"...Skin cancer is the most common of all cancers. It accounts for nearly half of all cancers in the United States. More than 2 million cases of non-melanoma skin cancer are found in this country each year. Melanoma, the most serious type of skin cancer, will account for about 68,130 cases of skin cancer in 2010.

What is non-melanoma (basal or squamous cell) skin cancer?

Most skin cancers are classified as non-melanomas, usually starting in either basal cells or squamous cells. These cells are located at the base of the outer

Can skin cancer be prevented?

The best ways to lower the risk of non-melanoma skin cancer are to avoid intense sunlight for long periods of time and to practice sun safety. You can continue to exercise and enjoy the outdoors while practicing sun safety at the same time. Here are some ways you can do this:

  • Avoid the sun between 10 a.m. and 4 p.m.
  • Seek shade: Look for shade, especially in the middle of the day when the sun's rays are strongest. Practice the shadow rule and teach it to children. If your shadow is shorter than you, the sun’s rays are at their strongest.
  • Slip on a shirt: Cover up with protective clothing to guard as much skin as possible when you are out in the sun. Choose comfortable clothes made of tightly woven fabrics that you cannot see through when held up to a light.
  • Slop on sunscreen: Use sunscreen and lip balm with a sun protection factor (SPF) of 15 or higher. Apply a generous amount of sunscreen (about a palmful) and reapply after swimming, toweling dry, or perspiring. Use sunscreen even on hazy or overcast days.
  • Slap on a hat: Cover your head with a wide-brimmed hat, shading your face, ears, and neck. If you choose a baseball cap, remember to protect your ears and ...."  .... read more...
Melanoma

Melanoma $100 Challenge – Melanoma Foundation of New Zealand 2012 appeal

Malignant melanoma is a potentially serious type of skin cancer. It is due to uncontrolled growth of pigment cells, called melanocytes.

New Clinical Guidelines on the Management of Melanoma in Australia and New Zealand have been released by the New Zealand Guidelines Group and the Australian Cancer Network. Please refer to these for up to date information on the care of patients with this disease.

What are melanocytes?

Normal melanocytes are found in the basal layer of the epidermis, i.e. the bottom part of the outer layer of the skin. The melanocytes produce a protein called melanin, which protects the skin by absorbing ultraviolet (UV) radiation. Melanocytes are found in equal numbers in black and in white skin, but the melanocytes in black skin produce much more melanin. People with dark brown or black skin are very much less likely to be damaged by UV radiation than those with white skin.

Non-cancerous growth of melanocytes results in moles (properly called benign melanocytic naevi) and freckles (ephelides and lentigines). Cancerous growth of melanocytes results in melanoma.

Who is at risk of melanoma?

Melanoma is most common in white skinned individuals, but it may rarely develop in those with dark skin as well. About one in fifteen white skinned New Zealanders are expected to develop melanoma in their lifetime – Australia and New Zealand have the highest reported rates of melanoma in the world. It was the third most common cancer in New Zealand in 2008.

Melanoma can occur in adults of any age but is very rare in children. In New Zealand in 2003:

  • Fewer than 1% occurred in those under 20 years
  • 13% occurred in people 20 to 40 years
  • 36% in those aged 40 to 59 years
  • 51% in those aged over 60 years

According to New Zealand Cancer Registry data, 2256 invasive melanomas were diagnosed in 2008; 48% were in males. There were 371 deaths from all types of melanoma in 2008 (69% were male).

The main risk factors for developing the most common type of melanoma (superficial spreading melanoma) include:

  • Increasing age (see above)
  • Previous invasive melanoma or melanoma in situ
  • Previous nonmelanoma skin cancer
  • Many melanocytic naevi (moles)
  • Multiple (>5) atypical naevi (funny-looking moles or moles that are histologically dysplastic)
  • Strong family history of melanoma with 2 or more first-degree relatives affected
  • Fair skin that burns easily

However these risk factors are not important for the less common types of melanoma.

