand women are affected by the disease. Mortality due to melanoma is determined by 2 thousand men and women. From official data it is clear that about 14 thousand Germans fall ill with this type of cancer every year. It is also worth knowing that of all the deaths in the world from cancer, 1% of them are due to melanoma.

The disease is considered to be of different ages, but the majority of patients are elderly people, after 70 years. Over the past half century, the incidence of the disease has increased by 600%. However, you should not relax if this age is still very far away. Unfortunately, melanoma is often diagnosed in middle-aged people, young people and even children.

Many moles: could it be melanoma?

Since melanoma develops from a mole, it would be logical to ask: are people with many moles on their body susceptible to cancer? Oncologists answer: yes. People with nevi, papillomas and skin tendencies to pigmentation need to be careful not to expose the skin to solar radiation and mechanical damage.

Many years of medical research have shown that people with Eastern European skin type have melanoma on the limbs and torso. Persons with blond, red hair, eyes of green, gray, blue shades are more susceptible to it. The risk group consists primarily of people with pink freckles, congenital age spots (nevi) and atypical moles located on open areas of the body, forearm, foot and back. Trauma to the nevus in some cases leads to skin cancer. In older people, age-related pigmentation on the skin is a signal of concern, which in no case should be ignored, since melanoma develops well against this background. The appearance of this pathology is influenced by the following factors:

• hereditary predisposition;
• regular exposure to ultraviolet rays;
• Dubreuil's melanosis;
• xeroderma pigmentosum;
• the presence of a large number of moles (more than 50 pieces) and freckles on the body.

Thus, if there was at least one case in the family cancer, then all subsequent generations automatically fall into the risk group, and if a person is constantly exposed to ultraviolet rays, and in addition has light skin covered with freckles, then he needs to be especially careful about his health. These people should also be aware of factors that can provoke the rapid development of cancer cells (which are present in the body of every person, but only lie dormant for the time being). Provoke the development of cancer other than exposure environment Possibly severe stress, prolonged illness, alcohol, smoking, drugs.

The rapid formation of moles and freckles on the skin is also a cause for concern.

Where does melanoma grow?

However, melanoma occurs in people of all skin colors. People in different countries encounter this skin pathology.

The tumor will not be considered malignant if hair growth is detected on the skin. This does not happen in the area affected by melanoma. However, even if there is no hair on the neoplasm, do not panic, remember - if you take appropriate measures in time, the disease can be defeated.

Melanoma develops on age spots and healthy skin as well. In women it is found, most often, in the area of ​​the lower extremities, and in men on the entire surface of the body. Parts of the body exposed to ultraviolet rays are more likely to be affected by this formation. However, areas of the body where the rays penetrate little or not at all are not excluded. This tumor also occurs in people between the fingers, on the soles of the feet, even on internal organs. Infant morbidity is extremely rare. It's scary, but even minimal sunburn or heatstroke prone to illness.

Everyone develops the disease differently

The disease progresses at different rates in different patients. There is a period of several months when the disease progresses very rapidly and leads to death. Some people survive melanoma for more than 5 years with ongoing maintenance therapy.

Another danger is that metastases appear very early; a person may not even be aware of the disease for a long time. Damage occurs to the bones, brain, liver, lungs, skin, heart. Metastases may not appear if the melanoma has not spread shallowly, that is, no further than the basement membrane.

Types of melanoma and symptoms

Modern medicine differentiates the disease discussed in today's article into types and defines in this distinction a set of symptoms that arise with this disease. The symptoms of melanoma are quite varied. Thanks to it and high-quality diagnosis, it is possible to detect the disease at an early stage.

