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Melanoma fight. "my battle with melanoma"

Melanoma

is a type of malignant tumor that develops from pigment cells. In turn, pigment cells are cells that contain pigment (

coloring

) substance -

melatonin

They are mainly found in the connective tissue of the epidermis (

i.e. in the skin

) and in the iris, giving these organs a characteristic shade. In the cells of the tumor, a large amount of melanin accumulates, which gives it a characteristic color. However, there are, albeit extremely rare, non-pigmented or achromatic tumors.

In the structure of cancer incidence, melanoma accounts for about 4 percent.

Caucasians are most at risk, in particular those with fair skin. This is due to several factors. One of the main ones is the reduction of the ozone layer in the atmosphere. Thus, it is known that the ozone layer located in the stratosphere (

upper atmosphere

According to Clark, skin oncology is divided into 5 degrees:

Melanoma is a malignant tumor that develops from pigment-containing melanocytes. The main feature of this neoplasm is early metastasis, which is the formation of secondary tumors in the lymph nodes and other organs.

Also, melanoma is characterized by aggressive growth with damage to healthy tissues.

A malignant neoplasm develops as a result of a change in the genome of cells, in which they acquire foreign properties. The development of melanoma to a large extent provokes the systematic effects of ultraviolet radiation on the skin (frequent sunbathing under the sun or in a solarium).

An important provoking factor is hereditary predisposition. Under the influence of this factor, melanoma of the eye often develops, which also occurs in children.

It is important to consider these provoking factors for the development of tumor formation for its prevention.

Causes of melanoma

Prolonged exposure to the sun. Exposure to ultraviolet radiation, including tanning beds, can cause melanoma to develop. Excessive exposure to the sun in childhood significantly increases the risk of disease. Residents of regions with increased solar activity (Florida, Hawaii and Australia) are more prone to developing skin cancer.

A sunburn caused by prolonged exposure to the sun more than doubles the risk of developing melanoma. A visit to the solarium increases this indicator by 75%.

The Agency for Research on Cancer within the WHO classifies tanning equipment as a "high risk factor for skin cancer" and classifies tanning equipment as a carcinogen.

Moles. There are two types of moles: normal and atypical. The presence of atypical (asymmetrical, raised above the skin) moles increases the risk of developing melanoma. Also, regardless of the type of moles, the more there are, the higher the risk of degeneration into a cancerous tumor;
Skin type. People with more delicate skin (they are characterized by lighter hair and eyes) are at increased risk.
Anamnesis. If you have previously had melanoma or another type of skin cancer and have recovered, the risk of developing the disease again increases significantly.
Weakened immunity. Negative effects on the immune system of various factors, including chemotherapy, organ transplantation, HIV / AIDS and other immunodeficiency conditions increase the likelihood of developing melanoma.

Types of melanoma

There are several types of melanoma classification. The main one is the TNM classification, which takes into account the stages of melanoma development and divides it into stages - from the first to the fourth. However, in addition to this, there is also a clinical classification, according to which there are four main types of melanomas.

The types of melanomas according to the clinical classification include:

superficial spreading melanoma;
nodular (nodular) melanoma;
lentigo melanoma;
peripheral lentigo.

Superficial spreading melanoma

The most common type of melanoma is superficially spreading melanoma, which occurs in 70 to 75 percent of cases. As a rule, it develops against the background of previous nevi and moles.

Superficial melanoma is characterized by a gradual increase in changes over several years, followed by a sharp transformation. Thus, its course is long and, relative to other forms of melanoma, is non-malignant.

It is more common in middle-aged people and affects both men and women equally. Favorite places of localization are the back, the surface of the lower leg.

Superficially spreading melanoma is not characterized by large sizes.

The characteristics of superficially spreading melanoma are:

small sizes;
wrong shape;
uneven edges;
polymorphic coloration interspersed with brown, red and bluish;
is often ulcerated and bleeds.

Compared with other subspecies, the prognosis for superficial melanoma is generally favorable.

Nodular (nodular) melanoma

Unlike the previous tumor, the nodular (

synonymous with nodular

) melanoma is less common, in about 15 to 30 percent of lesions. But, at the same time, it is characterized by a more malignant and aggressive course.

It is not characterized by a long period of increase in symptoms - the disease proceeds at lightning speed. Most often, nodular melanoma develops on intact skin, that is, without previous nevi and moles.

Initially, a dome-shaped dark blue nodule forms on the skin. Then it quickly ulcerates and begins to bleed.

Nodular melanoma is characterized by vertical growth, that is, with damage to the underlying layers. Pigmentless nodular melanomas occur in 5 percent of cases.

The prognosis for this disease is extremely unfavorable, affecting mainly the elderly.

Lentigo melanoma or malignant lentigo

Lentigo melanoma (

synonym for melanotic freckles

) occurs in 10 percent of cases, like the previous tumor, develops in old age (

most often in the seventh decade of life

According to the type of melanoma, they are divided into 4 categories. Three of them are distinguished by a gradual onset with the development of changes in only the surface layer of the skin.

Such forms very rarely acquire an invasive course. The fourth type is characterized by a tendency to rapidly grow deep into the skin and spread to other parts of the body and internal organs of the patient.

Superficial (superficial) melanoma

is the most common variant of the course of the disease (70% of cases). This is a melanoma of the skin, the symptoms of which are characterized by the long-term persistence of a relatively benign growth in the upper (outer) layer of the skin.