How does a melanoma grow?

Cancers proliferate at an uncontrolled rate because of abnormalities in the genes that control cell growth. Further genetic changes promote invasion into surrounding tissue. Melanoma is now thought to begin as uncontrolled proliferation of transformed melanocytic stem cells.

Superficial forms of melanoma spread out within the outside layer of skin (the epidermis). A pathologist may report this as the radial or horizontal growth phase. If all the melanoma cells are confined to the epidermis, it is melanoma in situ. Lentigo maligna is a special kind of melanoma in situ that occurs around hair follicles on the sun damaged skin of the face or neck. Melanoma in situ is always cured by excision because it has no potential to spread round the body.

When the cancerous cells have grown through the basement membrane into the deeper layer of the skin (the dermis), it is known as invasive melanoma. The pathologist may state that the tumour has a vertical growth phase, which is potentially more dangerous than the horizontal growth phase. Nodular melanoma appears to be invasive from the beginning, and has little or no relationship to sun exposure.

Once the melanoma cells have reached the dermis, they may spread to other tissues via the lymphatic system to the local lymph nodes or via the blood stream to other organs such as the lungs or brain. This is known as metastatic disease or secondary spread. The chance of this happening mainly depends on how deep the cells have penetrated into the skin. So early detection of melanoma is vital.

Where do you find melanomas?

Melanoma can arise from otherwise normal appearing skin (75% of melanomas) or from within a mole or freckle, which starts to grow larger and change in appearance. Precursor lesions include:

Melanomas can occur anywhere on the body, not only in areas that get a lot of sun. In New Zealand, the most common site in men is the back (around 40% of melanomas), and the most common site in women is the leg (also around 40%).

Although melanoma usually starts as a skin lesion, it can also rarely grow on mucous membranes such as the lips or genitals. Occasionally it occurs in other parts of the body such as the eye, brain, mouth or vagina.

What does a melanoma look like?

The first sign of a melanoma is usually an unusual looking freckle or mole. A melanoma may be detected at an early stage when it is only a few millimetres in diameter, but they may grow to several centimetres in diameter before they are diagnosed.

A melanoma may have a variety of colours including tan, dark brown, black, blue, red and, occasionally, light grey. Melanomas that are lacking pigment are called amelanotic melanoma. There may be areas of regression that are the colour of normal skin, or white and scarred.

During its horizontal phase of growth, a melanoma is normally flat. As the vertical phase develops, the melanoma becomes thickened and raised.

Some melanomas are itchy or tender. More advanced lesions may bleed easily or crust over.

A pigmented lesion (mole or freckle) should be checked by an experienced doctor if it has any of the characteristics described by the Glasgow 7-point checklist or by the ABCDE’s of melanoma. Not all such lesions prove to be malignant. Not all melanomas show these characteristics.

Glasgow 7-point checklist
Major features Minor features
  • Change in size
  • Irregular shape
  • Irregular colour
  • Diameter >7mm
  • Inflammation
  • Oozing
  • Change in sensation
The ABCDs of Melanoma
A
B
C
D
E
Asymmetry
Border irregularity
Colour variation
Diameter over 6 mm
Evolving (enlarging, changing)

Types of Melanoma

Melanomas are described according to their appearance and behaviour. Those that start off as flat patches (i.e. have a horizontal growth phase) include:

These superficial forms of melanoma tend to grow slowly, but at any time, they may begin to thicken up or develop a nodule (i.e. progress to a vertical growth phase).

Melanomas that quickly involve deeper tissues include:

Combinations may arise e.g. nodular melanoma arising within a superficial spreading melanoma or desmoplastic melanoma arising within a lentigo maligna.

Melanoma images

Melanoma
Typical SSMM
Melanoma
SSMM with regression
Melanoma
Amelanotic melanoma
Superficial spreading melanoma

More images of superficial spreading melanoma and melanoma in situ...

