DEFINITION

The melanoma is a skin disease consisting of a (malignant) cancerous transformation of the melanocitos, which are the cells that give color to the skin. The melanoma generally happens in adults, but it can be occasionally in children and adolescents.

The skin protects the body against the heat, the light, the infection and the injuries. It is constituted by two principal layers: the epidermis (exterior) and the corium (interior). The melanocitos are in the epidermis and contain a pigment called melanin, which gives the color to the skin.
The melanoma is much more serious than other types of leather cancers, as for example called epiteliomas, that originate in the basal or scaly cells (other types of cells of the epidermis). As most of the cancers, the melanoma talks each other better when it is detected soon. The melanoma can be spread (for metástasis) quickly to other parts of the body across the blood or the called lymphatic system (The lymphatic ganglions are small structures in the shape of string bean, which are in the whole body and which function is to produce and to store cells that fight the infections).

SYMPTOMS

Debit Vd. to worry about consulting with his doctor if it has any of the following signs and symptoms on a spot that it already had earlier:

• I change in the size, form or color
• exudation or bled
• itch
• pain to the tact
• bulkiness or appearance of nodes on the spot

The melanoma also can appear in the body as a new spot. The men with more frequency contract melanoma in the trunk, in the head or neck; the women with more frequency contract melanoma in the arms and legs.
In any case, his doctor or dermatologist will examine the skin carefully. If a spot or area pigmentada does not seem normal, the doctor, in the proper consultation, it will extirpate it (local excision) and will examine it in the microscope to see if it has cancer. It is fundamental that this biopsy is done correctly.

STAGES OR "STADIUMS" OF A MELANOMA

Once a melanoma is, other examinations will be done to determine if the cancerous cells have been spread to other parts of the body. This process is called a classification by stages. The doctor needs to know in what stage the illness is to plan the suitable treatment.
The following stages or "stadiums" are used for the melanoma:

• Stage 0. The abnormal cells are only in the exterior layer of the cells of the skin and do not invade the deepest textiles.
• Stage I. The cancer is in the exterior layer of the skin (epidermis) and/or in the top part of the internal layer of the skin (corium), but it has not been spread to the nearby lymphatic ganglions. The tumor has a thickness of less than 1.5 mm
• Stage II. The tumor has a 1.5 mm thickness to 4 mm has been spread to the low part of the internal layer of the skin (corium), but neither not to the textile placed under the skin nor to the nearby lymphatic ganglions.
• Stage III. Any of the following situations means that the tumor finds in the stage III:
  • The tumor is of more than 4 mm of thickness.
  • The tumor has been spread to the corporal textile placed under the skin.
  • There are additional tumors that have grown to one centimeter of the original tumor (tumors satellites).
  • The tumor has been spread to the lymphatic ganglions of the area, or there exist tumors satellites that have grown between the original tumor and the lymphatic ganglions of the area.
• Stage IV. The tumor has been spread to other organs or to lymphatic ganglions removed from the original tumor.
• Appellant. Illness appellant means that the cancer has turned out to be again (appealed) after having being treated. It can reappear in the original place or in another part of the body.

TREATMENT OF THE MELANOMA

In all the patients with existen treatments for melanoma.

Four classes of treatment are used:

• Surgery (eradication of the cancer)
• Chemotherapy (use of medicines to destroy the cancerous cells)
• Radiotherapy (use of x-rays in high doses or other beams of high energy to destroy the cancerous cells)
• Biological therapy (use of the immune system of the body to fight the cancer)
• The surgery the stages of es the initial treatment for all melanoma. The doctor can extirpate the melanoma using one of the following operations:
  • Conservative rescission. An operation in which there is extracted any cancer that stays after the biopsy, together with a small quantity of the skin about the cancer (generally less than 1 cm).
  • Wide surgical eradication. An operation in which the cancer is extirpated and departs from the skin about the tumor. Perhaps it is necessary to take part of the skin of another area of the body to place it in the place where the cancer (graft) has been extracted.
• The chemotherapy consists of the use of medicines to destroy the cancerous cells. It can be in pills, or can get in the body with a needle in a vein or muscle. It is said that the chemotherapy is a systemic treatment because the medicines interfere to the blood stream, they travel across the body and can destroy cancerous cells in the whole body.
  