Only after a long period of time does superficial melanoma grow into deeper layers.

Stages of melanoma

There are different stages of melanoma, which depend on how malignant cells are spread and whether they affect nearby lymph nodes, on how large the size of the malignant neoplasm and how deep the tumor has reached.

It is on the basis of this that the oncologist determines at what stage the development of the disease is.

In the development of melanoma, like other diseases, there are several stages. However, there are several options for classifying staging.

Adherence to a particular classification often varies by country or region. However, there is a basic international classification that all specialists in this field use.

Types of melanoma classifications include:

international classification TNM - characterizes the size of the tumor, the presence of metastases;
5-stage classification - common in the west;
clinical classification - unlike previous classifications, it describes only three stages.

The most common is the international classification - TNM. This classification takes into account the main criteria - T - the degree of invasion (

How deep has the melanoma grown?

), N - damage to the lymph nodes, M - the presence of metastases. Abroad, the most popular is the 5-stage classification and the 3-stage clinical classification.

Melanoma stages according to TNM

Criterion		Description
T - the degree of invasion (germination) of melanoma in depth, the thickness of melanoma itself is also taken into account	T1	melanoma thickness less than one millimeter
	T2	melanoma thickness from one to two millimeters
	T3	melanoma thickness from two to four millimeters
	T4	melanoma thickness more than four millimeters
N - damage to the lymph nodes	N1	one lymph node affected
	N2	two to three lymph nodes affected
	N3	more than four lymph nodes affected
M - localization of metastases	M1a	metastases in the skin, subcutaneous fat and lymph nodes
	M1v	metastases in the lungs
	M1s	metastases in internal organs

Early stages of melanoma

The initial or zero stage of melanoma is called melanoma in situ. At this stage, the tumor does not grow, being in the same place. It looks like a small mole of black color, it may contain blotches of red.

first stage melanoma

According to the international TNM classification, melanomas of the T1–2N0M0 category belong to the first stage, which means that the thickness of the melanoma of the first stage varies from one to two millimeters, there are no metastases.

According to the 5-stage classification, melanoma of the first degree is localized at the level of the epidermis and / or dermis, but does not metastasize through the lymphatic vessels to the lymph nodes.

The thickness of the tumor is up to one and a half millimeters. According to the clinical classification, the first stage is a local stage.

The characteristics of the first stage according to the clinical classification are as follows:

a single primary neoplasm;
satellite (associated with the main formation) tumors within a radius of five centimeters from the primary tumor are acceptable;
the presence of metastases at a distance of more than five centimeters from melanoma.

second stage melanoma

According to the international TNM classification, melanomas of the T3N0M0 category belong to the second stage. This means that the thickness of melanoma in the second stage is from two to four millimeters, there are no metastases in the lymph nodes and internal organs.

According to the Western 5-stage classification, the thickness of melanoma of the second stage varies from one and a half to four millimeters. At the same time, it extends to the entire dermis (.

that is, on the thickest layer of the skin

According to the new approved international classification, when determining the stage of the course of melanoma, the diagnostic criteria are the thickness of the tumor (Breslow thickness), the presence of microscopic ulcerations and the rate of division of cancer cells.

Thanks to the new system, it became possible to make a more accurate diagnosis and plan the most effective treatment.

Breslow thickness is measured in millimeters and characterizes the distance from the upper layer of the epidermis to the deepest point of tumor growth. The thinner the melanoma, the higher the chance of a cure. This indicator is the most important aspect in predicting the course and effectiveness of therapeutic measures.

melanomas are characterized by a limited tumor. This means that the cancer cells have not yet metastasized to the lymph nodes or other organs. At this stage, the risk of re-development of melanoma or further spread of the tumor is quite low.

Depending on the thickness, there are:

Melanoma "in situ" ("on the spot"). This is the initial stage, when the tumor has not yet grown deep into the epidermis. This form is also referred to as the zero stage;
Thin tumors (less than 1 mm). The development of the tumor indicates the initial (first) stage of melanoma;
Medium thickness (1 - 4 mm). Starting from this moment, the course of melanoma passes into the second stage;
Thick melanomas (more than 4 mm in thickness).

The presence of microscopic ulceration exacerbates the severity of the course of the disease and marks the transition to advanced stages. The rate of cell division is also an important criterion in determining the prognosis of the course.

Even a single confirmed process of dividing a culture of cancer cells per square millimeter characterizes the transition to more severe stages of the course of melanoma and increases the risk of metastasis.

In this case, the method of choice is a more aggressive treatment strategy to achieve the desired effect. At the first and second stages, melanoma is characterized by an asymptomatic increase in the size of pigmentation areas, their elevation above the skin level without bleeding and pain.

At this stage, there are important changes in the course of the disease. At this stage, the Breslow thickness is no longer taken into account, but the definition of ulceration becomes indicative.

The third stage is characterized by the spread of tumor cells to the lymph nodes and the surrounding areas of the skin. Any spread of the tumor beyond the boundaries of the primary focus is characterized.

As a transition to the third stage. This is confirmed by biopsy of the lymph node closest to the tumor.

