Skin Cancer (Melanoma)
The skin is the largest organ in the body. It covers and protects the organs inside the body. It also protects the body against germs and prevents the loss of too much water and other fluids.  The skin has three layers. From the outside in, they are: the epidermis, the dermis, and the subcutis.

A type of cell, melanocytesis also present in the epidermis. These cells produce the pigment called melanin. Melanin gives the tan or brown color to skin and helps protect the deeper layers of the skin from the harmful effects of the sun.

Melanoma is a cancer of the skin that begins in the melanocytes. Because most of these cells keep on making melanin, melanoma tumors are often brown or black. Melanoma most often appears on the trunk of fair-skinned men and on the lower legs of fair-skinned women, but it can appear other places as well. Melanoma is almost always curable in its early stages.

Incidence
Cancer of the skin is the most common of all cancers. Melanoma accounts for about 4 percent  of skin cancer cases, but it causes about 79 percent of skin cancer deaths. The number of new cases of melanoma in the United States is on the rise. The American Cancer Society estimates that in 2004 there will be 55,100 new cases of melanoma in this country. About 7,910 people will die of this form of skin cancer.

Symptoms
These and other symptoms may be caused by melanoma or by other skin conditions. A doctor should be consulted if any of the following problems occur:

• A mole that
• changes in size, shape or color
• has irregular edges or borders
• is more than one color
• is asymmetrical (if the mole is divided in half, the two halves are different in size or shape)
• itches
• Oozes or bleeds
• Change in pigmented (colored) skin
• Satellite moles (new moles that grow near an existing mole)

Diagnosis

Biopsy
If the doctor thinks you might have a melanoma, he or she will take a sample of the lesion to look at under a microscope. This is called a biopsy.

Treatment
Four types of standard treatment are used to treat melanoma – surgery, chemotherapy, radiation therapy and biologic therapy

Surgery
Surgery to remove the tumor is the primary treatment for melanoma. The doctor may remove the tumor using the following operations

Local excision:  Taking out the melanoma and some of the normal tissue around it.

Wide local excision; With or without removal of lymph nodes.

Lymphadenectomy:  A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer.

Sentinel lymph node biopsy: The removal of the first lymph node the cancer is likely to spread to from the tumor during surgery. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed for biopsy. A pathologist views the tissue under a microscope to look for cancer cells.  If cancer cells are not found, it may not be necessary to remove more lymph nodes.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. The way the chemotherapy is given depends on the type and stage of the cancer being treated.  The Medical Oncology/Hematology division at Sinai directs the chemotherapy program at LifeBridge.

Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy e-rays or other types of radiation to kill cancer cells. The Department of Radiation Oncology at Sinai Hospital  provides the most advanced radiotherapy for many cancers. 

Biologic therapy
Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct,or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

Clinical trials
Clinical trials are research studies conducted with people who volunteer to take part.  The study examines questions and tries to find better ways to prevent, screen for, diagnose or treat a disease. People who take part in cancer clinical trials receive up-to-date care from experts.

For trials that are currently available to melanoma cancer patients, click here:

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