The types of this tumor are as follows:

1. Superficially widespread melanoma.

This formation grows very slowly, but is considered the most common and occurs, according to statistics, in 47% of cases. It grows horizontally, has an uneven shape and is slightly convex to the touch. Reaching its peak, it begins to resemble in appearance a black glossy plaque. Only then does it gradually grow vertically and then grow deep into the skin;

2. Nodular or nodular melanoma is growing quite rapidly and is the second most common, according to statistics, it occurs in 39% of cases. This type is more aggressive and quite swift;

3. Peripheral or malignant lentigo changes the tissues of the skin, which later turn into cancer, and this type occurs in 6% of cases. It is considered a precancerous condition. The skin lesion is flat, not convex;

4. Amelanotic melanoma or acral melanoma occurs on the soles of the feet and palms of the hands. It occurs extremely rarely in medical practice.

Early stage melanoma: how to determine

Very often, people with an already advanced stage of melanoma turn to an oncologist, when the tumor has already begun to metastasize to various organs. Due to the painlessness of this type of skin cancer and the speed of its development, it is imperative to know the symptoms of melanoma. A person can be saved if melanoma is detected at its very initial stage. Melanoma can be identified by:

1. The appearance of a skin formation with an irregular shape;

2. The distinctive color of the formation;

3. The edges of the tumor have a jagged or arched shape;

4. Dark spot measuring 5 mm or more;

5. A spot similar to a mole, which is located above the skin level.

From all of the above, we can draw the following conclusion: it could be melanoma if a mole suddenly appears that was not there before. At the same time, it is irregular and heterogeneous in shape, and has blurred edges. It may itch and hurt. It is completely absent hairline. There may be ulcers on it, oozing blood or ichor (but this only happens in some cases).

Sometimes melanoma develops from an existing mole. Be careful if:

• there used to be hair on the mole, but now it has fallen out;
• the mole has increased in size;
• the mole has changed color (for example, it used to be light brown, but now it has become very dark, almost black);
• the nevus has increased in volume - it has noticeably risen above the skin;
• keratosis became noticeable on the nevus - dark, dry pimples appeared;
• dark spots appeared around the mole.

Melanoma symptoms

Skin melanoma is formed from a mole (nevus) in 70% of cases and is located in the torso, limbs, head and cervical region. In women, as a rule, the lower limbs and chest are affected, and in men - the chest and back. In addition, men are prone to epidermal nevus. The lesion occurs on the palms, soles and scrotum. The skin changes its color, the structure appears and the area bleeds. These are the defining and most important signs in making a preliminary diagnosis.

Melanoma is black, sometimes with a blue tint, and looks like a nodule. There are non-pigmented melanomas, in which there is no specific color, and they are painted with a pink tint. The size varies from 0.5 cm to 3 cm. The affected surface may bleed and have a compacted structure. Using a magnifying glass during examination, you can make a preliminary diagnosis.

It is very difficult to identify this disease in the early stages. Stage I cancer may not attract attention. To determine the disease, the doctor must have extensive experience working with similar diseases.

Let's look at the most common types of melanomas in more detail. We will talk about superficially widespread, nodular (nodular), malignant lentigo.

Lentigo maligna has a long horizontal growth phase, which can last up to 20 years or more. In old age, the disease develops against the background of pigmentation on the neck and face.

Superficially widespread melanoma occurs in people with an average age of 44 years. Formation appears both on closed areas of the skin and on open ones. The upper back is most often affected in men, while in women the lower extremities are affected. When formed, the plaque acquires a chaotic contour, in some places it becomes discolored and the color appears mosaic-like; the epidermis undergoes changes and thickens significantly. After a few years, a node appears on the plaque, then the melanoma grows vertically.

Nodular melanoma is the most aggressive among other types. The average age is 53 years. It occurs slightly more often in men than in women. The upper and lower extremities are affected, cervical region, head and back. The node forms quickly, the skin undergoes changes, reaches the peak of development in a few months and already has bleeding.

Incorrectly selected treatment threatens repeated relapse. Against this background, distant metastases occur. In most cases, chemotherapy is used. Treatment can be prescribed in combination, in which case the patient takes antitumor drugs, which gives a chance of recovery in 40% of cases.