Now such a diagnostic method is indicated when the tumor size increases more than 1 mm or if there are signs of ulceration. The third stage is characterized by the late symptoms of melanoma described above (pain, bleeding, etc.).

means that tumor cells metastasize to distant organs. Metastases in melanoma spread in (according to the time of involvement in the pathological process):

Lungs
Liver
Bones
Gastrointestinal tract

At this stage, symptoms of metastatic melanoma appear, which depend on the lesion of a particular organ. At stage 4, melanoma has a very unfavorable prognosis, the effectiveness of treatment is only 10%.

If the doctors diagnosed the tumor at stage 3, that is, when the cancer cells have already begun to spread to the lymph nodes, then the patient is prescribed a surgical operation to remove the neoplasm, as well as the lymph nodes.

After that, the patient undergoes immunotherapy using interferon.

If melanoma cancer cells have entered the brain, liver or bones, then, in addition to surgery, a person is prescribed radiation, immune, and chemotherapy.

Treatment of melanoma at stage 4 is aimed at prolonging the life of the patient, there is no question of a complete recovery here.

In its development, skin cancer goes through 4 stages.

At the first stage, skin lesions occur without the development of metastases. Here, treatment allows you to almost completely get rid of the disease.
The second stage is characterized by deeper skin lesions with metastases. Here, the percentage of cure depends on the size of the tumor.
In the third stage, the lymph nodes are affected. The success of treatment depends on the number of affected nodes.
In the fourth stage of the disease, metastases affect the internal organs, and the disease is considered almost incurable. Treatment is about keeping the patient alive.

Melanoma develops from the pigment cells in our skin that produce melanin. These cells are located in the largest number in nevi - moles and birthmarks. Often, a tumor forms at the site of an existing mole, but sometimes it can appear spontaneously on clean skin.

Each of us should know what safe nevi look like, which do not threaten the body in any way, and what melanomas look like in the initial stages.

Make it a rule to regularly inspect the skin, especially its open areas that often come into contact with the sun: face, arms, legs, chest, ears.

A normal nevus is considered to be a small spot of brown or black color, which has a uniform color and smooth edges. An ordinary mole does not change size, shape or color. Melanoma, in turn, behaves differently, and it can be recognized by the following signs:

asymmetry of the shape of the birthmark - the edges are torn, fuzzy, uneven;
discoloration of an existing nevus - melanomas are distinguished by the presence of gray, purple, red, blue and other shades that are unusual for normal moles;
increase in diameter - for the neoplasms described above, a diameter of more than 6 mm is characteristic.

If a pigmented defect on the skin began to suddenly increase in size and change color, then you should immediately contact a dermatologist. An experienced specialist can distinguish a benign defect from a malignant one instantly (at a glance).

In melanomas of the 2nd degree, ulcerations often appear - a violation of the integrity, accompanied by the release of fluid.

In the early stages, skin cancer is almost asymptomatic. Noticeable systemic or general deterioration occurs only after metastasis.

When skin cancer begins to metastasize, a person experiences the following deterioration:

malaise;
intoxication;
weight loss
blurred vision;
pain in joints and bones.

Metastases complicate treatment. It is difficult to predict how long people with metastases live, but it is safe to say that it will not be long. A grade 2 tumor with a standard course of metastases does not give.

In some cases, they begin to appear at an early stage of tumor development in nearby lymph nodes.

For grade 2 melanoma, wide excision is the standard treatment option. If the tumor is 1-2 mm thick, then it and a 1-2 cm area of healthy skin around it are removed. If the thickness is more than 2 mm, then more than 2 cm of healthy skin around it is excised.

If during a biopsy (a clinical examination of the affected tissue) cancer cells are found in the lymph node, then the patient is prescribed lymph node dissection - the removal of all lymph nodes located next to the tumor.

Melanoma is prone to recurrence. According to statistics, after surgical removal, it reappears in 15% of cases within 5 years. The thicker the tumor, the more likely it is to recur.

Therefore, after surgical removal, the patient is observed for 10 years. For the first 5 years, he will have to be examined frequently - once every 3 months, then once every six months. For the next 5 years, it is necessary to be examined once a year.

At stage 4, melanoma metastasizes to other organs. It can be:

The tumor of the fourth stage is characterized by a number of painful sensations. They are inherent only in late malignant processes:

cracks in moles or skin;
pain in the skin and mole;
bleeding from a birthmark.

A stage IV tumor is characterized by a range of painful sensations.

Among other things, the following conditions can be observed at stage 4:

Thickening of the skin.
Chronic cough.
Weight loss for no reason.
Enlarged lymph nodes under the armpits and in the groin.
Nervous attacks.
The acquisition of a gray tint by the skin (melanosis).
Headache.

Symptoms and signs of skin melanoma

Signs of melanoma directly depend on the stage of the course, the form of the disease. Usually these are nodules, plaques on the skin of small sizes, similar to moles.

They can appear on almost any part of the body: arms, legs, face, back. It is the growth of malignant melanocytes that occurs not only in depth, but in width during the growth of the tumor, reaching 10 cm in diameter.

If the initial melanoma of the skin is diagnosed, then the symptoms may be absent, then at stages 3-4, the melanoma of the skin appears already in a pronounced form. In patients:

general health deteriorates
there is a strong intoxication of the body
moles quickly increase in size, change color and shape.

