About all

Where does melanoma usually spread to first. Melanoma Spread and Danger: Understanding the Importance of Timing

by alexxlab

How dangerous is melanoma really? The answer lies in the timing of detection and treatment. Discover the critical differences between early-stage and advanced melanoma, and how it can impact survival rates.

Содержание

The Significance of Early Melanoma Detection

Skin cancer, particularly melanoma, is the world’s most common cancer. However, there is a glimmer of hope – when caught early, skin cancers are highly treatable. The key lies in the timing of detection and treatment. The difference between an early-stage melanoma and one that has progressed can be the difference between life and death.

Stages of Melanoma: From Localized to Metastatic

Melanoma in its earliest stages is considered localized, meaning the malignant cells have not spread beyond the original tumor site. These in situ melanomas, confined to the top layer of the skin, have an estimated 5-year survival rate of around 99% in the United States. However, once a melanoma penetrates deeper into the skin’s layers and begins to metastasize, the prognosis becomes much more dire.

Lymphatic Spread: The First Step Towards Metastasis

The first place a melanoma typically spreads to is the lymph nodes, where the cancer cells can then potentially travel to distant organs throughout the body. Once a melanoma has spread to the lymph nodes (stage III), the 5-year survival rate drops to around 62%. And if the cancer has reached distant sites (stage IV), the 5-year survival rate plummets to just 18%.

The Race Against Time: Preventing Melanoma Progression

Every melanoma has the potential to become deadly, but the difference between an early-stage and advanced tumor is profound. The survival rates highlight the critical importance of detecting and treating melanomas before they have a chance to progress. Since the speed of progression can vary, it’s essential to be proactive with regular self-exams and annual skin checks with a dermatologist.

Leland’s Story: Overcoming the Odds

Leland Fay’s experience illustrates the gravity of melanoma’s progression. When the 46-year-old Colorado native was diagnosed with stage IV melanoma in 2012, his prognosis was bleak – he was given as little as 6 weeks to live. However, through a combination of surgeries, immunotherapy, and radiation, Leland defied the odds and is now leading an active, full life 5 years after his diagnosis. His story underscores the importance of early detection and treatment.

Taking Action: Melanoma Prevention and Screening

To ensure the best possible outcome, The Skin Cancer Foundation recommends monthly self-exams to spot any new or changing lesions, as well as an annual total body skin exam with a dermatologist. These proactive measures can help catch melanomas early, before they have a chance to progress and become life-threatening.

What is the difference in survival rates between early-stage and advanced melanoma?

The difference in survival rates is dramatic. For melanomas detected while still localized (stage 0 or I), the estimated 5-year survival rate is around 99%. However, once a melanoma has spread to the lymph nodes (stage III), the 5-year survival rate drops to approximately 62%. And if the cancer has reached distant organs (stage IV), the 5-year survival rate plummets to just 18%.

Why is it important to detect melanoma early?

Detecting melanoma early is crucial because the cancer’s progression can be rapid and deadly. Once a melanoma begins to spread beyond the original tumor site, the prognosis becomes much worse. Early detection allows for prompt treatment, which can stop the cancer in its tracks and dramatically improve the chances of survival.

How can I ensure I’m detecting melanoma early?

To maximize your chances of early detection, The Skin Cancer Foundation recommends performing monthly self-exams to check for any new or changing lesions, as well as scheduling an annual total body skin exam with a dermatologist. These proactive measures can help catch melanomas before they have a chance to progress to more advanced stages.

What is the first place melanoma typically spreads to?

The first place melanoma typically spreads to is the lymph nodes. The cancer cells can drain into the lymphatic fluid and be carried through the lymphatic channels to the nearest lymph node basin. From there, the cancer can potentially spread to distant organs throughout the body.

How did Leland Fay’s story illustrate the importance of early detection?

Leland Fay’s experience demonstrates the stark difference between early-stage and advanced melanoma. When he was diagnosed with stage IV melanoma in 2012, his prognosis was extremely poor – he was given as little as 6 weeks to live. However, through aggressive treatment, Leland was able to overcome the odds and is now leading an active, full life 5 years after his diagnosis. His story highlights the critical importance of catching melanoma before it has a chance to progress.