Forms of manifestation of melanoma

Malignant melanoma often metastasizes to the brain, heart, lungs, and liver in a hematogenous and lymphogenous manner. The nodes begin to spread and are located along the limb, skin or torso.

It happens that a person goes to the doctor with a complaint of enlarged lymph nodes. A competent doctor will ask many clarifying questions to the patient to draw up a complete picture of the disease. For example, it may turn out that the patient recently had a wart removed that was a melanoma.

Symptoms of eye melanoma

Melanoma damages tissue not only on the skin, but also on the visual organ, the eye. The first symptoms include the appearance of a tumor, rapid deterioration of vision, the appearance of photopsia and progressive scotoma.

Photopsia is accompanied by the appearance of sparks, dots, spots in the field of view. There are two types of scotoma:

1. Positive scotoma (a blind area appears in the field of vision, which is perceived by a person as a black spot);

2. Negative scotoma (the blind area is not perceived by a person in any way).

Negative scotoma is determined using certain techniques.

Small melanoma can be confused with a pigmented nevus, which is located in ocular membrane. A positive scotoma should be differentiated by an experienced ophthalmic oncologist, since glaucoma has similar symptoms.

The growth rate of ocular melanoma can only be determined through certain studies. The treatment tactics are chosen by the doctor after a detailed study. Radiation therapy, local resection or ocular enucleation are prescribed.

Stages of melanoma

The disease has 5 stages, with stage zero being the mildest. Cancer cells are still present only at the cellular level. The malignant tumor has not yet grown deeper.

Stage I has a tumor formation no more than 1-2 mm in thickness, above the skin level. There may be ulceration, but this is not necessary. The lymph nodes located next to the affected area of ​​the skin are not subject to negative effects from the tumor.

Stage II has tumor formations from 2 mm thick and characteristic lesions. There are no distant or regional metastases.

At stage III they appear pathological changes skin, a nearby lymph node is affected by cancer cells. Sometimes at this stage, melanoma cells spread further through the lymph system.

Stage IV always has cancer cells in the lymph system and the disease has already spread to other areas of the skin, organs and tissues of the body. Death in 100% of cases.

Practice shows that relapses occur even with properly selected treatment; in addition, the disease returns not only to the places where it was before, but also to those areas of tissue that were not exposed to melanoma.

Diagnosis of melanoma

A number of manipulations help diagnose melanoma. The doctor uses a special magnifying glass. Radioisotope testing helps make a diagnosis. Thanks to it, you can see a large amount of phosphorus in the tumor, which means that the tumor is malignant.

If skin cancer is suspected, a puncture or biopsy is used, but not for melanoma. The fact is that any damage to the skin can make the situation worse.

Cytological examination helps to make a final diagnosis. An imprint is taken from the surface of the formation along with the lesion.

A detailed conversation with the patient helps in diagnosing melanoma. It is necessary to pay attention to the symptoms that appear in the patient. Weight loss, deterioration of visual acuity, joint pain, headache and general malaise are common. X-ray, CT and ultrasound help to accurately determine the presence or absence of metastases on a person’s internal organs.

Treatment of melanoma

The disease is treated in two ways: surgery and combination treatment. With combined treatment, the tumor is removed after radiation.

Read more about the treatment of melanoma in our article: Treatment of melanoma.

Combined treatment occurs in two stages. Close-focus X-ray exposure is used in the first stage. Radiation reaction occurs 2 or 3 days after exposure to the tumor. Therefore, the operation is carried out before or after this moment. Malignant formation removed with sufficient healthy tissue around. To return the skin to its usual appearance, it is necessary to perform plastic surgery, because a wound defect accompanies this type of procedure.

A patient facing malignant melanoma must have regional lymph nodes removed, even if the disease is not detected in them, because melanoma tends to spread metastases to nearby lymph nodes. Such caution affects the prognosis of the disease and gives a chance for a favorable outcome. Enlarged lymph nodes indicate possible metastasis to them. The combined treatment method involves irradiating them with gamma therapy, after which the necessary lymph nodes are removed through surgery. Recent years Such combined methods of fighting cancer are used quite often, which indicates the positive effect of the combination of these procedures.