Signs of melanoma are not difficult to identify by conducting your own examination. If:

an ordinary mole suddenly began to grow, changed color, became colorless or vice versa, darkened up to black shades and acquired an uneven color
in the abdomen it tingles, itches, which indicates increased cell division
a red inflamed rim appeared around the speck
an incomprehensible purulent exudate oozes from a mole
child spots formed nearby
nevi have become dense, with uneven jagged edges, then this is a reason for an urgent appeal to an oncologist.

At the 4th stage of melanoma development, the skin nevus begins to bleed, the integrity of the skin is broken, strong pigmentation appears around the mole, the place itches and hurts. This indicates tissue damage in the skin, the spread of melanoma and the appearance of metastases.

When melanoma metastasizes, the patient experiences severe headaches, swollen lymph nodes, a sharp weight loss for no reason, cough, and the appearance of subcutaneous seals.

Many are interested in the question, how is melanoma detected? Actually, it's easy to spot. The main thing is to detect the disease in time.

Signs of melanoma are specific. Even if at least one of the listed modifications is detected, it is no longer possible to postpone the examination.

Only at an early stage of melanoma development can treatment give positive results.

If the patient's state of health has sharply worsened, then most likely the cells degenerate into cancer cells, which has a toxic effect on the body, signs of intoxication are clearly expressed.

The patient begins to get tired quickly, the joints hurt, vision deteriorates sharply and vision falls, weight decreases. Moles acquire fuzzy outlines with visually uneven, jagged and asymmetrical edges.

melanoma symptoms

It is believed that more than 50% of all melanomas are formed from pre-existing moles (nevi). Therefore, it is important to know the main signs of a “dangerous mole”. Periodically, you need to examine the existing nevi, birthmarks, freckles, and other areas of the skin in order to notice any changes in time.

Ordinary moles, as a rule, have a round or oval shape, smooth and clear edges, do not exceed 6 mm in diameter and practically do not change their appearance. The following signs are considered suspicious for the development of melanoma:

an increase in the size of the pigment formation over several weeks or months;
change in the shape of the mole, the appearance of rays at its edges, uneven and fuzzy borders;
the formation next to the pigment spot of small child "moles";
discoloration, the appearance of a red or pink rim around the mole;
bleeding of the surface of the mole, the appearance of ulcers or crusts;
itching or pain in the area of pigmentation.

Diagnosis of melanoma

Diagnosis of melanoma of the skin can be carried out independently or by contacting a doctor: a dermatologist or an oncologist. Since this tumor appears on the surface of the skin, each person himself is able to detect it, and even before the moment when the stage of the tumor is late.

To understand whether there is melanoma, the diagnosis comes down to the study of moles on the body of a person.

Ways to recognize melanoma are simple:

the mole becomes uneven edges;
the color of the mole begins to change in the direction of darkening or lightening;
the size of the mole begins to suddenly increase;
a person's well-being changes for the worse.

If at least one of the symptoms is noted, further diagnosis of melanoma should be made by an oncologist.

To make sure that we are talking about this particular disease, additional tests and studies will be prescribed, such as a tumor marker for melanoma, a blood test for melanoma, and some others.

Only on the basis of these studies, the main of which is the oncomarker of skin melanoma, can a diagnosis of malignant melanoma of the skin be made and treatment started.

When the diagnosis is made and therapy is carried out, the patient himself must control his condition and note whether the melanoma hurts, what temperature he has with melanoma and how he feels. This will help to adjust the treatment if necessary.

Analysis for melanoma and biopsy is performed after each course of treatment and after surgical removal of the tumor. This will avoid such unpleasant complications as recurrence of melanoma or secondary melanoma, as well as keep the patient's condition under control.

Complex methods for diagnosing skin melanomas are:

Diagnosis of melanoma, like other diseases, is to collect an anamnesis (

medical history

), inspection and appointment of additional studies.

The collection of anamnesis in the diagnosis of malignant melanoma occupies an important place. So, during the survey, the doctor is interested in when the changes appeared, how they started, how quickly the mole grew and whether it changed color. Family history (

hereditary diseases

) is no less important. Today obligate (

compulsory

) precancerous disease is considered atypical birthmark syndrome. In families where family members suffer from this syndrome, the risk of developing melanoma is increased several dozen times. Data on previous trauma, prolonged exposure to the sun are important.

Melanoma checkup

Diagnostic criteria for malignant melanoma are as follows:

neoplasm unevenly protrudes above the surface of the skin;
peeling of the skin;
numerous erosions and bleeding sores;
maceration (softening);
ulceration of melanoma;
the development of concomitant nodules (is a sign of metastasis);
melanoma color variation - includes areas of red, white and blue on a brown or black background;
color enhancement along the periphery of the melanoma, resulting in a ring of coal-black merging nodules;
an inflammatory corolla can also form around the contour of the melanoma;
in the area of melanoma, the skin pattern completely disappears;
uneven edge with corners and notches;
blurred outline borders.

Several research methods are used to detect metastases. X-rays are taken to detect lung metastases. Computed tomography may also be performed. When examining the spinal cord and brain, magnetic resonance imaging is used. In addition to these methods, positron emission therapy is used. In this case, glucose contaminated with radioactive substances is introduced into the human body, after which places with its greatest accumulation in the body are identified. These will be cancer cells. To detect metastases in the liver or bones, a radioactive substance is injected into the body, after which the body is scanned to detect cancer cells.

Melanoma treatment

Depending on the stage and form of melanoma diagnosed, the treatment may be different. Many patients who have this tumor are concerned about whether melanoma is being treated.