What can I do to ensure I’m detecting melanoma as early as possible?

The key steps to early melanoma detection are regular self-exams and annual skin checks with a dermatologist. By performing monthly self-exams to look for new or changing lesions, and scheduling yearly full-body skin exams, you can increase the chances of catching any potential melanomas in their earliest, most treatable stages.

How Dangerous is Melanoma? It’s All a Matter of Timing

Skin cancer holds the unfortunate distinction of being the world’s most common cancer. Though its prevalence around the globe is disturbing, there is some good news: When caught early, skin cancers are highly curable.

You might already know that catching a cancer early means a more favorable prognosis. But it can be difficult to comprehend just how big a difference early detection makes with melanoma, the most dangerous form of skin cancer. Melanoma should never be underestimated, but treating a tumor early rather than after it is allowed to progress could be lifesaving.

Leland Fay, 46, understands better than most the seriousness of this distinction. When the Monument, Colorado native was diagnosed with melanoma in 2012, he was given a bleak prognosis due to the advanced stage of the tumor — it had already reached stage IV.

Leland hadn’t thought much of the little black mole on his head a few months earlier, when a dermatologist froze it off during a routine exam. But the mole resurfaced, bigger than it had been originally. After a biopsy and imaging tests, doctors told Leland it was melanoma, and that it had already spread. He could have as few as six weeks to live.

Luckily, with the help of several surgeries, immunotherapy, radiation and the “faith and support of family and friends,” Leland overcame the odds. He still goes in for treatments, but five years after his diagnosis, he is leading an active, full life. He recognizes, however, how different his journey could have been if the melanoma was caught earlier: “Better to have a little inconvenience with a biopsy than let melanoma advance.”

To fully comprehend the significance of timing, it can be helpful to understand exactly what happens to a melanoma when it advances to a later stage, and what it means when a melanoma spreads beyond the original tumor site.

Scratching the Surface

A melanoma in its earliest stages is localized. This means that the tumor’s malignant cells have not multiplied to the point that they extend beyond the skin. The very earliest melanomas (stage 0) do not even extend past the top layer of the skin, the epidermis. These tumors are called in situ, a Latin phrase that means “in (original) position,” and they are considered noninvasive. If a tumor penetrates deeper, into the dermis, it is considered invasive (stages I and II). On average, the estimated five-year survival rate for melanomas detected while still localized is very high: about 99 percent in the U.S.

Digging Deeper

The chances of curing a melanoma drop sharply once it spreads, or metastasizes, beyond the original tumor site. Normally, the first place a melanoma tumor metastasizes to is the lymph nodes, by literally draining melanoma cells into the lymphatic fluid, which carries the melanoma cells through the lymphatic channels to the nearest lymph node basin. Lymphatic fluid is an important part of the immune system that bathes the tissues, and is responsible for carrying foreign invaders like bacteria to the lymph nodes, where these invaders are destroyed by the lymphocytes, the white blood cells.   Unfortunately, when melanoma cells are carried to the lymph nodes, they can potentially be carried beyond the nodes to distant organs. Once a melanoma has metastasized beyond the original tumor site, either to the skin en route to the lymph nodes (“in transit” metastases) or to the lymph nodes themselves, it is considered a stage III melanoma. The five-year survival rate then drops to around 62 percent because of the high risk that the cancer can spread from the nodes throughout the body.

Once a tumor has spread to distant body sites such as organs, it is considered a stage IV melanoma, with an estimated five-year survival rate of only 18 percent in the U.S. These survival figures are improving every year because of new treatments (some therapies are keeping as much as 40 percent of stage IV patients alive for years), but they are no substitute for early detection.

Stop Tumors in Their Tracks

Every melanoma has the potential to become deadly, but the difference between an in situ melanoma and one that has begun to metastasize cannot be overstated. There is a drastic change in the survival rate for the various stages of tumors, highlighting the importance of detecting and treating melanomas before they have a chance to progress. It’s impossible to predict exactly how fast a melanoma will move from stage to stage, so you should be taking action as soon as possible.

To be sure you’re spotting any potential skin cancers early, The Skin Cancer Foundation recommends monthly skin checks, and scheduling an annual total body skin exam with a dermatologist. These skin exams can help you take note of any new or changing lesions that have the potential to be cancerous, and have them biopsied and taken care of before they can escalate.

