Melanoma: Causes, Symptoms, Treatment and Cost

Melanoma is a particular kind of skin cancer that develops in the cells that produce the melanin pigment, which gives skin its colour.

It has the potential to spread to other internal organs and is the most serious kind of skin cancer.

Melanoma usually appears as a dark spot on the skin and can be found anywhere on the body, but is most common on areas exposed to the sun, such as the face, neck, arms, and legs.

Following are the types of Melanoma:

• Superficial spreading melanoma: Around 70% of instances of melanoma are of this form, making it the most prevalent. It typically appears as a flat or slightly raised patch of discoloured skin that may be mottled, tan, brown, black or multicoloured. It often spreads outwards in a radial pattern from a central point.
• Nodular melanoma: This type of melanoma makes up 10-15% of all cases and is typically raised and firm to the touch, with a dome shape. It is usually black or blue-grey in colour and can grow quickly over the course of days or weeks.
• Lentigo maligna melanoma: This type appears as an area of darkly pigmented skin that spreads slowly over time and may have areas that are lighter in colour than others.It most often affects those over 50 and frequently affects the face or neck.
• Acral lentiginous melanoma: The least common kind of melanoma, it often appears on the soles of the feet, the palms of the hands, or in the gaps in between the fingernails or toenails.The discoloration appears as a streaky brown area that may be raised from the surface slightly, but it won't feel hard like nodular melanomas can be.
• Amelanotic melanoma: This type is rarer than other types and lacks pigment, making it harder to recognize since it doesn't have any colour changes associated with it. It can look like a red raised lump without any pigmentation to it at all and can occur on any part of the body.

The following factors are responsible for Melanoma:

• Unprotected exposure to ultraviolet (UV) radiation:The most common cause of melanoma skin cancer is exposure to UV radiation from the sun or tanning beds. UV light may cause DNA damage in skin cells, which can cause those cells to proliferate out of control and develop into tumours.
• Genetic factors: Melanoma can be caused by inherited mutations in certain genes, such as the BRAF gene, which increase a person's risk of developing melanoma.
• Fair skin: Since they have less natural protection from UV radiation, those with pale skin are more prone than individuals with darker skin tones to acquire melanoma.
• Personal history of melanoma: Individuals who have already had one or more melanomas are more likely to have more of them.
• Age: While it may happen at any age, melanoma is more prevalent in persons 50 and older.
• Moles: A person's risk for melanoma is increased by having several moles or moles with atypical appearances.

The most common symptom of melanoma is:

• the development of a new mole
• A change in an existing mole. This can include changes in size, shape, colour, or texture.

Other symptoms may include:

• An itchy or painful mole
• A mole that bleeds or oozes fluid
• A mole with irregular edges and/or multiple colours
• a mole that is bigger than a pencil rubber in size.
• In some cases, melanoma may present itself as a dark spot on the skin that is not raised and does not have any defined borders.
• Melanomas may also appear as flat red patches on the skin that can be mistaken for other skin conditions such as eczema.
• In rare cases, melanoma can also appear as swollen lymph nodes near the affected area of skin or as an ulcerated lesion on the skin that does not heal.

Following are the ways to prevent Melanoma:

• Avoid excessive sun exposure: Melanoma is mostly brought on by sun exposure, thus it's critical to limit exposure to the sun whenever possible. While outside, dress protectively by donning caps and long sleeve shirts, and try to find cover whenever you can. Use broad-spectrum sunscreen with an SPF of at least 30 to all exposed skin while you're outdoors.
• Monitor your skin: Check your skin regularly for changes in size, shape or colour of existing moles or other marks on your skin. If you notice any changes, schedule a visit with your doctor right immediately for a more thorough evaluation.
• Avoid tanning beds: Melanoma and other kinds of skin cancer are more likely to develop as a result of UV radiation from tanning beds.Tanning beds should be avoided entirely.
• Get vaccinated against HPV: Human papillomavirus (HPV) infection increases the risk of melanoma in some cases. Vaccination against HPV can help reduce this risk.
• Eat a healthy diet: Eating a balanced diet that is rich in fruits and vegetables may help reduce the risks of developing melanoma and other types of cancer.