This disease is treated at absolutely all stages, the difference lies only in the prognosis for recovery. It is important that when a melanoma is diagnosed, how to treat it should be decided by the oncologist, and not by the patient himself.

Treatment of melanoma in the early stages (from zero to second) - the main thing at this stage is the complete removal of the neoplasm and part of the surrounding skin and subcutaneous fat.

As a rule, the skin area removed in this case does not exceed a few centimeters. The operation is performed with anesthesia.

If the area of the removed skin is too large, it is possible to carry out further plastic surgery to replace it. Patients diagnosed with the disease in the third stage are also concerned about the question, can melanoma be cured? In this case, as a rule, simply removing the neoplasm is not enough, because after it the tumor grows and spreads to other areas of the skin.

During treatment, it is necessary to remove the affected lymph nodes, as well as the surrounding tissue. This operation is quite complicated and may have consequences in the form of lymphorrhea, but often the operation is successful.

Treatment of melanoma after surgery is radiation or chemotherapy.

Melanoma is a disease that appeared a long time ago, so many people practice the treatment of melanoma with folk remedies that have been tested by time.

In this case, the treatment is aimed both at getting rid of ulcers and bleeding, and at stopping the development of the tumor. Ideally, when skin melanoma is diagnosed, treatment with folk remedies should occur in conjunction with the treatment prescribed by the doctor and under his supervision.

Folk methods for treating melanoma include herbal medicine and melanoma treatment with soda. In herbal medicine, various herbal tinctures are used.

Ginseng tincture is most often used, it is especially effective if you drink it in small portions during the week before the operation to remove the tumor.

It boosts the immune system and helps the body fight cancer cells.

Eleutherococcus tincture, if taken 20 drops several times a day, helps to reduce the negative effects of stress on the body and helps in the fight against tumors.

Another way to treat melanoma with folk remedies is to apply soda to the skin covered by this disease. It is enough to gently apply a cloth soaked in a soda solution to the neoplasm several times a day.

Important! With the diagnosis of "melanoma", treatment with folk remedies is not contraindicated, but should occur under the supervision of a physician.

Treatment of melanoma, like any tumor, involves surgery, radiotherapy and chemotherapy. However, the choice of treatment method depends solely on the characteristics of melanoma and its stage.

At the same time, it should be noted that melanoma is poorly sensitive to radiotherapy and does not always respond to chemotherapy.

Melanoma treatments are as follows:

surgical treatment, which involves excision of the tumor;
chemotherapy;
radiation therapy;
biological therapy (immunotherapy).

The choice of treatment depending on the stage of melanoma

	Treatment method
Initial stage (0)	It involves excision of the tumor with the capture of up to one centimeter of healthy tissue. Further, only observation by an oncologist in dynamics is recommended.
	Initially, a biopsy is performed, followed by excision of the tumor. In this case, the capture of healthy tissue is already 2 centimeters. If there are metastases in the lymph nodes, then they are also removed.
	Surgical treatment and chemotherapy are used. Initially, a study is carried out on the defeat of lymph nodes by metastases. Next, a wide excision of melanoma is performed (capturing healthy tissue by more than 2 centimeters), followed by removal of the lymph nodes. At the same time, the removal of melanoma and lymph nodes can take place in one or two stages. After removal, chemotherapy follows.
Stage III	Chemotherapy, immunotherapy, tumor excision are carried out. A wide excision of melanoma is also performed, in which healthy tissue is captured by more than 3 centimeters. This is followed by regional lymphadenectomy - removal of lymph nodes located near the primary focus. Treatment ends with chemotherapy. For the resulting defect after the removal of melanoma and adjacent tissue, plastic surgery is used.
	There is no standard treatment. Radiation therapy and chemotherapy are used. Operative (surgical) treatment is rarely used.

Chemotherapy for melanoma

In the treatment of melanoma, polychemotherapy is often used, which is based on the use of several drugs at the same time. The most commonly used drugs are bleomycin, vincristine, and cisplatin. So, for each type of melanoma, their own schemes have been developed.

The most common treatment regimens are as follows:

Roncoleukin 1.5 mg intravenously every other day in combination with bleomycin and vincristine. It is carried out in 6 cycles at intervals of 4 weeks.
Roncoleukin 1.5 mg intravenously every other day in combination with cisplatin and reaferon. Similarly, 6 cycles at intervals of 4 weeks.

Treatment of melanoma at the initial (0 and 1) stages consists in the surgical removal of the pigment formation and a small area of healthy skin around it. The amount of indentation from the tumor depends on the part of the body and the thickness of the melanoma, on average it is about 1 cm.

If the volume of tissues to be removed is large and it is not possible to sew the edges of the wound after the operation, the defect is closed by transplanting a piece of skin from another part of the body. For example, from the back, where the scar will not be noticeable.

Once a melanoma is removed at an early stage, the risk of recurrence is low, so additional treatment is usually not required. You may need to have a few additional check-ups before you can be discharged.

Treatment of melanoma stages 2 and 3 is carried out, as in the first case, with the help of surgical removal of the tumor. The operation also ends with wound closure or skin plastic surgery. However, these stages of melanoma are more likely to metastasize, so during the operation, surgeons can biopsy the sentinel lymph nodes.