“Trust your instincts and don’t take no for an answer,” Leland says. “Insist that a doctor biopsy anything you believe is suspicious.”

7 Warning Signs Melanoma Has Spread

Medically Reviewed

By

Amy Marturana Winderl

Medical ReviewerAradhana Ghosh, M. D.

iStock

There’s a lot to dislike about cancer, but one thing very high on the list? If it isn’t caught and treated early enough, it can spread throughout your body. That’s especially true for melanoma, a type of skin cancer that develops when the cells that give your skin its tan or brown color (called melanocytes) start to grow out of control. When those cancer cells spread, it’s called metastasis or metastatic melanoma. Ideally, melanoma is discovered and treated before that happens. But if it’s not, you may notice a variety of symptoms depending on exactly where the cancer has spread.

iStock

Two main things determine the stage of melanoma: The thickness or depth of the tumor and how far it has spread when it’s diagnosed, explains David Polsky, M.D., dermatologist at NYU Langone Medical Center in New York City. In stages 0, 1, and 2, the melanoma is limited to the skin. In stage 3, it’s spread to the lymph nodes, small structures throughout your body that help filter fluids and fight infection. In the most advanced stage, stage 4, melanoma cells have broken away from the original tumor, traveled through the body and formed a new tumor somewhere else.

iStock

Melanoma can spread from the original site on your skin and form a tumor in any organ or body tissue, but it’s most likely to metastasize to the lymph nodes, liver, brain, lungs, and less commonly, the bones. “Melanoma really likes the brain and the liver,” says Lisa Zaba, M.D., dermatologic oncologist at Stanford Medical Center in San Jose, CA. If you notice any of the following red flags, it might mean your melanoma has spread and warrants a call to your doctor right away.

iStock

“If melanoma spreads, it often goes to the lymph nodes first,” says Melinda L. Yushak, M.D., assistant professor of hematology and medical oncology at Emory University School of Medicine in Atlanta. The cancer cells will first travel to the nodes closest to the original tumor, she says. Lymph nodes are located throughout your entire body, but large clusters are found in the neck, underarms, chest, abdomen, and groin. If the cancer has made its way to the lymph nodes, it usually won’t be painful, but they’ll feel swollen or even hard to the touch, Dr. Zaba says.

iStock

Early on, there may be no noticeable symptoms that melanoma has spread to the liver. When symptoms do show up, they commonly include an enlarged, hard, or tender liver and pain in the upper right area of your abdomen, just below your ribs. Other signs cancer has spread to the liver are similar to symptoms of liver disease: fluid buildup in the belly (ascites) and yellowing of the skin and eyes (jaundice).

iStock

Just like the liver, not everyone will notice symptoms of melanoma spreading to the brain. But when symptoms do show up, it’s usually in the form of headaches, problems with eyesight, paralysis on one side of the body, or seizures. “If someone simply has a headache, that doesn’t mean they have advanced stage melanoma,” Dr. Yushak says. “But if it’s a headache that’s not going away after a week, and you never have headaches, then that’s something that definitely needs to be checked out.”

iStock/pixelheadphoto

Melanoma is also known to spread to the lungs, though Dr. Zaba notes that most people don’t experience noticeable symptoms in the lungs until a tumor has gotten pretty large. A cough that just won’t quit or recurring chest infections (a.k.a. feeling like you’re always a little sick) can signal that the cancer has traveled to the lungs, Dr. Polsky says. Shortness of breath or trouble breathing can also be a red flag.

iStock

The bones are considered a late-stage site of melanoma metastases—typically, it doesn’t spread to the bones until it’s already spread to another area of the body first. Melanoma can cause pain in the bones where it’s spread, and some people—those with very little body fat covering their bones—may be able to feel a lump or mass. Metastatic melanoma can also weaken the bones, making them fracture or break very easily. This is most common in the arms, legs, and spine. If you feel any sharp, sudden, or new pains that won’t go away, talk to your doctor.

iStock

Unintentional weight loss is a common side effect of any cancer. When it comes to melanoma, extreme weight loss usually only happens after the cancer has spread from the skin to other parts of the body. Dr. Zaba says she can sometimes tell if a patient’s melanoma has metastasized because it looks like they have cachexia, a syndrome marked by drastic loss of fat and muscle and increased weakness. Cachexia can also cause loss of appetite, which further contributes to the problem.

