The metastatic melanoma is a cancer that appears on the skin and has the ability to metastasize, something that happens when the tumor cell is going through the bloodstream or lymph nodes elsewhere in the body. It is the skin cancer with the highest mortality.
“The frequency of metastatic melanoma is independent of age and sex. What indicates the probability that a melanoma will become metastatic is its gross r -what we call the Breslow index- and the ulceration “, explains to CuídatePlus Lara Ferrándiz, member of the Spanish Academy of Dermatology and Venereology (AEDV) and dermatologist from the Melanoma Unit of the Virgen Macarena University Hospital , in Seville.
Thus, the Breslow index is the measurement of the invasive capacity in depth of melanoma and is measured in millimeters. The higher the Breslow index, the greater the risk of lymph node involvement and / or distant metastasis. Ulceration is the presence of erosion in the epidermal layer and is associated with a worse prognosis.
” There are histological subtypes of melanoma that have a higher probability of metastasizing. It is the case of nodular melanoma and the reason is that its thickness is greater ”, indicates the dermatologist of the Virgin Macarena. In addition, it recognizes that, on occasions, the prognosis of a melanoma in men is worse than in women because they consult later, which makes the thickness of the skin lesion at the time of diagnosis greater.
Is its prevention possible?
Melanoma appears more frequently in people with fair skin , or phototypes I and II, (the lighter the skin, the eyes and the hair, the greater the risk) and, above all, it is related to intermittent sun exposure. Children who have suffered a sunburn have a higher risk of developing melanoma in adulthood. For this reason, dermatology specialists insist on the importance of photoprotection in minors and on not neglecting this habit at any stage of life.
The presence of multiple nevi – many moles – is another risk factor in melanoma.
There is also familial melanoma that has a genetic component, but constitutes the lowest percentage of melanoma cases.
Regarding prevention, Ferrándiz says that while to minimize the risk of the appearance of a first melanoma, what you have to do is protect yourself from sun exposure, “ adjuvant treatment is used to prevent metastasis . This treatment is given to patients with melanoma with an intermediate-high risk of metastasis and stage III (regional lymph node metastatic disease) ”.
Be very attentive to symptoms
To detect a first melanoma as soon as possible “it is better to consult too much than to consult less. A dermatologist is able to detect melanoma in three seconds with a dermatoscope (a magnifying lens combined with polarized light). Therefore, we must go to the specialist if we observe any new mole that appears from 25 years of age or an old mole that grows, changes shape or color or that bleeds. In short, any mole that worries us ”, advises Ferrándiz.
In the case of a patient who has already had melanoma, it is very important that the scar and the area surrounding it be checked for pimples, spots, nodules or wounds. It is also essential to touch the lymph node basin (armpit, groin or neck, depending on where the melanoma has had) looking for irregularities. In addition, you must be aware of any symptoms such as weight loss without justification or the appearance of headaches and bone pain. The reason is that melanoma has the ability to metastasize to any organ.
Melanoma prognosis
In relation to the prognosis of melanoma patients, Ferrándiz indicates that “the 5-year survival is very good in initial stages (I and II) and continues to be low in patients with stage IV (those with distant metastatic disease). A lthough new therapies -the dirigida- therapy and immunotherapy are changing these figures still do not have accurate data to respect.