Many people are afraid to go to an oncologist for an appointment, they try to treat a malignant tumor at home. They believe that with the help of decoctions, fees, medicinal teas, you can be cured. But it's not.

Only excision, that is, surgical intervention, will help to completely get rid of melanoma. And it should be carried out at the very beginning, immediately after the diagnosis of the tumor.

After tumor resection, when the human body is under stress associated with surgery, chemotherapy, it is very important to increase immunity.

This method of therapy for malignant tumors is aimed at changing the immune system, its activation to destroy melanoma.

Drugs tell the body which protein can be perceived as foreign, and which one to consider as its own. And when the immune cells of the human body remember the foreign antigen, they start the process of eliminating the tumor. Immunotherapy is based on this principle.

Drugs used to increase immunity should be prescribed by a doctor. There are many drugs, these can be drugs such as Cycloferon, Ipilimumab and others.

Immunotherapy is used not only in the recovery period, but also in other cases, for example:

If suspicious moles are identified, their surgical removal is suggested, followed by cancer screening. In most cases, it is recommended to cut out moles that have constant contact with clothing or jewelry in order to avoid damage and subsequent development of cancer.

In the first and second stages, the tumor is removed surgically. In addition to the formation itself, part of the skin around is also removed. If the tumor is less than 1 mm in thickness, then the possibility of complications is reduced to almost zero. With a tumor thickness of more than 1 mm, the risk of developing metastases increases. If a tumor is found on the fingers, they are completely removed.

In the third stage, it all depends on the number of affected lymph nodes. The development of metastases in one lymph node allows the patient to live for a sufficient time.

If there are several affected lymph nodes, one of them is cut out for examination, if necessary, the rest are also removed. Since the lymph nodes are responsible for the immune system, it is necessary to take a responsible approach to health and protect the skin from all kinds of damage.

Melanoma at the last stage is difficult to treat. It's all about the metastasis of the tumor to different organs and the fact that malignant cells affect the lymph nodes.

Melanoma is treated with the following types of therapies:

immunotherapy;
chemotherapy;
radiation therapy.

Metastases in the lymph nodes and neoplasms are removed surgically. Sometimes this is preceded by irradiation, and nearby healthy tissues are captured. Metastases in the internal organs are treated depending on their location - either by therapy or by surgery.

Radiation therapy gives a good result if the patient is considered inoperable

Indications for surgery:

Removal of a single metastasis, if the general condition of the patient is good, and there are no other lesions.
Reducing the tumor mass in order to increase the sensitivity to chemotherapy.
Eliminate symptoms that make the patient's condition worse.

In the process of chemotherapy, stage 4 tumors use various drugs, such as dacarbazine and temozolomide. They prevent tumor growth. However, the effect is temporary, and life expectancy does not increase. The duration of the effect of drugs depends on the condition of the patient and his age.

Life expectancy makes it possible to increase such a modern drug as ipilimumab. It is actively used in the implementation of chemotherapy.

Immunotherapy is treated with interleukin-2 and interferon. Life expectancy with the use of these drugs increases, but the side effects are serious.

To increase life, a combination of several drugs is used. This makes it possible to increase immunity and reduce the size of the tumor. The patient's condition is getting much better.

Metastases most often affect the brain. Treatment in this case is carried out with the help of stereotactic radiation surgery.

If the spread is large, radiation therapy and glucocorticoids may be given. Treatment in severe cases is to relieve the patient's symptoms.

In this case, the side effects and positive properties of each drug should be taken into account.

Melanoma in the fourth stage can be recognized visually

At the moment, various studies and trials of new drugs are being carried out, this gives patients the opportunity to participate in the activities presented. Melanoma is successfully treated in Israel. The most modern methods of therapy and diagnostics are used here.

Chemotherapeutic treatment is used if there are distant metastases. In 20% of cases, this method helps to stabilize the tumor process. But the effectiveness of the method is limited, since the tumor has little sensitivity to chemotherapeutic agents. The most effective drugs are temozolamide, dacarbazine and vindesine.
If there are brain metastases, the prognosis is poor. In this case, Mustophoran is used. The tumor is affected by interleukin-2 and interferon, but the presented agents in combination with other cytostatics do not allow to achieve the effect that is obtained from the action of dacarbazine.
The most effective treatment with selboraf. The targeted agent makes it possible to increase survival and make a better prognosis. Indications for the use of the drug - a mutation in the genotype of the tumor cell. It is observed in half of the cases.
With the spread of the tumor throughout the body, the prognosis is disappointing. In this embodiment, radiation therapy is used. It is chosen for localized bone lesions and in the presence of distant metastases. However, the presented method is largely inferior to the surgical one.

Drug for the treatment of inoperable and metastatic melanoma

The prognosis in the presented situation is often disappointing. The survival rate is extremely low, due to metastasis to the brain and internal organs.

Mortality, as a rule, occurs during the year. Treatment as a surgical intervention and therapy makes it possible to postpone a lethal outcome.

Initial skin cancer or melanoma of the skin is treated by removing the tumor, as well as the surrounding tissues and fatty tissue under the skin. This is a small surgical operation under anesthesia, similar to plastic surgery by administering painkillers to the patient, then removing 2-3 cm of the subcutaneous layer of the epidermis.

At the 3rd stage, when the tumor has already reached a decent size and spread to other areas of the skin, treatment becomes difficult. A simple excision of the formation is no longer enough. It is required to eradicate the affected cells in the area of the lymph nodes together with the surrounding tissues.

