Melanomas are malignant tumors that develop from melanocytes, the cells in our skin that contain dark pigment and determine how dark our skin is. Rarely they can arise from other cells which contain melanin, such as those in the back of the eye.
There has been a rapid increase in the incidence of melanomas in recent years: an estimated 300 percent increase in the past 40 years. About 35,000 new cases are diagnosed every year in the U. S., and about 7,000 people will die annually of the tumor.
Melanomas are seen mostly in white people. Dark skinned people of Indian, African, or Asian origins have about one-tenth the likelihood of developing melanoma. It is also a tumor that tends to run strongly in families; having one first-degree relative (parent, sibling or child) who has had a melanoma raises your risk tenfold. Having two first-degree relatives
with the disease is estimated to carry more than 50 times the risk of developing the tumor.
The other major factor that seems to play a role in the development of melanomas is sun exposure, particularly severe sunburns before the age of 10. People with similar ethnic backgrounds who immigrate to a sunny country, such as Israel, after childhood have lower rates of melanoma than similar people born there, or who immigrate as children.
Melanomas usually develop in moles, and people with many moles are at greater risk. For this reason, a doctor examining your skin will pay particular attention to moles. Benign moles are usually of a uniform brown or tan color, are mostly round with a distinct border, are small, less than 6mm in diameter, and will number from ten to fifty in a typical adult.
Moles that are worrisome and should be checked by a doctor are those that are multicolored, particularly if they were originally uniform in color, those with irregular and perhaps indistinct outlines, are greater than 6mm in diameter, and are numerous.
Because melanomas occur on the skin where they are quite visible, they should be caught early if everyone were to inspect their skin regularly. Once the tumor has grown beyond the uppermost layer of skin and penetrated into the deeper layers they are very prone to metastasize, that is spread widely in the body, and chemotherapy has not proven to be very successful in treating melanomas. The immune system is thought to be very important in controlling melanoma metastases; a great deal of research is going on to try to develop ways to strengthen the immune system or to immunize patients against their melanoma, so that the immune system will kill the melanoma cells.
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