Melanoma metastases
Melanoma is a skin cancer, the most malignant and aggressive tumor. It arises from pigment cells that produce melanin (melanocytes). The risk of development is associated with the skin phototype. It is localized more often in the skin, less often in the mucous membranes and retina of the eye. Metastases are secondary foci of cancerous malignant neoplasms that spread through the body by hematogenous (through the blood, settling in organs and tissues) or by the lymphogenous route (through the lymph, settling in the lymph nodes).
Why is melanoma so dangerous? First, it is one of the fastest growing tumors. Secondly, it early, one might even say swiftly, gives metastases. Thirdly, it spreads with equal probability both by hematogenous and lymphogenous routes to almost all organs. And, fourthly, there is a considerable list of risk factors and causes of its occurrence:
- ultraviolet radiation (natural and artificial);
- the presence of nevi (moles);
- phenotype (white skin, blonde hair, blue eyes, freckles);
- heredity;
- suffered sunburn (even in childhood);
- multiple moles;
- pre-retirement and retirement age;
- pigmented xeroderma (hypersensitivity to UV radiation);
- melaniform nevus (benign damage to the skin);
- previously transferred melanoma.
Melanoma can be a metastasis caused by another cancer, or it can itself metastasize to other organs. Thus, it can be either a primary or a secondary tumor. Melanoma metastases are much more dangerous, since they can lead to the failure of vital organs in a short time. A skin tumor is classified depending on the clinical form:
· Surface spreading;
· Nodal;
· Acrolentiginous;
· Lentiginous;
· Achromatic (non-pigmented).
In addition to cutaneous melanomas, there are:
· Lentiginous melanoma of the mucous membranes;
· Melanoma of the retina;
Subungual (looks like a black spot under the nail);
· Malignant melanoma of soft tissues.
Most often, neoplasms metastasize to the lungs, brain, skin and subcutaneous tissues, lymph nodes, liver, bones. If a person falls under many points of risk factors, he should be very careful about moles on his body and control even the slightest changes in them. This is very important and necessary for timely diagnosis, successful immediate treatment and prevention of metastases.
So what should you pay attention to in order not to waste precious time? Indeed, in this situation, the time saved is the health donated to the person, and sometimes life. The development of melanoma has the following symptoms: a change in the color and shape of the nevus, its enlargement, ulceration, the disappearance of a clear outline, itching, bleeding and hair loss from its surface, nodulation.
The development of the tumor forms a compacted infiltrate (accumulation of blood and lymph) at its base. The surface of the age spot rises above the level of the skin (exophytic growth) or ulcerates (endophytic growth). With exophytic nodes, a mushroom, flat-knobby or hemispheric tumor is formed of a moderately dense consistency, heterogeneous color and crooked outlines. Then she disseminates lymphogenous or hematogenous.
With lymphogenous metastases, the primary focus may not show signs of growth. Symptoms of developed melanoma are an increase in regional lymph nodes, the appearance of foci around a pigment spot (benign in appearance), or at its base. With metastasis of melanoma, the patient manifests symptoms dictated by the localization of the secondary focus, as well as general symptoms: vision deteriorates, body weight decreases, general malaise and bone pain appear.
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At the first suspicion of a tumor, you should consult a dermatologist or oncologist. The diagnosis is based on the results of histological (after complete excision of the tumor) and cytological studies, clinical data, samples with radioactive phosphorus. The possibility of biopsy is limited, punctures and partial damage to the tumor are unacceptable in order to avoid the spread of the disease.
To detect metastases, scintigraphy, magnetic resonance imaging, computed tomography, ultrasound of lymph nodes, liver, brain, lungs, bones, etc. are performed. The variety of clinical forms of primary and secondary tumor foci significantly complicates the diagnosis. Since 1967, five microstages of melanoma have been divided according to Clark (from I to V level). Since 1970, three stages according to Breslow have been divided: thin (invasion up to 0.75 mm), intermediate (from 0.76 to 3.99 mm) and thick / deep (more than 4.0 mm).
Melanoma is curable in the early stages if it was diagnosed in time and managed to affect only the upper layers of the skin. In such cases, the tumor is excised with the capture of healthy tissue (1-3 cm). With horizontal tumor growth, there is a fairly high probability of cure (from 97 to 100%). Vertical growth is unfavorable and requires additional exposure to chemotherapy, immunotherapy, as well as radiation and photodynamic therapy.
With a secondary lesion of the lymph nodes, resection is performed, but the chances of recovery are reduced. With distant metastases to other organs, the prognosis is disappointing. Treatment is prescribed depending on the localization of secondary foci. In the later stages of the disease, radiation and chemotherapy are added to surgical methods. After removal of the primary melanoma, regular monitoring by a doctor (every 3-6 months) for five years, then every year is necessary.
From all of the above, it follows that melanoma is better prevented than treated.
Since melanoma is very dangerous, it is best to take all possible measures to prevent it. Prolonged exposure to the sun increases the likelihood of getting sick, so sunscreen should not be neglected, especially for people at risk. Avoid sunburn, use creams with an SPF of at least 15, wear a hat, and keep a close eye on changes in pigmentation on your body.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
