The number of skin cancers in the form of melanoma, or black skin cancer, is constantly increasing. Meanwhile, this number even doubles almost every seven years. However, there are clear regional differences in the disease of melanoma.
What is melanoma?
Malignant melanoma or black skin cancer is a highly malignant tumor of the pigment cells (melanocytes). The term “malignant melanoma” comes from the Greek, where the word “maligne” means “black.” Therefore, it is also called black skin cancer. It is a particularly malignant tumor disease of the pigment cells. The aggressiveness of melanoma is increased by the early formation of metastases, which spread throughout the body via the blood and lymph channels. The black skin cancer can affect not only the skin, but also the eyes, mucous membranes, internal organs or the central nervous system. The number of cases of melanoma is only constantly increasing worldwide, but it is also the disease that most often leads to death.
Causes
The main cause of melanoma is strong UV radiation from the sun. However, one reason of the increasing black skin cancers is not only the increasing UV radiation due to the decreasing ozone layer, but also the changing leisure activities. Vacation trips of fair-skinned people to warmer countries, excessive sunbathing and sports performed in blazing sun increasingly expose people with sensitive skin to aggressive solar radiation. The beauty ideal of tanned skin, which is equated with health and vitality, means that educational campaigns do not have the desired success. However, certain risk factors can increase the likelihood of melanoma. Particularly noteworthy would be severe childhood sunburns, fair-skinnedness, freckles, tendency to sunburn, DNA disorders, family history of black skin cancer, or previous melanoma.
Symptoms, complaints, and signs
Schematic diagram showing the anatomy and structure of the skin with black skin cancer. Click to enlarge. In most cases, black skin cancer is diagnosed without the affected person noticing any symptoms. This is due to the fact that melanoma rarely presents with symptoms that are not purely visual. Thus, in rare cases, a melanoma may bleed, ooze, itch or otherwise feel uncomfortable. A malignant melanoma can also develop underneath a nail. In this case, discoloration may appear, followed later by detachment of the nail. Basically, all changes of pigment spots and birthmarks are a tending sign for the development of skin cancer. The rule is that all spots that visibly change or differ from other spots are worrisome. For example, black skin cancer tends to grow in a raised manner (occasionally with nodule formation), to grow in one direction, and to not be as sharply demarcated from the skin as moles and pigmented spots. Rather, there is a blurred transition into the surrounding skin. If a birthmark grows suddenly, this is also a possible symptom. The same applies to birthmarks, which show different colorations within themselves. Black skin cancer is not limited to black discolorations, but can also turn out brownish, yellowish or reddish.
Diagnosis and progression
Indications of melanoma may be enlarged, color-changed or itchy moles. But also color changes of whole skin areas can be an indication of black skin cancer. In very dark-skinned individuals, melanomas tend to occur on the lighter-skinned areas of the skin, such as the palms of the hands or on the mucous membranes. Regular self-examination of conspicuous skin areas can contribute to early detection. In the case of abnormalities, the exact diagnosis is made by a dermatologist with the help of microscopic images. There are five criteria that can indicate melanoma. These are: an asymmetric shape, a fuzzy or irregular border, multicolor, large diameter (more than 5mm) and a raised appearance of the skin site. The course of melanoma initially begins with enlargement at the affected site. This is followed by scattering to other parts of the body, including organs.
Complications
Metastases to various organs are the most common complications of black skin cancer. While early-stage melanoma is still easily treatable, the likelihood of daughter tumors increases steadily as the cancer grows. Liver and brain metastases in particular are difficult to treat and reduce life expectancy; malignant heart tumors also frequently originate from malignant melanoma. Lymph nodes, skeleton and lungs can also be affected by metastases, which can be manifested by headaches, rapid fatigability, seizures, a tendency to fracture bones and shortness of breath on light exertion, among other symptoms. Without treatment, daughter tumors arising from black skin cancer usually lead to death within a few years. The only chance of cure is early surgical removal of the causative skin tumor, which in rare cases may also be associated with complications: Surgery on a tumor that has already penetrated far into the tissue can result in functional limitations in the affected area, and secondary bleeding, wound healing disorders and excessive scarring are also possible consequences. If nerves are injured, it is not uncommon for paralysis and sensory disturbances to occur, which may regress but may also be permanent. In individual cases, radiation, chemotherapy, or immunotherapy is necessary to prevent further spread after surgery, which can weaken the immune system and severely impair general well-being.
