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SKIN CANCER, MALIGNANT MELANOMA

DESCRIPTION

A malignant melanoma is a skin cancer that spreads to other areas of the body, primarily the lymph nodes, liver, lungs, and central nervous system. Most melanomas begin in a mole or other pre-existing skin lesion. Excessive exposure to sun is a major factor in causing malignant melanoma. It usually affects the skin of the head, neck, legs, or back, but rarely occurs in the eye, mouth, vagina, or anus. Melanomas are more likely to occur in adults, but some affect children. The incidence of melanomas has increased since 1970.
Appropriate health care includes:
  • Surgery to remove suspicious skin lesions or to remove nearby lymph glands if the child's tumor has spread.
  • Hospitalization for radiation treatment and chemotherapy, if the child's tumor has spread.

    SIGNS & SYMPTOMS
    A flat or slightly raised skin lesion that can be black, brown, blue, red, white, or a mixture of all colors. Its borders are often irregular and may bleed.

    CAUSES
    Uncontrolled growth of cells that give skin its brownish color (melanocytes). When the cells grow down into deep skin layers, they invade the child's blood vessels and lymph vessels and are spread to other body areas.

    RISK FACTORS
    The following factors increase the likelihood of developing a melanoma:

  • Moles on the child's skin.
  • Excessive sun exposure.
  • Pregnancy.
  • Genetic factors. This is most common in light-complexioned, blond people, and is rare in black people.
  • Radiation treatment or excessive exposure to ultraviolet light, as with sun lamps.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Instructions for a child in a high-risk group:
  • Protect yourself from excessive sun exposure. Wear broad-rimmed hats and protective clothing. Use maximum protection sun-block preparations on exposed skin.
  • Examine your skin, including genitals and soles of the feet, regularly for changes in pigmented areas. Ask a family member to examine your back. See your doctor about any skin area (especially brown or black) that becomes multicolored, develops irregular edges or surfaces, bleeds, or changes in any way.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Biopsy of suspicious lesions. The melanoma's depth must be established to determine appropriate treatment.

    POSSIBLE COMPLICATIONS

    Fatal spread to the child's lungs, liver, brain, or other internal organs.

    PROBABLE OUTCOME
    Varies greatly. Early melanomas that have not grown downward are curable with surgical removal. Once a child's tumor has spread to distant organs, this condition is currently considered incurable. However, symptoms can be relieved or controlled. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

    TREATMENT

    HOME CARE

    No specific instructions except those listed under other headings.

    MEDICATION

  • Your doctor may prescribe anti-cancer drugs.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    No special diet.

    OK TO GO TO SCHOOL?

    Yes, when condition and sense of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has a skin lesion with any characteristics of a malignant melanoma.
  • During treatment, changes occur in another skin area on the child.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects. ‡
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