Melanoma
Lentigo maligna melanoma
Melanoma
Lentigo maligna
Melanoma
Nodular melanoma in lentigo maligna
Lentigo maligna melanoma

More images of lentigo maligna melanoma...

Melanoma
Acral lentiginous melanoma
Melanoma of nail unit
© Dr Ph Abimelec – dermatologue
Melanoma
Amelanotic subungual melanoma
Acral lentiginous melanoma

More images of acral lentiginous melanoma and subungual melanoma...

Melanoma
Black nodular melanoma
Melanoma
Amelanotic nodular melanoma
Melanoma
Ulcerated nodular melanoma
Nodular melanoma

More images of nodular melanoma, Metastases and rare forms of melanoma...

Diagnosis of melanoma

Melanoma may be suspected because of the history of change (if known) or the appearance of the skin lesion. The dermoscopic appearance is particularly helpful in the diagnosis of early melanoma. Dermoscopy requires special training. Dermoscopy is not necessary if the lesion has the typical clinical appearance of melanoma.

A suspected melanoma should be surgically removed with a 2 to 3-mm margin (excision biopsy) and sent to a pathology laboratory for examination under a microscope (histology). A small biopsy is best avoided, except in unusually large lesions. An incisional or punch biopsy could be misleading.

The pathological diagnosis of melanoma can be very difficult. Histological features of superficial spreading melanoma in situ include the presence of buckshot (pagetoid) scatter of atypical melanocytes within the epidermis. These cells may be enlarged with unusual nuclei. Dermal invasion results in melanoma cells within the dermis or deeper into subcutaneous fat.

Extra tests using immunohistochemical stains may be necessary.

Pathology report

The pathologist's report should include a macroscopic description of the specimen and melanoma (the naked eye view), and a microscopic description. The following features should be reported if there is invasive melanoma.

  • Diagnosis of primary melanoma
  • Breslow thickness to the nearest 0.1 mm
  • Clark level of invasion
  • Margins of excision i.e. the normal tissue around the tumour
  • Mitotic rate – a measure of how fast the cells are proliferating
  • Whether or not there is ulceration

The report may also include comments about the cell type and its growth pattern, invasion of blood vessels or nerves, inflammatory response, regression and whether there is associated in-situ disease and/or associated naevus (original mole).

What is Breslow thickness?

The Breslow thickness is reported for invasive melanomas. It is measured vertically in millimetres from the top of the granular layer (or base of superficial ulceration) to the deepest point of tumour involvement. It is a strong predictor of outcome; the thicker the melanoma, the more likely it is to metastasise (spread).

What is the Clark level of invasion?

The Clark level indicates the anatomic plane of invasion.

Level 1 In situ melanoma
Level 2 Melanoma has invaded papillary dermis
Level 3 Melanoma has filled papillary dermis
Level 4 Melanoma has invaded reticular dermis
Level 5 Melanoma has invaded subcutaneous tissue

The deeper the Clark level, the greater the risk of metastasis (secondary spread). It is useful in predicting outcome in thin tumours, and less useful for thicker ones in comparison to the value of the Breslow thickness.

Treatment of melanoma

Melanomas are removed surgically. The extent of surgery depends on the thickness of the melanoma and its site. Most thin melanomas do not need extensive surgery. The lesion is removed using a local anaesthetic, and the defect stitched up. A small area of normal skin around the melanoma is also excised to make sure that all the melanoma cells have been removed. Often this is done as a second procedure (re-excision) when the pathology has confirmed melanoma.

For thicker melanomas (those over 1 mm or so in thickness), a much wider area of skin is cut out. A skin graft might be necessary, which replaces the removed skin with skin taken from another part of the body.