When should you see a doctor?
Melanoma is always a case for a doctor’s visit, because black skin cancer spreads to surrounding tissue structures faster than it appears. At first glance, a melanoma often appears harmless and is often mistaken by patients for a birthmark, especially since melanomas can also arise from pre-existing changes in the skin. Under the skin surface, however, the cancer has access to the lymphatic system and can thus quickly spread to other organs if it is not detected in time and surgically removed. In particular, people with many moles and pigmented spots should regularly check the affected areas of skin for changes. If a birthmark increases in size, changes color, appears raised or otherwise alters its visual appearance, this should be clarified by a dermatologist. The dermatologist will first take photos of the area and document the development. If, on the other hand, such a skin area bleeds for unexplained reasons, is more sensitive than usual or causes pain, the doctor must quickly clarify whether it is a melanoma. Even if melanoma is already known, those affected should regularly keep an eye on the surrounding skin areas. If moles change or new ones appear, the attending physician should examine them and determine whether they are harmless changes or new melanomas.
Treatment and therapy
When treating melanoma, it is important to diagnose it as early as possible. If it is completely removed at an early stage, the chances of a complete cure are very high. The most important form of treatment is surgery. Here, the melanoma is removed as completely as possible. This means that a safety distance of about 1 to 2 cm, depending on the size of the skin cancer, is maintained. Also, the melanoma must be removed in depth, if possible, down to the muscle. Sampling for biopsy is not done to avoid spreading the black skin cancer. In the case of melanoma on the face, the safety distance can also be replaced by an incision procedure controlled under a microscope. This prevents disfigurement of the face. However, if the melanoma has already metastasized, the chances of cure are very low. Different therapy methods are used, such as chemotherapy, immunotherapy, vaccination or radiation therapy. However, these usually lead only to a short-term improvement in the state of health. Further surgical procedures may also be performed to remove newly formed tumor cells of melanoma.
Outlook and prognosis
People between the ages of 40 and 60 are considered to be in the risk group for developing the disease. They are disproportionately likely to be diagnosed with melanoma. Men usually develop the disease on the back, and women on the lower leg. The prognosis is favorable if the tumor is removed at an early stage. Metastases have then not yet formed.An exclusively superficial growth can be treated successfully. Statistically, the diagnosis of “black skin cancer” affects one in five hundred Germans. Ten years after diagnosis, about 90 percent of the men and a good 95 percent of the women affected are still alive. The deaths are usually due to the fact that metastases have spread to the organs. If metastases have formed in the liver, lungs or brain, there is a high probability of death within the next few years. The size of the melanoma is also an indicator of the chances of survival. Characteristically, it grows in a non-specific way. If the extension is only one millimeter, the chances of survival are considered very good. The small size indicates a tumor in the initial stage. With larger growths, the chance of cure decreases continuously.
Prevention
To prevent the development of melanoma, intense UV radiation to the skin should be avoided. This applies to both natural sunlight and artificial UV radiation in solariums. To protect against intense UV radiation, sun protective clothing, hats and sunglasses should be used. Furthermore, the use of sun creams with a high sun protection factor is of course recommended. This is especially true for children. In order to detect skin changes at an early stage, regular self-examination is helpful. However, this does not replace a regular visit to a dermatologist.
What you can do yourself
Melanoma, which is also called black skin cancer, must be treated by a doctor. It is advisable in everyday life that people pay attention to changes in their skin. In particular, changes in moles and changing pigmentation of the skin should be closely observed and examined by a physician. As a general precaution, the skin should be protected from strong sun exposure, as UV radiation promotes the occurrence of melanoma. This measure is important for the prevention of melanoma, but it should also be followed if the individual is already suffering from melanoma. As with most cancers, it is not only the body that is affected by the disease, but also the mental well-being can be affected. A functioning social environment is important for those affected. Friends and family play an essential role during the healing process. In addition, those affected can seek psychological help. This help can take the form of psychological support or participation in a support group with other sufferers.
