Malignant melanoma, the malignant black skin cancer, is a tumor that mainly occurs on the outer skin. The incidence of skin cancer is constantly increasing. Today, around one in 75 people will develop melanoma in the course of their lives.
Below you will find further information and selected melanoma specialists.
The malignant changes in melanoma originate in the pigment-forming cells of the skin, the melanocytes. These skin cells are particularly sensitive to UV radiation. The German Cancer Center therefore considers excessive sun exposure to be one of the main causes of skin cancer.
Heavy UV exposure and recurring sunburns in childhood and adolescence massively increase the risk of melanoma. People with the following are particularly at risk of sunburn and skin cancer
Other risk factors are
In most patients, the tumor develops from an existing mole. A melanoma is therefore usually darkly pigmented.
Only rarely are so-called amelanotic melanomas found, which have no pigmentation. These mainly occur on the hands or feet.
At the time of diagnosis, the majority of skin cancer patients have no symptoms. Most tumors are diagnosed during screening examinations. Only sometimes do patients notice a slight itching or minor bleeding beforehand.
Basically, malignant melanoma can be divided into different types. The differentiation is based on
The following types of melanoma are distinguished:
Mucosal melanomas, choroidal melanomas in the eye and melanomas of the meninges are also possible, but rather rare.
It is not always clear at first glance whether it is just a normal mole or a melanoma. However, an initial rough distinction can be made using the so-called ABCDE rule:
If one or more criteria of the ABCDE rule are met, you should urgently consult a dermatologist.
It is also advisable to have a cancer screening examination of the skin carried out by your family doctor or dermatologist every two years. The doctor will then examine the suspicious moles with a dermatoscope. This enables them to assess the exact pigment structure of the moles.
Dermatologists check the patient's existing moles during skin cancer screening © LIGHTFIELD STUDIOS | AdobeStock
If the suspicion of cancer is confirmed, the affected area is surgically removed under local anesthesia and examined under a microscope.
If the diagnosis of "melanoma" is then confirmed, the tumor thickness according to Breslow must be determined. This is the most important prognostic factor for skin cancer.
If the tumor is thicker than one millimeter, a spread diagnosis must be carried out. The aim of this is to detect metastases in other organs and lymph nodes at an early stage. This includes, for example
are used.
The therapy depends primarily on the stage of cancer diagnosed.
The most important form of therapy is surgical removal of the malignant melanoma. The tumor is always removed as a whole to prevent metastasis. When removing the tumor, a sufficiently large safety margin of one to two centimetres should also be ensured.
From a tumor thickness of one to 0.75 millimetres, the surgeon also removes the so-called sentinel lymph nodes. These are the lymph nodes that first come into contact with the lymph fluid from the tumor area. If the sentinel lymph node is also affected by the cancer, the surrounding lymph nodes are also removed.
If the tumor is thicker and the lymph nodes are affected, the patient is recommended adjuvant therapy. The patient receives interferon alpha over a period of 18 months. This is a chemical substance that is intended to prevent a possible tumor recurrence (recurrence of the cancer).
If the tumor has already metastasized, a complete cure is unlikely. The therapy then aims to prolong the patient's life. In addition to chemotherapy with cytostatics (cell growth inhibitors), the following are also used
Another therapeutic method for the treatment of malignant melanoma is the stimulation of the immune system with antibodies. If this is successful, the immune system itself can fight the malignant cells. Various immunotherapeutic procedures are also currently undergoing clinical trials.
Malignant melanoma is the most aggressive and malignant tumor of the skin. Compared to other types of skin cancer, malignant melanoma metastasizes to other organs at a very early stage. The chances of recovery therefore depend on various factors.
Particularly decisive for the prognosis is how advanced the disease is at the start of treatment. The tumor thickness according to Breslow and the depth of penetration according to the so-called Clark level play an important role here. If the melanoma is still small and growing rather superficially, the prognosis is quite good.
The chances of recovery deteriorate if the tumor has already spread beyond the dermis (middle layer of the skin). If there are metastases in
liver, a cure is virtually impossible.
The ten-year survival rate for malignant melanoma is around 80 percent. This means that 80 percent of all patients are still alive ten years after diagnosis.
In the case of lymph node metastases and metastases in other organs, however, the ten-year survival rate is only ten to 20 percent.
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