Following are the ways to diagnose Melanoma:

• Physical Examination: A physical exam of the skin is the first step in diagnosing melanoma. The doctor will look for any suspicious moles or changes on the skin.
• Dermoscopy: A dermatoscope is a hand-held, portable device with a magnifying lens that can be used to closely examine suspicious moles or lesions on the skin. This can help in diagnosing melanoma.
• Biopsy: If a mole or lesion appears to be suspicious, a biopsy may be performed to diagnose melanoma. A little piece of the mole or lesion is removed during this treatment and submitted to a lab for microscopic inspection.
• Blood Tests: Blood tests, such as complete blood count (CBC) and liver function tests may also be done if melanoma is suspected in order to check for any signs of cancer spread throughout the body.
• Imaging Tests: To find any cancer that has spread throughout the body and to assist establish the stage of melanoma, imaging tests including X-rays, CT scans, and MRI scans may be utilised (how far it has spread).

Complications of Melanoma are as follows:

• Disfigurement: Melanoma can cause disfigurement if it is not treated early. The tumour may cause the skin to become discoloured, ulcerated, and/or raised.
• Metastasis: The melanoma may spread to other body areas if it is not discovered and treated at an early stage. This is referred to as metastasis, and if it affects key organs, it may be fatal.
• Quality of Life: Melanoma can have a significant impact on quality of life due to its physical and psychological effects, such as depression and anxiety.
• Compromised immunity: Due to the spread of cancer, some patients may suffer from a weakened immune system causing them to be more vulnerable to other infections.

Some common Home remedies for Melanoma are given below:

• Panchakarma Therapy: Panchakarma therapy is an ancient Ayurvedic treatment used to help cleanse and detoxify the body. It could improve immunological function, increase energy levels, and reduce inflammation. It may also aid in the treatment of melanoma by reducing the growth of malignant cells.
• Use Turmeric at home: Strong antioxidant and anti-inflammatory effects may be found in turmeric. It may slow the development of melanoma and perhaps even stop cancer from spreading to other body regions.
• Use Gotu Kola as a herbal remedy: Gotu kola is a herb that has long been used in traditional medicine for its health benefits. It may be beneficial for treating melanoma as it helps reduce inflammation and promote wound healing, which can help slow down the growth of cancer cells.
• Holy Basil: Another plant having anti-inflammatory and antioxidant characteristics that may be used to treat melanoma is holy basil. It helps reduce inflammation, improve immunity, and promote healthy cell growth, which can help slow down cancer cell growth.
• Ashwagandha: Ayurvedic medicine uses the herb ashwagandha to treat a number of conditions, including anxiety and depression. It may also be beneficial for treating melanoma as it helps reduce inflammation, improve immunity, and boost energy levels.

The following are recommended to eat while suffering from Melanoma:

• Antioxidant-rich foods, such as fruits and vegetables, may lower inflammation and shield the body from oxidative stress.
• Fish and plant oils include omega-3 fatty acids, which may also help lessen the inflammation linked to melanoma.
• Citrus fruits and leafy greens, which are foods high in vitamins A, C, and E, may aid in the battle against cancer cells.
• Eating plenty of fibre-rich foods can also be beneficial for people with melanoma as fibre helps to flush toxins from the body.
• Probiotic-rich foods, such as yoghurt and kimchi, can also be helpful as they help maintain a healthy balance of gut bacteria which may have anti-inflammatory properties.

The following foods are required to avoid if you are suffering from Melanoma:

• Avoid processed, salty, and fried foods: These types of foods can increase inflammation in the body, which can worsen the symptoms of melanoma and put you at risk for further complications.
• Reduce your intake of dairy products since they are heavy in saturated fat, which has been associated with an increased risk of melanoma.
• Avoid alcohol: Alcohol use may increase your risk of developing melanoma and other kinds of skin cancer.
• Cut back on red meat consumption: Red meat contains high levels of saturated fat, which has been linked to a higher risk of developing melanoma.
• Reduce your intake of sugary drinks: Sugary drinks provide empty calories that can contribute to weight gain, which has been linked to an increased risk of developing melanoma.

