Melanoma is the most aggressive type of skin cancer that develops from a neoplasm of melanocytes and cells produced by melanocytes. Melanocytes are the cells that are responsible for the production of melanin. When melanoma advances and spreads to other parts of the body, it is called metastatic melanoma. It is also known as stage four melanoma. When metastatic, it is likely to spread to the following parts of the body; brain, liver or stomach, lungs, lymph nodes and other tissues under the skin. Mostly, metastatic melanoma cannot be cured. But through support systems and treatment, the patient is able to live much longer and better. New therapies have been uncovered to increase the survival rate of the patient.
Symptoms of Metastatic Melanoma
The presence of unusual moles may indicate that the melanoma has not yet metastised. The following are characteristics of moles that are caused by melanoma;
The two halves of a healthy mole look similar when a line is drawn through it. Moles that are caused by melanoma are not asymmetrical. The two halves are different when a line is drawn through it.
The borders of the moles that are not caused are smooth. The moles that are caused by melanoma have rough or jagged edges.
The moles that are caused by melanoma have more than one color. This colors may be brown, tan, red, white, blue or black.
The moles that are caused by melanoma are much bigger in size as compared to begnin moles. Mostly the diameter is larger than that of an eraser on pencil.
Symptoms of Metastatic Melanoma
- Lumps under the skin that are hardened.
- Swollen lymph nodes that maybe painful.
- When melanoma has spread to the lungs, it may cause difficulty in breathing. The patient may also develop a cough that does not go away.
- When the melanoma has spread to the liver and stomach, it may cause enlarged liver and loss of appetite.
- When the melanoma spreads to the bone, it may cause pain in the bones and broken bones.
- Seizures are caused when the melanoma has spread up to the brain.
- Weight loss
- General weakness and numbness of arms or legs.
Causes of Metastatic Melanoma
Melanoma is caused by long term exposure to ultraviolet rays, either from the sun or tanning beds. This damages the DNA of the melanocytes, causing it to grow out of control, causing melanoma. Some parts of the body are not exposed to sunlight may still get the diseases. When the melanoma is not detected or treated early, it risks developing to metastatic melanoma.
Risk Factors of Metastatic Melanoma.
People who are at higher risk of getting melanoma are the people with the following characteristics. People with fair skin, lighter hair and eye color, People with many moles that are irregular and people who have family history of melanoma.
People who are at risk of developing metastatic melanoma are the people with primary melanomas which are visible skin growth, people with melanomas that are not removed and the people with a suppressed immune system.
Older people are more likely to develop melanoma than young people. Despite of this fact, melanoma is one of the most common cancer in young people under thirty years of age especially women. Men who are above fifty years of age are more likely to develop melanoma as compared to women above fifty years.
Skin exam is carried out by the doctor or the dermatologist. When a suspicious growth is detected, biopsy is carried out to check for skin cancer. There are two types of biopsies that may be carried out. In punch biopsy, a round piece of skin is removed for testing. In excisional biopsy, the entire growth is taken out. If the test comes out positive for melanoma, excisional biopsy is carried out. The tumor is evaluated based on its thickness. The thicker the tumor the more serious the cancer.
To determine the spread of the tumor, imaging test and blood test is carried out. Types of imaging tests include
- Chest X-RAY
Pictures of the inner parts of the body are taken using radiation in low doses
- CT-Scan ( Computerized Tomography scan))
Powerful X-RAY are used to look in detail parts of the body.
- MRI (Magnetic Resonance Imaging)
Pictures of organs and body structures are taken using radio waves and powerful magnets. It also shows blood flow and helps in locating cancer growth.
- PET scan
Radioactive material is used to look for signs of cancer.
Enlarged lymph nodes are checked and thin needles are used to remove sample cells for testing in a process known as fine needle aspiration biopsy. To remove the likelihood of lymph nodes having cancer, sentinel node biopsy is carried out, where the doctor injects dye in to the area where the cancer was and later removed from the nearest lymph nodes and tested after spreading. If the lymph node does not have cancer, it means the cancer has not spread.
Metastatic Melanoma in most instances cannot be cured. The treatment is meant to shrink or stop growth of the diseases where it has spread, prevent it from spreading further and to make the patient comfortable. The following treatments are used
This procedure is carried out to remove tumors or affected lymph glands to help the patient to have fewer symptoms and live longer. On its own, surgery does not cure cancer. Other treatments are used to for effective treatment.
ii. Radiation and chemotherapy can help some patients, depending on the size and location of the cancer.
This is when drugs are given to the patient to help boost the immune system for better the attack of the cancer. This is gotten through an IV or a high dose shot. These drugs may help the patient live a longer life by shrinking the metastatic melanoma. The drugs may have serious side effects.
Complications Caused By Treatment
Treatment may cause pain, nausea and fatigue. Removal of lymph nodes may lead to lymphedema. Chemotherapy may cause confusion during treatment. Peripheral neuropathy may occur, which may be permanent.
When caught and treated early, melanoma is curable. For stage four metastatic melanoma, the average five year survival rate is 15 to 20 percent. Annual skin cancer checks with dermatologists and follow ups in case of previous melanoma in the past is encouraged to ensure early detection.