At the initial stage of the development of the tumor process, a radical surgical removal of the neoplasm is performed with excision of nearby areas of healthy tissue, which has a positive effect. After the operation, a course of conservative therapy is prescribed, aimed at suppressing the further development of melanoma:

Immunotherapy - the tumor is treated with the use of special immunomodulators (Laferon, Laferobion), which stimulate the antitumor response of the immune system.
Chemotherapy - includes the use of certain drugs (cytostatics) that suppress the intensity of cancer cell division.

Against the background of ongoing conservative therapy after surgical removal of the tumor, nutrition for melanoma includes dietary recommendations with the mandatory introduction of plant foods rich in fiber and vitamins into the diet.

There are alternative methods of therapy, including the treatment of melanoma with soda, but they have not proven their effectiveness, their use in the early stages without examination by a specialist and radical removal of the neoplasm can lead to an acceleration of the progression of the pathological process and a deterioration in the subsequent prognosis.

The consequences of tumor development

Distant metastases in various organs lead to a violation of their functional state, as well as the appearance of intense pain of the corresponding localization.

Most often, metastases affect the liver, brain and bones of the skeleton. As the pathology progresses and the number of cancer cells increases, intoxication (poisoning) of the body with the products of their vital activity develops.

Such a condition, along with a violation of the state of organs and lymph nodes affected by metastases, leads to death.

Prevention of melanoma

The best way to avoid any skin cancer is to protect your skin from prolonged exposure to ultraviolet light and sunburn. If you have sunburned at least once in your life, this can affect her health even many years later.

Every time the skin is exposed to excess solar radiation, it increases the chance of melanoma. Here are some simple ways to protect your skin from the sun.

Avoid the sun during its peak hours. Solar activity peaks between 11:00 am and 3:00 pm, but at other times the sun can also be hot and potentially harmful. Do not stay under the sun for a long time during the day. Stay in the shade and use sunscreen.

Wear sun protection if you have to spend a lot of time outdoors during spring and summer. Wear a hat that covers your face and head and goggles to protect your eyes. Buy glasses that are UV 400 labeled or offer 100% UV protection.

Use sunscreen. When buying sunscreen, make sure it's suitable for your skin type and protects against both ultraviolet A (UVA) and ultraviolet B (UVB).

If you are going to swim, use a waterproof sunscreen. Pay special attention to the protection of infants and children.

Their skin is much more sensitive than that of adults, and regular exposure to the sun can lead to the development of cancer in the future. Before going out, make sure children are properly dressed, their heads are covered, and sunscreen with a high SPF is applied to their skin.

Sunbathe moderately. If you intend to tan, do so gradually, with a limited amount of sun each day and sunscreen. Starting to sunbathe, spend no more than 30 minutes in the sun, gradually extending this time by five to ten minutes a day.

It is necessary to increase the consumption of protein foods in the form of poultry, fish, eggs. Eat plenty of carbohydrates to restore energy.

You should also drink a lot, in particular, clean water and juice. In addition to all this, it is recommended to exclude tea and coffee from your diet, reduce the amount of consumption of sweets.

Secondly, you need to change your lifestyle. It is necessary to increase the time for rest.

You should get enough sleep. Sleep should last at least 8 hours, it is additionally recommended to take a nap in the daytime.

But one should not lead a completely passive lifestyle. Walking, cycling or swimming will have a very good effect on the body.

Thirdly, it is necessary to protect the skin from direct exposure to the sun and avoid exposure from 10 am to 4 pm. When going outside, you should apply a protective cream with a high protection factor.

In clothes, preference should be given to cotton fabrics. On sunny days, all parts of the body should be covered, and sunglasses should also be worn.

The head should also be protected from the sun with a wide-brimmed hat.

To the question whether melanoma is curable or not, the answer will be this: it should be remembered that it is impossible to cure melanoma completely, and the recurrence of the disease is very often possible.

In this regard, you should regularly visit a doctor for examination.

Skin cancer is a very insidious disease, but you can reduce the risks by leading a healthy lifestyle and visiting a specialist regularly.

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40 days...
Sometimes it seems to me that much more time has passed, sometimes less ...
And the thought does not leave me that now I live two lives, moreover, they run parallel to each other ...
Today I want to write a story to Sasha, in his words.... This story has already helped many people find hope and I believe that it will help many more... He radiated light and gave people confidence.... Sasha taught me how to live, taught to appreciate the moments, taught to fight ...
He fought to the end, he believed in victory... And in a sense, he won... Because he did not give in to circumstances, but lived as if everything was fine with him, but we really had everything wonderful...

"My battle with melanoma"
I am 25 years old, my melanoma was removed 5 years ago - in June 2001, but the struggle with it continues to this day: operations, chemotherapy, moments of joy and despair. The battle has been going on especially actively for the last 2 years - since the autumn of 2004. So far, the score is not in my favor, but we (my wife and I) do not intend to give up.

We got married in 2003 (together since 2000).

In 2004, I graduated from the university (there was such a thing that on the day of chemotherapy and in the afternoon I went to a consultation before the state exams, I probably had a green one).

The disease did not interfere and does not prevent me from working (a programmer, I work via the Internet, I am not tied to a place).