Treatments of Melanoma are given below:

• Surgical excision: This is the approach used most often to treat melanoma. The malignant melanoma tissue, as well as a small margin of healthy tissue around it, must be surgically removed.
• Mohs surgery: This is a specialised type of surgery that is used to remove skin cancers (including melanoma) from delicate areas such as the face or hands. Little layers of skin must be pulled off one at a time and inspected under a microscope in order to eliminate any cancer cells.
• Sentinel lymph node biopsy: If the melanoma has spread to other areas of the body, such as lymph nodes, this procedure may be used to determine if it has spread further beyond these areas and whether additional treatments are required. During this procedure, a doctor will identify and remove the first 'sentinel' lymph node in which cancer cells may have spread and then check to see if any remaining cancer cells are present in other nodes nearby.
• Lymphadenectomy: If necessary, this procedure may be used to further remove any remaining cancer cells from nearby lymph nodes after a sentinel node biopsy has been performed.
• Amputation: In severe cases, amputation may be necessary if the tumour has spread too far for it to be removed with traditional surgery methods or if it is affecting important structures like nerves or arteries near the affected area.

It can be treated by a dermatologist, or a medical doctor who specialises in diagnosing and treating diseases of the skin, hair, and nails.

Depending on the severity and stage of the melanoma, other doctors such as an oncologist may also be consulted to provide additional treatment.

Given below are the best medicine suggested for Melanoma:

• Checkpoint inhibitors: medicines that stop the inhibitory signals sent by cancer cells, preventing cancer cells from evading the immune system. Examples include ipilimumab, nivolumab, and pembrolizumab.
• Interleukin-2 (IL-2): A cytokine that stimulates the growth and activity of certain immune cells. Examples include aldesleukin (Proleukin).
• BRAF inhibitors: Drugs that target the mutated BRAF protein found in about half of all melanomas. Examples include vemurafenib, dabrafenib, and encorafenib.
• MEK inhibitors: Drugs that target the MEK protein, which is downstream of BRAF in the same signalling pathway. Examples include trametinib, cobimetinib, and binimetinib.
• KIT inhibitors: Drugs that target the KIT protein, which is mutated in a small percentage of melanomas. Examples include imatinib (Gleevec) and sunitinib (Sutent).

It typically takes a person with melanoma between 4 and 18 months to recover from the disease, depending on their individual health and medical situation.

No, the effects of melanoma therapy are not long-lasting. Treatment can help to reduce the size of tumours and may even lead to remission, however in most cases melanoma can return after treatment has been completed.

The following are post-treatment recommendations for melanoma:

• Regular examinations: Patients should have regular examinations to detect melanoma recurrence and/or new primary tumours.
• Sun protection: Patients should cover up with sun protection clothes, use a broad-spectrum sunscreen with an SPF of 30 or greater, and stay out of the sun as much as possible.
• Vigilant skin self-exams: In order to spot any changes in moles or other skin lesions, patients should be cautious in completing routine skin self-exams.
• Follow-up care: Patients should follow up with their physician for regular checkups as instructed, and keep scheduled appointments for any scans or other tests that are recommended by their physician.
• Mental health support: Patients may benefit from mental health support and counselling during the post-treatment period to help cope with the emotional effects of having melanoma.

Depending on the kind of therapy used, the cost of melanoma treatments in India might vary significantly.

• Generally, surgical treatments such as Mohs surgery can cost anywhere from Rs. 30,000 to Rs. 40,000 or more.
• Radiation therapy can range from Rs. 10,000 to Rs. 20,000 per session, and chemotherapy costs about Rs. 10,000 to Rs. 15,000 per month for several months of treatment.
• In addition to these treatments, medications and injectables can range from Rs. 5,000 to Rs. 10,000 per injection or bottle of medication.

The side effects of the treatments are as follows:

• Pain: Pain may be experienced throughout melanoma treatments such surgery, radiation therapy, and chemotherapy.
• Fatigue: Treatments for melanoma can be physically and emotionally exhausting, leading to fatigue.
• Nausea and vomiting: Vomiting and nausea brought on by chemotherapy may be treated with medicines.
• Hair loss: Radiation therapy and chemotherapy may cause hair loss in the treated areas of the body.
• Skin changes: Radiation therapy can cause skin changes such as redness, blistering, peeling, and dryness in the treated area.
• Loss of appetite: Nausea and treatment side effects such as pain can lead to a decrease in appetite or weight loss.
• Neuropathy: Chemotherapy may lead to neuropathy (nerve damage). Symptoms include tingling, numbness, burning or pain in the arms or legs.

See a doctor in your area if you have any melanoma problems since these may include 'disfigurement, metastasis, secondary cancer, etc.,' with treatment regimens ranging from a few months to years depending on the severity of the condition.