How could we define a malignant melanoma?
It is defined as a skin cancer that is produced by an abnormal and uncontrolled growth of cells, called melanocytes.. It is the cutaneous tumor that causes more morbidity (complications, such as hemorrhage, infection, pain) and mortality. Its incidence in our population is estimated between 10-11 cases per 100,000 inhabitants per year. This tumor has a very important socio-economic impact compared to other tumors because of its involvement in young patients (second cancer after Leukemia in people under 65 years of age) and its aggressiveness, (tumors smaller than 1 millimeter thick can metastasize to distance and in tumors over 4 millimeters thick).
Is this tumor very frequent and why does it appear?
In recent decades, it has multiplied alarmingly. The causes of why this disease develops are not known with certainty but a series of risk factors are known that are related to the appearance of this tumor, such as sun exposure, ultraviolet rays, patients with diminished immunity or those people who have melanocytic nevi (freckles) in large numbers, for example having more than a hundred nevus, is an important risk factor for developing melanoma.
How can I know if a nevus (a freckle) is a melanoma and what to do?
In the case that a nevus appears again, changes color, grows or presents a hemorrhage, it is necessary to go to a specialist in melanoma surgery for its evaluation and if it is necessary to remove the lesion to be analyzed by the pathologist. The analysis of the nevus will tell us if it is a melanoma. If it is, it will not tell the thickness (Breslow index), the depth (Clark's index) and other characteristics of the tumor. Based on all this information will proceed to the treatment of Melanoma.
What is the surgical treatment of malignant melanoma?
The treatment of Malignant Melanoma in its beginning is always surgical, a wide extirpation must be carried out (about 2 cm of margin around the tumor). In addition, an examination of possible metastases in the lymph nodes near the tumor, which is called sentinel node biopsy, should be performed.. This technique involves injecting a drug labeled with a radioactive isotope, in the area of the tumor, this drug will migrate to the lymph node of the lymph node territory closest to the tumor (sentinel lymph node) that must be removed and analyzed by the pathologist.. The ganglionic territories are located in the cervical zone, axillary zone and inguinal area. If there is metastasis, lymph node lymph node dissection (removal of all lymph nodes) from the affected territory will be performed.
Can malignant melanoma be cured?
Like all oncological diseases, Melanoma can be considered to be cured if it has not metastasized or relapsed 10 years after its extirpation.. Early diagnosis and surgery in its initial stages allows a greater survival and better control of the disease. In more advanced stages (metastases in lymph nodes or in different viscera), surgery for metastases, radiotherapy, immunotherapy and the appearance of new drugs (Ipilimumab, Verumafenib) and others that are in the experimental phase allow control and sometimes decrease metastases and improve the survival of these patients.