Melanoma

Melanoma: A Malignancy of the Integumentary System

Katherine Konnert
34 BIOL 1015
University of Cincinnati Clermont College
2 December 2014

Melanoma

Melanoma is a malignant tumor of the melanocytes, which are pigment-producing cells in the
basal layer of the epidermis of the skin. There are four types of melanoma: superficial spreading
melanoma, lentigo malinga melanoma, acral lentiginous melanoma, and nodular melanoma. The
first three types originate in the outer layers of the skin, but can grow deeper, and have the
possibility of metastasizing to other parts of the body. The fourth type, nodular melanoma,
differs in that it is usually already invasive by the time it is diagnosed (The Skin Cancer
Foundation, 2014).
Etiology
The most widely accepted etiology of melanoma is that it is caused by ultraviolet radiation,
commonly sustained from the sun or from tanning beds. The radiation causes skin cells to
mutate and multiply into a malignant tumor. Heredity also plays a role in the development of
melanoma. According to The Skin Cancer Foundation (2014), each person with a first-degree
relative diagnosed with melanoma has a fifty percent greater chance of developing the disease
than those without a familial history. There are several other risk factors, including having fair
skin, numerous moles, and a compromised immune system, although it isnt clear how these
factors cause melanoma (The Skin Cancer Foundation, 2014; Melanoma Skin Cancer, 2014).
Symptoms and Diagnosis
The signs and symptoms of melanoma present as lesions, which may itch or bleed. Usually,
melanoma looks like an atypical mole that is black or brown in color, but the lesions can also be
nude, pink, red, purple, blue or white. The mnemonic, ABCDE, is a diagnostic tool to help the
patient and physician evaluate moles and lesions for melanoma. It stands for asymmetrical,
uneven border, multiple colors, a diameter greater than one fourth of an inch, and evolving. If

Melanoma

any part of the mnemonic describes a lesion, then that lesion should be considered suspicious.
Self-exams that procure a potential melanoma should be followed up with a skin exam by a
dermatologist (The Skin Cancer Foundation, 2014; Melanoma Skin Cancer, 2014). Then, the
dermatologist can obtain a skin biopsy to determine if a lesion is malignant. If a diagnosis of
melanoma is made, the melanoma will be classified by type and stage, according to its thickness,
depth, and invasiveness. A biopsy of the lymph nodes and imaging scans may be used to
determine if the melanoma has metastasized (Melanoma Skin Cancer, 2014).
Treatments, Prognosis, and Prevention
Once the diagnosis of melanoma is made, the treatment is usually to excise the tumor along
with a margin of skin around it. Then, a biopsy will be taken from that margin of skin to ensure
that the entirety of the malignancy was removed. An even more effective technique called, Mohs
Micrographic Surgery, has recently become popular. In this type of surgery, the tissue will be
excised only one layer at a time while being microscopically studied for cancer cells during the
operation. The surgery concludes when a layer of tissue does not show any malignancies. In
the case of a large area of skin being removed, a skin graft may be used to maintain a desired
appearance (The Skin Cancer Foundation, 2014). If the melanoma is advanced, a new
immunotherapy drug called, Keytruda, may be the next course of action in treatment. It has been
found to shrink tumors by about twenty-four percent in those with advanced cases of melanoma
(Philippidis, 2014).
The Skin Cancer Foundation (2014) reminds us that although melanoma is not the most
prevalent type of skin cancer, it is the most deadly. If the melanoma has been discovered early,
before it has metastasized, the prognosis is very good. The five year survival rate for those with
early detection is ninety-eight percent. However, invasive melanoma that has not been caught

Melanoma

early can easily spread to other parts of the body. In these cases, the prognosis can be grim, as
the five year survival rate is sixty-two percent once the melanoma has reached the lymph nodes
and only nineteen percent when it has spread to other bodily organs (The Skin Cancer
Foundation, 2014).
Prevention is the key to receiving an optimistic prognosis with a diagnosis of melanoma. No
one can escape from the hereditary factors that increases the risk of the cancer, but there are
simple ways to prevent ones exposure to the ultraviolet radiation that directly causes the disease.
These include limiting exposure to sunlight by diligently wearing sunscreen, covering oneself
with clothing, and avoiding tanning and burning. Because early detection is the best way to
prevent invasive melanoma, it is essential to regularly complete a self-exam of ones skin and
seek treatment with a physician if any suspicious lesions are found (The Skin Cancer
Foundation, 2014).
Research and Conclusion
Along with growing awareness about prevention methods, research is making an encouraging
impact on the treatment of melanoma. Scientists have discovered that women have a thirty
percent greater survival advantage than men, so studies are being done on the relationship
between gender disparities and melanoma survival (Clark, Keegan, & Swetter, 2014). Perhaps
the most promising research is being done on a new immunotherapy drug called, Keytruda.
Wendy Selig, the president and CEO of the Melanoma Research Alliance (Philippidis, 2014),
demonstrated her optimism about research and the future of melanoma when she stated, This is
the latest in a string of major breakthroughs in melanoma treatment that will galvanize the field
of melanoma research and cancer treatment

Melanoma

References
Clark, C. A., Keegan, T. H., & Swetter, S. M. (2014). Why Do Men Have Worse Melanoma
Survival Than Women? Is it Behavior, Biology, or Both? (A. C. Dr. Halpern, A. A. Dr.
Marghoob, & A. W. Dr. Kopf, Eds.) The Melanoma Letter, 32(Summer 2014), pp. 4-6.
Melanoma Skin Cancer. (2014, s). Retrieved from American Cancer Society.
Philippidis, A. (2014, September 5). Merk Melanoma Drug is First PD-1 Inhibitor OK'd by FDA.
Signs and symptoms of melanoma skin cancer. (2014, September 5). Retrieved from
American Cancer Society: http://www.cancer.org/cancer/skincancermelanoma/detailedguide/melanoma-skin-cancer-signs-and-symptomsGenetic
Engineering & Biotechnology News.
The Skin Cancer Foundation. (2014). Melanoma And Skin Of Color. Retrieved from Skin Cancer
Foundation: http://www.skincancer.org/media-and-press/Press-Release-2009/melanomaand-skin-of-color
The Skin Cancer Foundation. (2014). Melanoma. Retrieved from Skin Cancer Foundation:
http://www.skincancer.org/skin-cancer-information/melanoma