Today marks World Day melanoma. It is the least common variety of skin cancerbut at the same time can be the most serious and is more likely to spread throughout the body. The incidence of this type of tumors has been increasing in recent years around the world, which has raised alarm among oncologists and dermatologists.
“It is a neoplasm that arises from the melanocytes, which are the cells that produce the pigment. It mainly affects the skin, although it can originate from the mucous membranes and eyes. Its incidence is increasing worldwidealthough in some countries like Australia, thanks to their prevention campaigns, they have shown a slight decrease. Argentina presents a sustained increase in incidence comparable to what happens in most of the rest of the world,” warns the oncologist Yanina Pflüger (MN 120531), head of the Melanoma and Sarcoma Service of the Alexander Fleming Institute (IAF).
The expert details that the people at greatest risk are those who have the phototype 1 (white skin and light eyes), while also elevating it ultraviolet radiation, due to excessive sun exposure or the use of tanning beds. “Other predisposing factors are multiple moles, sunburn in past decades and immunosuppression,” he lists.
Melanoma gives warning signs that make it possible to address it in time to access a treatment with better prospects for success. “As patients, we must be attentive when performing self-examination to any lesion that changes shape, color, size or begins to generate any symptoms such as itching, burning or stinging.
The key rule to prevent:
«There is a rule that is A B C D Eto remember everything that should draw our attention about a mole. A: asymmetry, B: irregular edges, C: irregular color, D: diameter greater than 6 mm, but for me the main one must be E: Evolution“, says the doctor Marcela Moreno (MN 106.685), head of the Oncological Dermatology Service of the IAF.
Patient self-examinations of the skin They should be monthly. The dermatologist emphasizes the concept that any lesion that evolves (that is, in which a change is noticed) should draw our attention.
If in doubt, consult. And it is also important to keep in mind that not all lesions that present any of these characteristics mean that they are or will be malignant.
Marcela Moreno (MN 106,685).
Your colleague Carolina Spinelli (MN 117.118), Dermatologist at the Cutaneous Oncology Unit of the IAFadds three more steps to the mnemonic. “In recent years we also added the letters EFG to stand out that when faced with an injury E (elevated), F (firm), and G that is growing (for Grow in English) in the last monthit should be present to rule out Nodular Melanoma, which is a type that grows rapidly invasively,” he explains.
How to take care of your skin:
When talking about prevention, experts agree that photoprotection It is the measure on which the most work should be done. “Mainly at an early age, since care for people under 20 years of age is essential. The first step is avoid exposing yourself during midday hours, especially in the times of the year with the highest temperatures, which is the one with the highest solar UVR index. If you do, do not forget the use of high sunscreens (factor 50 or more), renewing it every two hours. But it is very important to emphasize physical protection, through the use of appropriate clothing, hat and sunglasses,” explains Dr. Moreno. Another key indication is avoid the use of tanning bedswhose exposure is directly related to melanoma due to the ultraviolet radiation they emit.
The first step is to avoid exposing yourself during midday hours, especially during the hottest times of the year, which is the time when we have the highest solar UVR index.”
Carolina Spinelli (MN 117.118), Dermatologist.
As a general guideline, it is recommended perform clinical and dermoscopic dermatological control once a year, but the person who determines the periodicity is the dermatologist. “This will depend on the patient’s skin type, the number and type of moles they have, activities they carry out or carried out, a history of sunburns at an early age, whether they have a personal or family history of skin cancer and what type. The control of a patient with light skin, with multiple moles and a history of significant photoexposure due to the activities she carries out, is not the same as a patient with a higher phototype with very few moles. In both cases they must have periodic control, but in the latter it can be more relaxed”clarifies the IAF expert.
Dr. Spinelli emphasizes that control must be of the entire skin with a handheld dermatoscope. If the patient has a history of melanoma or more than more than 100 nevi (as new lesions are known) or atypical nevus syndromeyou will be indicated for total body digital dermoscopy, known among patients as mole mapping.
Patients who have had cutaneous melanoma have a higher risk of developing a new one, warns Dr. Yanina Pflüger. “They also have a higher risk of developing non-melanoma skin carcinomas, since their risk factor for skin phototype and sun photodamage is shared,” she adds.
In the case of children, It is the pediatrician who carries out the control. In certain circumstances, such as the presence of a giant congenital melanocytic nevus or atypical nevus syndrome, you will be referred to a specialist for a more specific evaluation.
How is the treatment:
“Treatment will depend on the instance in which melanoma is diagnosed. Localized injuries should be initially operated for complete resection. And in many cases the regional lymph node area must be surgically studied. If the resection has been complete, the need to add subsequent systemic treatment for a year will subsequently be evaluated,” explains Dr. Pflüger and adds that when detection occurs in advanced instancessystemic treatment with targeted therapy or immunotherapy is indicated.
Within these new treatments, the head of the Melanoma and Sarcoma service at the IAF highlights that in recent decades there has been an increase in the approvals of new melanoma therapies that are already widely disseminated and in use for patients. “There are new molecules in development that are generally being tested in clinical trials and many of them are used in combination. In this way we try to have not only new options but also improve the effectiveness of current therapies,” she adds.
Within the framework of World Melanoma Day, which is commemorated this May 23, experts promote the importance of disseminating and complying with prevention guidelines, with the aim of improving the current situation of patients and the global scenario of this type of tumors. “Statistics continue to report year after year the increase in the number of cases of skin cancer, but this could correspond to patients over 40 years of age who were exposed to the sun inappropriately during their childhood, adolescence and early adulthood, which is the time What greater sun exposure we have, and of greater importance when talking about photoprotection, concluded Dr. Marcela Moreno.
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