Posted by Bill Sandweg on 27 September 2021.
A diagnosis of melanoma was often a death sentence. It was and remains today one of the most dangerous of the skin cancers. However, as science has marched on, there have been a number of developments in prevention, diagnosis and treatment, which make this disease a lot less lethal.
We know a lot more about how melanoma develops than we did even 10 years ago. If you are of a certain age group (looking at you, Boomers), you grew up without sunscreens. No summer was complete without at least one or two sunburns so bad your skin peeled off. We now know that this type of intense exposure in our younger years can damage the DNA in the skin so that in our later years, melanoma develops.
We also know that routine sun exposure in our later years can cause changes in the skin which lead to melanoma. My grandchildren don’t go to the pool or the beach until their mom has covered them in sunscreen and they are wearing rash guards to keep the sun off.
Another piece of new knowledge is the role of heredity in melanoma development. There are certain genes, which can be inherited, and which make it much more likely that a person will develop melanoma. If you have a family history of melanoma, you might want to be tested for the presence of these genes.
Having spent a lot of time in the sun when I was younger, I am now spending a lot of time in the dermatologist’s office having him look at my skin. I am seeing melanomas in every funnily colored and itchy skin growth. That is not necessarily a bad thing. So far, I have dodged all the bullets and everything has been nice and benign. The point here is to monitor your skin and go see the dermatologist as soon as you see something suspicious. When melanomas are diagnosed early, they can be excised with a good prognosis.
In preparing to write this post, I learned that there are some interesting new alternatives to the traditional excisional biopsy. In the traditional biopsy, a tool is used to remove the suspicious growth, which is then sent to the pathology lab for examination. There is an examination now called an optical biopsy. This device allows the dermatologist to look into the skin to a shallow depth to see if there are enough suspicious traits to justify a traditional biopsy.
A second alternative to a traditional biopsy involves the use of sticky tape applied to the questionable growth. When the tape is peeled off, it takes skin cells with it which can be examined for the presence of melanoma cells.
As with any cancer, the sooner it is diagnosed, the greater the likelihood of successful treatment. The definitive treatment for a melanoma is to cut it out. If caught in time, it has not yet metastasized and excision is all the treatment you need. If caught after it has metastasized, all is not lost. New drug treatments, called immune checkpoint inhibitors, have been developed which defeat the ability of the melanoma to turn off the body’s T-cells, which would otherwise attack the melanoma cells. These inhibitors are the main line of defense against advanced melanomas, which have already metastasized by the time they are discovered. They have saved the lives of many patients, who would have died only a few years ago.
Knowledge is power and we now know a lot more about melanoma than we ever knew before. However, none of that knowledge is of any value, if we don’t put it to use by changing our behaviors, being watchful, and getting to the doctor promptly.