INTRODUCTION: Melanoma is a condition in which malignant (cancer) cells form in the skin cells called melanocytes (cells that give the skin color). It can also occur in the eye and is called intraocular or ocular melanoma; however it can happen anywhere on the body. It is the most dangerous of the common forms of skin cancer and oftens appears as a growing coloured skin spot, usually occuring in adults, but it is sometimes found in children and adolescents. The disease is more aggressive than basal cell skin cancer or squamous cell skin cancer.

CAUSE: Melanoma is caused by a combination of genetic predisposition and external factors such as ultraviolet exposure. Heavy exposure to the sun is the most important factor in development of the disease. UV radiation causes damage to the DNA of cells, typically thymine dimerization, which when unrepaired can create mutations in the cell's genes. Genetic analysis has shown that 92% of all melanoma are caused by this indirect DNA damage. This however does NOT mean that sunburn is the cause of this cancer. It is one of the rarer types of skin cancer but causes the majority of skin cancer related deaths especially if it is found late. At this time, the causes are not fully understood.

TYPES: There are 4 kinds of melanoma--each with its own set of symptoms. (A)Superficial spreading melanoma: small lesions with irregular border and brown, red, white, blue or blue-black spots on trunk or limbs. (B)Nodular melanoma: shiny, firm, dome-shaped brown, black or pink bumps any place on skin. (C)Acral lentiginous melanoma: irregular brown to black flat lesions on palms, soles, tips of fingers or toes and mucous membranes; can also be a brown or black streak under a finger or toe nail. (D)Lentigo maligna melanoma: large brownish irregular spot with darker speckles on skin overexposed to sun, especially the face or arms.

SYMPTOMS: The key to treating this disease is recognizing the signs early. People who see any of the following symptoms should report them to their MD immediately: an existing mole or dark patch that is getting larger or is a newly growing mole with a ragged edge, a mole with a mixture of different shades of brown and black. Contact your health care provider if you see any symptoms of melanoma, especially the following: If any existing skin growth changes in color, size, or texture, If an existing lesion produces pain, swelling, bleeding, or itching. Remember however that the majority of melanomas have no symptoms when they are found.

TREATMENT: Successful treatment depends on many factors, including the patient's overall health and whether the disease has spread to the lymph nodes or other organs. After diagnosis and staging (the determination of the extent of the disease), the MD develops a treatment plan to fit each patient's needs and is usually aimed at shrinking the tumor and improving symptoms.

Treating advanced (stage III) melanoma may necessitate surgical removal of the tumors and any affected lymph nodes, followed by systemic or local chemotherapy with one or multiple agents. In some cases, a person may live many months or even years with metastatic melanoma (depending on the aggressiveness of the treatment). An experimental treatment developed at the National Cancer Institute (NCI), part of the National Institutes of Health in the United States was used in advanced (metastatic) melanoma with moderate success.

PROGNOSIS: The prognosis (chance of recovery) and treatment options depend on the following. The stage of melanoma: whether cancer is found in the outer layer of skin only, or has spread to the lymph nodes and/or to other places in the body. If the cancer has spread to other areas of the body, the best treatment is to remove the cancerous tissue if possible.

The five-year survival rate for treated Stage III patients is about 60%, and both the cancer and the treatment often compromises quality of life. A licensed MD should be consulted for diagnosis and treatment of any and all medical conditions.

CONCLUSION: Melanoma is a cancerous tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye (uveal melanoma). It usually is seen as an irregular brown, black and/or red spot, or an existing mole that starts to change color, size or shape. The disease is more likely to be caused by intense exposure to sunlight in early life. They can be any place on your body and is uncommon in the Aboriginal, Asian and African races.

This condition, as with other skin cancers, are only very rarely irritating to touch and often do not look bad at first. The most serious form of skin cancer, it is also the fastest growing cancer in the USA and accounts for almost 3% of all newly diagnosed cancers annually. It ranks 6th in cancer incidence in males and 7th in females, and these incidences have doubled in the past ten years.

Melanoma can affect individuals in their 20's and 30's but the average age at the time of diagnosis is between 55 to 57 and is the most common cause of death from skin cancer. Around 160,000 new cases are diagnosed worldwide each year, and it is more frequent in males and caucasians.

According to the World Health Organization Report about 48,000 melanoma related deaths occur worldwide per annum. They are very dangerous and they kill thousands of Americans each year. Today, they are found only after they become visible on the skin. In the future, however, doctors will hopefully be able to find them based on a person's genotype (The genetic constitution of an individual), not just his or her phenotype (The entire physical, biochemical, and physiologic makeup of an individual).

The most important way to prevent it is to limit your sun exposure while routine examination of the skin by both you and your physician increases the chance of finding this condition early should you develop it.