Melanoma prognosis: is it possible to survive?

Melanoma is an extremely dangerous and fast-growing cancer disease. The main thing is clinical stage, which was relevant at the time of diagnosis when contacting an oncologist. After all, the earlier the disease is detected, the greater the chances of a favorable outcome. Approximately 85% of patients survive a five-year period in stages I and II, when the tumor has not yet spread beyond the cancer site. Since at stage III metastases spread throughout the lymph system, the survival rate is 50% over a five-year period when only one lymph node is affected. If several lymph nodes are affected by the disease, then the possibility of recovery is reduced to 20%. As stated earlier, the fourth, or last stage melanoma has distant metastases, so the five-year survival rate is only 5%.

As a rule, the diagnosis is made at stage I or II, which significantly increases the chances of defeating the disease. Tumor thickness plays a role important role in determining the forecast, because its mass indicates the presence of metastases.

96-99% survival rate over five years is due to surgical intervention, unless the tumor thickness is 0.75 mm or less. Patients with a thickness of no more than 1 mm are at low risk and account for about 40%. A sharp regression or vertical increase in the tumor indicates the appearance of metastases, but the final answer will only be given by histological examination.

In 60% of cases, metastases spread if the melanoma has grown to 3.64 mm or higher. Such dimensions are very dangerous because they lead the patient to death. But the tumor can be noticed much earlier, because it rises above the level of the skin and significantly changes its color.

The location of the tumor on the body affects the prognosis. Skin lesions on the forearm or lower leg give a better chance of recovery than the presence of cancer cells in the area of ​​the hands, feet, mucous membranes and scalp.

Forecasting, in some way, is determined by belonging to one gender or another. The first two stages often have a better prognosis for women than for men. This is due to the fact that in women the disease develops lower limbs Therefore, it is easier to see it at an early stage, and timely detection of the tumor gives greater hope for recovery.

A less favorable prognosis is determined for elderly patients. This is due to the fact that tumors are detected quite late and older men more often suffer from another form of melanoma, namely acral lentiginous melanoma.

Statistics show that after 5 or more years the tumor returns in 15% of cases after its removal. The fact is that the likelihood of relapse depends on the thickness of the cancer. Accordingly, the thicker the removed tumor, the greater the chance that it will return in a few years.

In the first two stages, unfavorable prognosis is sometimes encountered. There is a high risk of increased mitotic activity and satellites (small areas of tumor cells measuring at least 0.05 mm or even larger), which begin to form in the subcutaneous tissue or reticular layer of the dermis. Melanoma often spreads satellites and micrometastases simultaneously.

Using the method of comparing Clark's histological criteria, a prognosis is made for stages I and II of the disease. The location of the tumor in the epidermis determines the first stage of invasion in accordance with the Clark system. Penetration of a malignant tumor into the layers of the epidermis determines the second stage of invasion. When the tumor reaches the space between the papillary and reticular layers of the dermis, this indicates stage III of invasion. Stage IV is characterized by penetration of the formation into the reticular layer of the dermis. Germination occurs in subcutaneous tissue at stage V according to Clarke criteria. Survival rate for each individual criterion is 100% at stage I, 95% at stage II, 82% at stage III, 71% at stage IV and 49% at stage V.

Every person should understand that timely access to the clinic makes it possible to prevent the serious consequences of illness. Any changes in the nevus are a reason for a thorough examination. It is necessary to pay attention to changes in its color, size and shape. Ulcerations and bleeding cannot be left to chance, because stages III and IV cannot be treated with modern medicine. Even the most advanced technologies and the latest equipment have not yet learned to cope with advanced forms of cancer. Prevention and early diagnosis of the disease help prevent severe illness and its consequences. Don’t forget to inspect your skin yourself. If you have the slightest suspicion of melanoma, contact your doctor immediately.

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