iStock

A handful of general symptoms can be signs your melanoma has spread, though they’re pretty nonspecific—meaning they could be symptoms of many things, from the flu to cancer. If you experience fever, chills, and/or night sweats, tell your doctor so they can figure out if something else is to blame, Dr. Polsky says. If the cause still isn’t clear, they’ll send you for additional tests and scans to figure out what’s going on.

causes, symptoms, signs, what it looks like, stages, diagnosis, treatment (removal), prognosis

Causes

Symptoms

Classification

Complications

Diagnosis

Treatment

Prognosis and prevention

Melanoma is a malignant tumor that grows from melanocytes responsible for skin pigmentation. Most often it affects the epidermis, but sometimes it also occurs on the mucous membranes, the retina of the eye.

The main danger of this oncological disease is that tumor cells spread very quickly throughout the body. After lung cancer, melanoma is the second leading cause of death worldwide. Most often diagnosed after the age of 30 years.

Causes and triggers

Modern scientists have clearly established that the main cause of melanoma is exposure to ultraviolet rays on the human body. And it can be not only the sun, but also a visit to the solarium

It is also noted that the disease is most often detected in people with fair skin, red or white hair and blue eyes. The disease is most rarely diagnosed in people with dark skin, as well as in representatives of the Negroid race. Predisposing factors can be heredity, sunburn, congenital nevus, multiple moles on the body.

Melanoma in children is quite rare, but it looks like a common wart without pigmentation. Therefore, it is important to show all suspicious skin formations at this age to a dermatologist and conduct digital dermatoscopy.

Symptoms

Skin melanoma often occurs without any significant symptoms. The patient may notice that a birthmark has appeared on one or another part of the body, which is unlike all the others. Education can differ in size, color, shape.

The main signs that help to suspect something is wrong are as follows:

  • the appearance of severe itching in the area of ​​a mole or a spot that does not subside for a long time;
  • hair loss from this place, especially if the suspicious area is located on the arm or leg, where the hairline is especially noticeable;
  • changing the color of an existing formation literally to black or dark brown;
  • the appearance on the surface of the formation of painful ulcers;
  • an increase in the spot in size in a short period of time;
  • change in the boundaries of moles – they become uneven, asymmetry appears;
  • from time to time you can notice that such a mole begins to bleed, especially if the patient tries to soothe the itch with scratching.

However, there is no single reliable evidence that the resulting formation on the skin is malignant. The symptoms of melanoma are varied, and in each case they manifest themselves in different ways. Therefore, the answer to the question of what melanoma looks like will sound like this: it may look different from all other moles, nevi, freckles. This is what should be of concern in the first place.

Doctors distinguish 4 main types of this cancer. In most cases, superficially spreading is diagnosed. Its feature is a long course without any symptoms. In men, it is localized mainly on the back, in women – on the legs.

Lentigo melanoma looks like an irregular spot. It occurs in older people and is localized mainly on the face, neck, back of the hands.

Nodular melanoma is a brown or black formation protruding above the epidermis. Usually it is these formations that are left without attention, but they grow quickly, dense in consistency. It can occur on the back, on the head or on the neck.

In 2% of all cases there are variants without pigmentation. They are difficult to diagnose and rarely cause concern in the patient, as they resemble only a pink-red speck.

Nail melanoma is one of the most common manifestations of the disease. At the initial stage, this is just a dark spot on the nail plate. As it grows, there is a deformation of the nail, ulcers on it, bleeding. Subungual melanoma is most often detected in women and men over 60 years of age. About 170 cases are detected per year in Russia.

Classification

In modern dermatology and oncology, melanoma is classified according to the phases of development and clinical types. In the development of this disease, two phases are distinguished – horizontal and vertical.

Doctors also use the international classification according to the TNM system in their practice. The first letter indicates the extent of the primary tumor. The second is about the presence of metastases in the lymphatic system. The third letter is an indication of metastases in distant organs. It is very important to detect signs of melanoma as early as possible in order to prevent complications and the spread of metastases.