Staging

Melanoma staging means finding out if the melanoma has spread from its original site in the skin. Most melanoma specialists refer to the American Joint Committee on Cancer (AJCC) cutaneous melanoma staging guidelines (2009). In essence, the stages are:

Stage Characteristics
Stage 0 In situ melanoma
Stage 1 Thin melanoma <2 mm in thickness
Stage 2 Thick melanoma > 2 mm in thickness
Stage 3 Melanoma spread to involve local lymph nodes
Stage 4 Distant metastases have been detected

Should the lymph nodes be removed?

If the local lymph nodes are enlarged due to metastatic melanoma, they should be completely removed. This requires a surgical procedure, usually under general anaesthetic. If they are not enlarged, they may be tested to see if there is any microscopic spread of melanoma. The test is known as a sentinel node biopsy.

In New Zealand, many surgeons recommend sentinel node biopsy for melanomas thicker than 1 mm, especially in younger persons. However, although the biopsy may help in staging the cancer, it does not offer any survival advantage. The necessity for sentinel node biopsy is controversial at present.

Lymph nodes containing metastatic melanoma often increase in size quickly. An involved node is usually non-tender and firm to hard in consistency. If this occurs between planned follow-up visits, let your doctor know promptly.

If the melanoma is widespread, other forms of treatment may be necessary, but are not always successful in eradicating the cancer. Immunotherapy and biologics such as ipilimumab and vemurafenib are showing promise.

What happens at follow-up?

The main purpose of follow-up is to detect recurrences early but it also offers an opportunity to diagnose a new primary melanoma at the first possible opportunity. A second invasive melanoma occurs in 5-10% patients; an unrelated melanoma in situ affects in more than 20% of melanoma patients.

The Australian and New Zealand Guidelines for the Management of Melanoma (2008) make the following recommendations for follow-up for patients with invasive melanoma.

  • Self skin examination
  • Regular routine skin checks by patient's preferred health professional
  • Follow-up intervals are preferably six-monthly for five years for patients with stage 1 disease, three-monthly or four-monthly for five years for patients with stage 2 or 3 disease, and yearly thereafter for all patients.
  • Individual patient’s needs should be considered before appropriate follow-up is offered
  • Provide education and support to help patient adjust to their illness

The follow-up appointments may be undertaken by the patient's general practitioner or specialist or they may be shared.

Follow-up appointments may include:

  • A check of the scar where the primary melanoma was removed
  • A feel for the regional lymph nodes
  • A general skin examination
  • A full physical examination
  • In those with many moles or atypical moles, baseline whole body imaging and sequential macro and dermoscopic images of melanocytic lesions of concern ( mole mapping)

In those with more advanced primary disease, follow-up may include:

  • Blood tests, including LDH
  • Imaging: ultrasound, X-ray, CT, MRI and/or PET scan.

Tests are not typically worthwhile for stage 1/2 melanoma patients unless there are signs or symptoms of disease recurrence or metastasis. And no tests are thought necessary for healthy patients who have remained well for 5 years or longer after removal of their melanoma, whatever stage.

What is the outlook?

Melanoma in situ is not dangerous; it only becomes potentially life threatening if an invasive melanoma develops within it. The rates of melanoma in situ are not reported by cancer registries. The risk of spread and ultimate death from invasive melanoma depends on several factors, but the main one is the measured thickness of the melanoma at the time it was surgically removed.

The Melanoma Guidelines report that metastases are rare for melanomas <0.75mm and the risk for tumours 0.75–1 mm thick is about 5%. The risk steadily increases with thickness so that melanomas >4 mm have a risk of metastasis of about 40%.

New Zealand statistics gathered by the Cancer Registry between 1994 and 2004 revealed 15,839 invasive melanomas. Of these, 52% were under 0.75 mm in thickness, 22% were between 0.76 and 1.49 mm, 15% were between 1.5 and 3 mm in thickness and 11% were more than 3 mm in thickness. Thicker tumours were slightly more likely to be diagnosed in males, and more likely in older people than younger ones.

"...

