Melanoma

GENERAL INFORMATION:

What is melanoma? Melanoma (mel-ah-NOH-mah) is also called cutaneous melanoma or malignant melanoma. It is a type of skin cancer. Melanoma is the most serious type of skin cancer. Normally, the cells in our body divide (split) only when needed. Cancer cells grow and divide without control or order, often making a lump or bump. This lump or bump is called a tumor. Melanoma can spread to other healthy parts of the body if not found immediately. Once it has spread, the cancer cells are harder to control.

What causes melanoma? Caregivers do not know exactly what causes melanoma. You are at a higher risk for getting melanoma if you spend time under the sun. You are also at higher risk of getting melanoma if:

• You or a close family member have had a melanoma before.
  
  
• You have had one or more blistering sunburns as a child or teenager.
  
  
• You have light colored skin, hair or eyes.
  
  
• Your freckles or moles increase in number or look different from before.
  
  
• Your skin burns rather than tans when you are in the sun.
  
  
• You have other skin diseases such as xeroderma pigmentosum.

What are the signs and symptoms of melanoma? Melanoma may appear as a new mole, or in moles you already have. Men often get their new moles on the skin between the shoulder and hips (trunk). Women usually get new moles on their arms and legs. Moles may also be found on the palms of the hands, the soles of the feet or under the nailbed.

What should I look for when I look at my own skin? Caregivers describe a melanoma based on the ABCDE system:

• A symmetry: If a line is drawn through the middle of the mole, the two halves are unequal.
  
  
• B order: The border of the mole is not smooth.
  
  
• C olor: The color can vary from blue, black, brown, or red.
  
  
• D iameter: The size of the mole is larger than a pencil eraser.
  
  
• E volution: The mole changes in appearance and symptoms such as:
  
  
  • It bleeds or has fluid leaking (oozing) out.
    
    
  • It changes in size, shape, or color.
    
    
  • It feels itchy, hard, lumpy, swollen, or tender.

How is melanoma diagnosed? You may first need to have all or part of the lump removed. This is called a biopsy. The tissue will then be sent to the lab for tests. If it is melanoma, these tests will tell you about the stage and level of the cancer.

• The stage of the cancer describes how far it has spread. Stage zero is the earliest stage and stage four is the most advanced. In stage four, the cancer has spread to other body organs. Melanoma can spread to the brain, lung, liver, bones or lymph nodes. Cancer that has spread is called metastatic, and is harder to treat.
  
  
• The level of cancer is based on how thick and how deep the melanoma is. Thin melanomas, and those that are not deep have a better chance of being cured.

• Blood tests.
  
  
• Chest X-ray.
  
  
• Computerized pictures of the bone (bone scan) or skin (dermatoscopy).
  
  
• Computerized tomography (CT) scan of other organs.
  
  
• Ultrasound of the abdomen (stomach).

How is melanoma treated? Melanoma is treated differently depending on whether or not it has spread to other parts of your body.

• If the cancer has not spread , surgery to remove the tumor is the most common treatment.
  
  
• If the cancer has spread , you may need one or more of the following treatments:
  
  
  • Biological therapy medicine to help your immune system fight the cancer.
    
    
  • Chemotherapy medicine to kill cancer cells.
    
    
  • Radiation therapy (x-rays) to kill cancer cells.
    
    
  • Surgery to remove cancer cells.

How should I take care of my skin?

• Protect your skin from the sun's ultraviolet (UVA UVB) rays.
  
  
  • Wear sunscreen that has an SPF (sun protectant factor) of 15 or higher. The sunscreen should also have UVA and UVB protection. Follow the directions on the label when using sunscreen. Put on more sunscreen if you are in the sun for more than an hour. Also reapply sunscreen often if you go swimming or are sweating a lot.
    
    
  • Stay out of the sun between 10 AM and 4 PM. The sun is strongest and most damaging to your skin between these times.
    
    
  • Protect your lips by using lipsticks and lip balms that have sunscreen in them.
    
    
  • Wear long-sleeved shirts and pants to protect your arms and legs when you are out in the sun. Wear a hat with a wide brim to protect both your face and neck.
  
  
• Do not use tanning booths. These can damage your skin as much as the sun.
  
  
• Look for new bumps on your skin once a month. A mole is a small, dark bump on the skin. Know what your regular birthmarks and moles look like. A new mole that appears on your skin after 30 years of age should be watched closely for changes.

For support and information:

• Melanoma can be a life-changing disease for you and your family. Accepting that you have skin cancer is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Your caregiver can help your family better understand how to support a person with skin cancer.
  
  
• You may also want to join a support group with other people who have cancer. Ask your caregiver for contact information for support groups. Contact the following for more information:

• American Cancer Society
  Phone: 1-800-227-2345
  Web Address: http://www.cancer.org
  

• National Cancer Institute
  Phone: 1-800-422-6237
  Web Address: http://www.cancer.gov
  

• The Skin Cancer Foundation
  245 5th Avenue, Suite 1403
  New York, NY 10016
  Phone: 1-800-754-6490
  Web Address: www.skincancer.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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