Melanoma, like any other disease, has its own stages of development. At the very beginning, it develops only on the surface of the skin, and this stage is called zero. At the first stage, germination reaches 1 mm, but there are no obvious signs of the disease. At the second stage, the germination depth will be 2–4 mm. On the third, the lymph nodes are affected, and on the fourth, distant organs and the appearance of metastases in them.

Complications

If you do not pay any attention to the tumor, then over time it will begin to increase in size, ulcers will appear on it, and it will begin to bleed.

Another common complication is the progression of oncology, which manifests itself as metastasis both to neighboring organs and to those that are at a considerable distance.

And, of course, the lymph nodes are affected. In this case, survival for 5 years even after surgery and other oncology treatment is recorded only in 7% of all cases.

Diagnosis

Melanoma is diagnosed and treated by an oncologist or dermatologist. First, a survey and examination of the patient is carried out, possible factors that could provoke the disease are determined. Then moles, both suspicious and all others, are subjected to dermatoscopy. This is a procedure during which the formations are examined under a magnifying glass. Such a simple study helps to identify the first signs of oncology.

In modern medical practice, biopsy and histological examination are carried out only after the complete removal of the mole. A partial biopsy is not recommended for use, since trauma to the oncological nevus can cause the rapid spread of cancer cells to healthy tissues and organs.

CT, MRI, ultrasound are used to identify affected lymph nodes.

Treatment

The main treatment for melanoma at the initial stage is removal. The operation is carried out under the control of a microscope, as well as using a laser. Cryodestruction is not used for this tumor, since it is impossible to determine in advance exactly how deep the melanoma has grown into the skin.

Melanoma removal is not the only way to get rid of the tumor. But if the disease has already affected the lymph nodes or other organs, then combined treatment is used, which consists of chemotherapy with several drugs, immunotherapy and radiation therapy.

Interleukin 2, Interferon-alpha, Atezolizumab, Pembrolizumab, Ipilimumab, Vemurafenib are becoming drugs of choice for immune treatment. The dose of radiation therapy is selected strictly individually for each patient. Of the chemotherapeutic agents, Dacarbazine, Lomustine, Tamoxifen are used. But even in this case, an operation is required to remove melanoma.

Gene therapy for melanoma is under investigation, as well as the possibility of using certain viruses that can affect the growth and development of cancer cells.

No specific diet is required for melanoma therapy. However, it is important to include as many vegetables and fruits in your diet as possible and completely eliminate alcoholic beverages, everything fatty, fried and canned. It is these clinical recommendations for melanoma that modern specialists give today.

Prognosis and prevention

It is important to identify and remove melanoma as early as possible, only in this way the prognosis will be favorable, and in 90% of all cases a long-term remission occurs. In the remaining 10% of cases, there is a risk of relapse. Survival also depends on the stage of the disease, the symptoms present, and the treatment used. Doctors give the most unfavorable prognosis with damage to the lymph nodes, the presence of nearby and distant metastases.

As a preventive measure, avoid exposure to the sun at its peak, refuse to visit the solarium and always protect the skin with sunscreen. If you suspect melanoma, you should immediately consult a doctor to confirm or refute the diagnosis.

The author of the article:

Shapovalova Valeria Olegovna

cosmetologist, dermatologist, trichologist

work experience 7 years

reviews leave feedback

Clinic

m. Sukharevskaya

Reviews

Services

  • Title
  • Dermatologist’s consultation2300

Feature
A Asymmetry (asymmetry). Unlike benign moles, the shape of most melanomas is asymmetrical.
B Border (edges). While nevi have clear borders, melanomas usually have uneven, “torn”, indistinct edges.
C Color (color). Moles are evenly colored. The color of melanoma is heterogeneous, from light brown to almost black.
D Diameter (diameter). Moles are usually less than 6 mm, melanomas are larger. It can be compared with the diameter of an eraser on a pencil.
E
Evolution (changes in dynamics):
E Elevation. If the neoplasm rises more and more above the surface of the skin over time, this may indicate its malignant nature.
F Firmness (density). Benign nevi are usually soft to the touch and easily displaced relative to the surrounding tissues. Melanomas are dense and difficult to move.
G Growth (growth). If the neoplasm increases, this is an alarming sign.