  • Skin cancer is the most common form of cancer in the United States. More than 3.5 million skin cancers in over two million people are diagnosed annually.1

  • Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.2

  • One in five Americans will develop skin cancer in the course of a lifetime.3

  • Over the past 31 years, more people have had skin cancer than all other cancers combined.4

  • Nearly 800,000 Americans are living with a history of melanoma and 13 million are living with a history of nonmelanoma skin cancer, typically diagnosed as basal cell carcinoma or squamous cell carcinoma.5

  • Actinic keratosis is the most common precancer; it affects more than 58 million Americans.6 Approximately 65 percent of all squamous cell carcinomas arise in lesions that previously were diagnosed as actinic keratoses. In patients with a history of two or more skin cancers, 36 percent of basal cell carcinomas arise in lesions previously diagnosed as actinic keratoses.7

  • Basal cell carcinoma (BCC) is the most common form of skin cancer; an estimated 2.8 million are diagnosed annually in the US.8 BCCs are rarely fatal, but can be highly disfiguring if allowed to grow.

  • Squamous cell carcinoma (SCC) is the second most common form of skin cancer.9 An estimated 700,000 cases are diagnosed each year in the US,10 resulting in approximately 2,500 deaths.2

  • Between 40 and 50 percent of Americans who live to age 65 will have either skin cancer at least once.11

  • About 90 percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.12

  • Treatment of nonmelanoma skin cancers increased by nearly 77 percent between 1992 and 2006.13
 


MELANOMA
  • One person dies of melanoma every hour (every 62 minutes).2

  • One in 55 people will be diagnosed with melanoma during their lifetime.14

  • Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.15

  • The survival rate for patients whose melanoma is detected early, before the tumor has penetrated the skin, is about 99 percent.16 The survival rate falls to 15 percent for those with advanced disease.2

  • The vast majority of mutations found in melanoma are caused by ultraviolet radiation.12

  • The incidence of many common cancers is falling, but the incidence of melanoma continues to rise at a rate faster than that of any of the seven most common cancers.17 Betwcauses more than 75 percent of skin cancer deaths.21

  • Survival with melanoma increased from 49 percent (1950 – 1954) to 92 percent (1996 – 2003).22

  • Melanoma is the fifth most common cancer for males and sixth most common for females.2

  • Women aged 39 and under have a higher probability of developing melanoma than any other cancer except breast cancer.2

  • About 65 percent of melanoma cases can be attributed to ultraviolet (UV) radiation from the sun.23

  • One or more blistering sunburns in childhood or adolescence more than double a person’s chances of developing melanoma later in life.24

  • A person’s risk for melanoma doubles if he or she has had more than five sunburns at any age.25

  • Survivors of melanoma are about nine times as likely as the general population to develop a new melanoma.26

  • MEN/WOMEN
    • The majority of people diagnosed with melanoma are white men over age 50.14

    • One in 39 Caucasian men and one in 58 Caucasian women will develop melanoma in their lifetimes.2,27

    • Approximately 39,000 new cases of melanoma occur in men each year in the US, and 29,000 in women.2

    • Approximately 5,700 deaths from melanoma occur in men each year in the US, and 3,000 in women.2

    • Five percent of all cancers in men are melanomas; four percent of all cancers in women are melanomas.2

    • Adults over age 40, especially men, have the highest annual exposure to UV.28

    • Melanoma is one of only three cancers with an increasing mortality rate for men, along with liver cancer and esophageal cancer.29,27

    • Caucasian men over age 65 have had an 8.8 percent annual increase in melanoma incidence since 2003, the highest annual increase of any gender or age group.30

    • Between 1980 and 2004, the annual incidence of melanoma among young women increased by 50 percent, from 9.4 cases to 13.9 cases per 100,000 women.31

    • The number of women under age 40 diagnosed with basal cell carcinoma has more than doubled in the last 30 years; the incidence of squamous cell carcinoma among women under age 40 has increased almost 700 percent.32