We regularly travel by car, ski, relax on the sea in spring and autumn during the velvet season (of course, without sunbathing and heat - swimming in the early morning and closer to sunset, by the way, in a cotton T-shirt, because I am embarrassed by scars on my body , and besides, it seems like protection from ultraviolet radiation - the whole body is in moles).

Briefly, my situation is as follows:
- The primary tumor was eliminated by wide excision in 2001, left under dynamic observation.
- One year later: metastases to regional lymph nodes, lymphadenectomy with PDT was performed, followed by adjuvant chemoimmunotherapy (dacarbazine, intron-a - 6 courses).
- A year and a half later: recurrence in the postoperative area, repeated excision, subsequent adjuvant chemoimmunotherapy (lomustine + intron-a - 4 courses).
- Six months later (September 2004) - it began ...

Liver: affected since September 2004, the fight against emerging foci is being carried out with the help of sessions of "high-temperature radiofrequency ablation" (RFA) at the Institute of Surgery. Vishnevsky - in total during this time 4 sessions of "burning out" of the largest foci were completed (in total, about 20 foci were "burned out" during these sessions); at the moment there are many foci in all segments ranging in size from 0.5 to 2.5 cm, the growth of some of which will be stopped by the next RFA session: the operation is scheduled for Tuesday, November 15 (tomorrow - for hospitalization).
- Brain: for the first time in October 2005, 3 foci were found on CT and MRI (and also 3 "under suspicion"); On October 31, a radiosurgery session was held using the Gamma Knife device (at the Burdenko Institute of Neurosurgery), all lesions were exposed to radiation.
- Abdominal cavity: for the first time in October 2005: 2 lesions - retroperitoneal lymph node, greater omentum (size up to 2 cm).
- Lungs: for the first time in October 2005: 2 foci (up to 1 cm in size - right lung) - the CT report says "presumably post-pneumonic or post-tuberculosis type" - they were not there before, I did not suffer from pneumonia and tuberculosis.
- Bones: radionuclide scintigraphy, first detected in May 2005, progression confirmed in October 2005: affected several thoracic and lumbar vertebrae, right femur and ilium, left humerus, left parietal bone, one rib on the left.
-Soft tissue: several lesions under the skin.

Since the discovery of foci in the liver (since autumn 2004), he received chemotherapy:
- Autumn-Winter 2004: dacarbazine + cisplatin + intron-a, on the background of tamoxifen, 2 courses, very hard to endure (uncontrollable vomiting every half hour for the first 4 days, nothing kept in the stomach, lost several kilograms), the effect on the foci in the liver actually did not give, canceled.
- Summer-Autumn 2005: Mustoforan, 5 courses, progression continued against the background of this treatment.
- Winter 2005 - Summer 2006: "Roncoleukin" (4 courses), "Roncoleukin + Hydroxyurea" (3 courses) - stabilization.
July 2006: liver, lungs, head - multiple lesions from 0.1 to 1 cm ....

A story about the treatment of melanoma, which, in fact, was not intended for me. They gave it to me in vk and I "copy-pasted" it here. Just, once again I want to do "propaganda", because it is precisely such stories that are becoming more and more :(. This is more likely not even a story, but a cry for help.

MELANOMA.

In the summer of 2013, Veronica discovered that one of the moles on her back started to change. She went to the clinic, where she was told that the mole should be removed, but as such there is no need, especially in the summer it is better not to do this, wait for the fall.

IN November 2013 had an operation to remove moles and, histology showed, it was a shock to her family.

Diagnosis: Back skin melanoma, pT3b N0 M0, 2b st. Histology: according to Clark 2, according to Breslow 3 mm, with manifestation and severe lymphoid infiltration, no tumor growth along the resection line.

Preventive treatment with interferon was prescribed, dosage of 3 million, every three months an examination in oncology. Nika did not tolerate injections well, but she had to hold on and still entertain her daughter, who had not yet gone to kindergarten, her husband was torn between home and work as best he could.

IN July 2014 found a single liver metastasis, a month later they had an operation to remove it and recommended to continue treatment with the same drug. Together with a segment of the liver, the gallbladder was also removed (which, in the end, according to the professor in Israel, was healthy and did not need to be removed). The disease progressed rapidly, the treatment did not help, it was decided to go abroad.

A one-room apartment was immediately sold and after a month and a half they ended up in Israel. Examination showed multiple metastases in the liver and nearby lymph nodes.
As the professor said we are talking about prim Uncle Vadik), the 1st metastasis could not be removed, it only contributed to the weakening of the immune system, and the progression of the disease (and this is all in 1.5 months).

If you do not start treatment, give 4-6 months. And once again 4-6 months (!), Veronika is only 30 years old, she is so smart and 4-6 months!!! Shock! Shock! Shock! Tafinlar appointed, purchased 8 packs for 56 days, price 27 thousand $. In seven weeks, you need to be with the professor to watch the dynamics of the decrease in metastases and buy medicines. This drug acts from 4 to 6 months for each person individually, but then it will cease to act and you will need to switch to another group of drugs ( Yervoy). We cannot say how much a full course of treatment with Yervoy costs and according to what scheme, her husband saw a check in a pharmacy for $ 96,000.

Veronica started taking Tafinlar on September 24, she is doing well, holding on, her husband is selling a car for the second trip and the purchase of the drug. But further where to take the money, there is no answer yet.