There are several types of skin cancer. Of all, melanoma is most deadly but rarest. Melanoma statistics indicate that it is responsible for about 15% of all skin cancer cases.
The epidermis or the uppermost skin layer contains cells that give the skin its color or melanin. The cells are called melanocytes. Melanoma gets its name from the fact that it originates in these cells. The term metastasis is used to describe a process by which cancers spread or invade other body tissues or organs. It in fact is for this reason that metastatic melanoma is so deadly.
Prognosis and survival rate depend on the stage the cancer is caught. In initial stages, the disease is very curable. In fact, surgical incision may be all that is needed to get rid of the tumor. Things change drastically as the cancer develops into internal melanoma. By the time it reaches its fourth stage, treatment is only aimed at prolonging lifetime rather than curing the disease. For this reason, catching it early is very much crucial. This article will train you on how to recognize the disease and also what to except after positive diagnosis.
What is metastatic melanoma?
We know that it is a deadly disease, but what is metastatic melanoma exactly? To understand this disease well enough, let’s look at the meaning of both terms individually;
- Melanoma – cancer develops when cells behave in an abnormal manner. Cellular functions are governed by instructions contained in a chemical known as DNA. Sometimes, this chemical becomes damaged. This results in loss or compromise of some of the governing instructions. As a result, cells are no longer able to behave normally. In case of cancer, cells start dividing rapidly and uncontrollably. These unwanted cells then accumulate to form a lump. Normally, such abnormal cells would ‘commit suicide’. The instructions for this self-destruction process are unfortunately compromised in the case of cancer. Cancers are named according to parts of the body they invade. When melanocytes are involved, it is known as melanoma.
- Metastatic – you may have wondered why it is so that other types of growths are not classified as dangerous as cancer. The main reason is that cancer often migrates from its initial site to other body regions. Its cells use circulatory system or lymphatic system for transport. This process is known as metastasis.
By definition, metastatic melanoma is therefore a form of skin cancer, one that originates in melanocytes and has the ability to migrate and invade other body organs.
Metastatic melanoma symptoms
A patient can live for long with metastatic melanoma without realizing it. For one the disease is not painful initially. Noticeable symptoms only manifest much later in advanced stages. It is more resourceful to rely on signs rather than symptoms when dealing with this cancer.
In almost all cases, a lesion or growth that resembles a mole will develop. It may be elevated or in form of a flat spot. With time, the tumor keeps growing deeper into skin layers before metastasizing.
Below are symptoms that may follow if the cancer metastasizes in the following areas;
- In brain – headaches, numbness in extremities, seizures and general weakness. Melanoma in the brain is almost not curable.
- In lungs – chronic cough, difficulty breathing, blood in coughs.
- In other skin regions – multiple mole-like lesions or growths.
- In liver – loss of appetite, lump in upper abdomen.
- In lymphatic system – multiple swollen lymph nodes, fever.
- In bones – weak bone density causing frequent fractures, bone pain.
Losing weight without trying to and feeling tired even without work are also common symptoms of spreading cancer.
Metastatic melanoma causes
Following are causes and risk factors;
This is perhaps the most common of all melanoma causes. Some types of UV rays are harmful to cells’ DNA. It is for this reason that you are advised to avoid overdoing sunbathing or overuse of tanning beds.
It is not that moles are potentially harmful. It is just that melanoma can disguise itself as a harmless mole. Moreover, malignancy can originate in already formed moles, making it harder to notice.
There are reasons to believe that people with very closely related family members who have ever been diagnosed with melanoma are more vulnerable.
Being light skinned
Statistics have shown that individuals with fair skins are more likely to develop this cancer compared to dark skinned ones. Body regions that are covered with light skin are also more prone. The same goes for areas that are more likely to be exposed to direct sunlight. It is for this reason that melanoma on ear is more likely than on genitals.
Metastatic melanoma on eye
In rare cases, melanoma spreads to uveal, mainly the choroid. This is part of the eyes in which blood vessels are contained.
Over exposure to UV rays is mostly to blame for melanoma in this part of the body. If not caught early, ocular melanoma may result in vision loss.