    • Until age 39, women are almost twice as likely to develop melanoma as men. Starting at age 40, melanoma incidence in men exceeds incidence in women, and this trend becomes more pronounced with each decade.29
    een 1992 and 2004, melanoma incidence increased 45 percent, or 3.1 percent annually.18

  • An estimated 114,900 new cases of melanoma were diagnosed in the US in 2010 — 46,770 noninvasive (in situ) and 68,l30 invasive, with nearly 8,700 resulting in death.19

  • Melanoma accounts for less than five percent of skin cancer cases,20 but it..." .....  to this article....
The Web Your Health And Tech Friend
 "...main risk factors for developing the most common type of melanoma (superficial spreading melanoma) include:
  • Increasing age (see above)
  • Previous invasive melanoma or melanoma in situ
  • Previous nonmelanoma skin cancer
  • Many melanocytic naevi (moles)
  • Multiple (>5) atypical naevi (funny-looking moles or moles that are histologically dysplastic)
  • Strong family history of melanoma with 2 or more first-degree relatives affected
  • Fair skin that burns easily...."  ... find this in the article below...
"...Apple Cider Vinegar is a natural cure for acne. Please refer to our Acne Home Remedy page for more information on how to treat acne with Apple Cider Vinegar. ..."
...to this article...
 
&nbsp;
 
&nbsp;
"...Excessive bathing and applying conventional lotions temporarily moisturizes the skin, but, in fact, frequent washings strip away thin oily lipid layer, that protects the skin, imparts flexibility and helps keep moisture within."... see this article...

"...Once the melanoma cells have reached the dermis, they may spread to other tissues via the lymphatic system to the local lymph nodes or via the blood stream to other organs such as the lungs or brain. This is known as metastatic disease or secondary spread. The chance of this happening mainly depends on how deep the cells have penetrated into the skin. So early detection of melanoma is vital..." .... continue this below....

&nbsp;
 
&nbsp;
 

Most Common Skin Diseases

.......

 
Dec 22, 2009 | By Marie Zhuikov

Skin Cancer

There are several different types of skin cancers. Squamous cell carcinoma and basal cell carcinoma are the most common. Although melanoma is less common, it causes more skin-cancer deaths because it is more aggressive. Melanoma can occur anywhere on the body and involves the cells that allow us to tan (melanocytes). Basal cell carcinoma affects the deepest layer of the epidermis (outer layer of skin), with tumors that often look like pimple-like growths or shiny pink patches. Squamous cell carcinoma affects the epidermis and often appears as patches that are red, scaled or crusty. Diagnosis and treatment of all of these life-threatening cancers requires the aid of a physician..... "   .....  to this text.....

Melanoma | Early And Later Stages: Images | My Experience On Video

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Life is 'Lunatic' Crazy | Multi-Tasking To The Hilt!

Below is my video: a very early time in my detection and the beginning of treating my skin cancer. At first, I was afraid to call it cancer - because, I'm treating it myself, with Miracle Mineral Solution - and other substances, like colloidal silver. I was afraid to announce to the world that I'm doing this. But, since then... with more 'cancer spots' coming up; I'm 'out in the open'. Totally announcing to the world that I'm treating this skin melanoma with products like Black Salve.. etc. I'm getting good results. God bless you and yours! ~~~Nancy P.S. I was afraid, when I was filming this video: today (February 2014: I'm not afraid of cancer anymore!


P.P.S. I was 'afraid' to call it, 'cancer' - so I refer it to a 'skin eruption'... Not afraid anymore!


"...Normal melanocytes are found in the basal layer of the epidermis, i.e. the bottom part of the outer layer of the skin. The melanocytes produce a protein called melanin, which protects the skin by absorbing ultraviolet (UV) radiation. Melanocytes are found in equal numbers in black and in white skin, but the melanocytes in black skin produce much more melanin. People with dark brown or black skin are very much less likely to be damaged by UV radiation than those with white skin. ...."  ... see this below...

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