  If the melanoma happens in an arm or leg, the chemotherapy can administer with a skill called isolated arterial perfusión. With this method, the medicines of the chemotherapy put themselves straight in the blood stream of the arm or leg where the melanoma is. This allows most of the medicine to come straight to the tumor.
  Unfortunately, the chemotherapy has not demonstrated to be effective in the treatment of the melanoma, not even like administrated adjuvant chemotherapy - her after an operation to a person who does not have detectable cancerous cells, in order to destroy any cell of cancer that has stayed-.
  Clinical tests are carried out to find new medicines quimioterapéuticos effective.
• The radiotherapy use of x-rays of high consists of the energy to destroy the cancerous cells and to reduce the tumors. The radiation can come from a placed machine out of the body (external radiotherapy) or of materials that produce radiations (radioisotopes) put in the area where there are the cancerous cells (internal radiotherapy), by means of thin plastic pipes.
• The intention of the biological therapy is of trying that the proper body fights the cancer. Also one knows like modifying of the therapy biological answer (BRM) or immunotherapy. In this therapy natural materials are used or of synthesis to impel, to direct or to restore the natural defenses of the body against the illness. Most used in the melanoma it is realizing tests interferon. Clinical tests are carried out to find other biological therapies that are effective.

TREATMENT FOR STAGES

The treatment for the melanoma will depend on the type and stage of the illness, the age and the general state of health. A patient with melanoma has the option to receive a "standard" treatment - in accordance with his efficacy in a certain number of patients in previous studies - or or to choose to take part in a clinical essay.

The surgery is, at present, the only standard treatment for melanoma. The clinical tests are designed to find better methods for the patients' treatment with cancer. Clinical tests are carried out in many countries for most of the stages of melanoma.

The treatment of a typical melanoma might consist of the following thing.

STAGES 0 and I

• Eradication. Conservative excision after the biopsy, or made wide surgical eradication ambulatoriamente. A skin grafting might be done to cover the wound. Also the lymphatic ganglions can be extirpated about the tumor.

STAGE II

The most frequent options are:

• Wide surgical eradication and examination of the contiguous lymphatic nodules to look for possible metástasis.
• Wide surgical eradication of the tumor and of the nearby lymphatic ganglions. It is evaluated in clinical tests if the eradication of the lymphatic ganglions improves the results.
• Wide surgical eradication followed by adjuvant systemic chemotherapy or biological therapy.
• Wide surgical eradication followed by chemotherapy administered straight in the arm or leg where there was the melanoma (perfusión arterial isolated).

STAGE III

The most frequent options are:

• Wide surgical excision with or without biological therapy. A graft of the skin might be done to cover the wound. The nearby lymphatic ganglions can be extirpated if they contain cancer.
• Wide surgical excision followed by chemotherapy administered straight in the arm or leg where there was the melanoma (isolated arterial percussion). The nearby lymphatic ganglions can be extirpated if they contain cancer.
• Wide surgical excision followed by adjuvant systemic chemotherapy or biological therapy. The nearby lymphatic ganglions can be extirpated if they contain cancer.

STAGE IV

The most frequent options are:

• Surgery to extract lymphatic ganglions that contain cancer or tumors that have spread (that they have had metástasis) to other areas of the body.
• Radiotherapy to relieve symptoms.
• A clinical essay of systemic chemotherapy and/or biological therapy.

APPELLANT

• The treatment will depend on several factors, such as the treatment received previously and the place where the cancer has appeared again. Since there is no treatment accepted for the melanoma appellant, the treatment might consist of a clinical essay of systemic chemotherapy or biological therapy.

WHAT DOCTOR CAN TREAT ME?

Select a province A Coruna Alava Albacete Alicante Almeria Asturias Avila Badajoz Barcelona Burgos Caceres Cadiz Cantabria Castellón Ciudad Real Cordova Cuenca Gipúzcoa Girona Granada Guadalajara Huelva Huesca Illes Balears Jaen La Rioja Las Palmas León Lleida Lugo Madrid Malaga Murcia Navarre Ourense Palencia Pontevedra Salamanca Santa Cruz Tenerife Segovia Seville Soria Tarragona Teruel Toledo Valencia Valladolid Biscay Zamora Saragossa

Service offered for