Remember to also check for abnormal moles in your eyes next time you are self-examining. In fact, melanoma can also invade unlikely parts such as the lips. This is as long as there are melanin cells. Another but rare example is melanoma on finger in the inner part that forms the wrist.
Metastatic melanoma prognosis, stages and survival rate
Metastatic melanoma prognosis is best for growths that have not gotten past the dermis. These ones respond effectively to surgical removal. They however call for close monitoring. This is to ensure that they don’t come back and that the original tumor has also been identified and removed.
Generally, 4 stages of the disease can be identified. Classification depends on the extent to which the cancer has spread.
Survival rate drastically drops as the cancer jumps from one stage to another. It is measured in terms of living for the next five or ten years after positive diagnosis. The data below indicates 5-year survival rate;
- Stage I – this is the first stage. Here, tumors have recently formed. Survival rate is more than 95%.
- Stage II – tumors are more than 0.75 mm in diameter. They have taken root in the dermis. Some may bleed on the surface. Survival rate has reduced to about 80%. This is because there is a possibility that some malignant cells have broken loose. Immune system and other factors may however succeed in destroying them.
- Stage III – malignant cells have found a way into the lymphatic system, especially local lymph nodes. Survival rate drops to 50%.
- Stage IV – other body have been invaded. Survival rate is lowest, less than 20%.
How fast does melanoma spread? It mostly depends on the stage. In the earliest stage, the tumor has barely developed a blood circulatory system to keep its cells provisioned. It also has not adapted to the surrounding. This means that growth will be slow. As the tumor matures, growth will rate will drastically increase. Stage III melanoma can for example invade more than 20 lymph nodes in a month or less.
Metastatic melanoma diagnosis
- ABCDE rule – this is a self-diagnostic tool. It stands for asymmetry, border, color, diameter and elevation. A normal skin growth, lesion or mole should have two equal halves, be regular at edges, have be consistent in coloration, not be more than 5 mm. if otherwise and elevated, see a dermatologist for other tests. This strategy is more effective when dealing with potential melanoma on leg or arm but may be quite cumbersome for one on head.
- Biopsy – biopsy involves taking a small piece of skin and subjecting it to lab tests. It is a very accurate test for cancerous cells. If it tests positive, you doctor will suggest that the tumor be surgically removed immediately. Surgical removal also shows how thick the tumor is and consequently how serious the condition has gotten.
- Other tests – additional tests will be required to check if the cancer has spread. Most will involve imaging tests such as CT scans and MRIs. Blood tests may also be taken.
Your doctor will ask you several questions, most of which will have to do with the timeline and types of symptoms. Details on your medical history will also be important. This includes lifestyles habits that may act as risk factors such as frequent use of tanning beds.
Metastatic melanoma treatment
This is the most common type of metastatic melanoma treatment. As the name suggests, the tumor is removed after an incision has been made. Imaging tests may be required prior to the surgery. This will help identify the size of the tumor. The fortunate thing is that medical advancements nowadays allow minimal skin damage during this operation.
Surgery can take the form of amputation, such as in case of subungual melanoma treatment. In the past, patients used to have entire fingers or toes amputated. This has changed much, since only a part of affected finger or toe is removed nowadays.
When cancer cells have spread, it is harder to tell if you have dealt with all tumors, including cells that may be in the blood system. Chemotherapy uses toxins to kill cells that rapidly divide. This is because rapid division is a common characteristic of cancerous cells.
X-rays are used in this case to destroy cancer cells. For large tumors, it will require than several doses be administered.
This is a rather aggressive treatment option. It is ideal for advanced melanomas which can no longer be treated surgically. As the name suggests, drugs that boost the immune system are administered. Yervoy is a good example. The downside of these drugs for melanoma is that they have adverse side effects.
Chances are that a mole, lesion or growth on your skin is not related to any type of cancer. This doesn’t however mean that it cannot. The only way you can be certain is to have suspicious growths checked by a dermatologist.
If caught early, chances are that melanoma will be highly curable. In fact, aggressive treatment options such as chemo and immunotherapy will not be necessary. This quickly changes as the disease advances.