Melanoma: skin cancer

Melanoma is a malignant tumor that develops from cells responsible for producing melanin, called melanocytes .

As many men as women are affected by melanoma and the average age of diagnosis varies between 40 and 50 years.

This attack of the pigmentary system of the skin can, in rare cases, affect other parts of the body, among others under the nails .

In 2019 and according to Santé Publique, 15,513 new cases of skin melanoma were diagnosed. Diagnosis of melanoma at a late stage makes treatment more difficult: its high metastatic potential is in question.

Most of the time, melanoma appears as a brown or blackish colored spot . These spots are neither painful nor itchy (i.e., they don’t itch ).

In the elderly , melanoma lesions most often appear on the face and neck and follow chronic sun exposure. On the other hand, in the adult subject, it is above all the back and the trunk which are affected and this is secondary to voluntary and intermittent exposure.

In the beginning, the cancer cells are located on the surface of the skin and the cancer is in situ. When these cells spread to deeper skin layers, it is called invasive melanoma . In the absence of appropriate care, cancer cells can migrate via the lymph to the lymph nodes and then to other organs where they will form metastases.

Melanoma is a multifactorial pathology:

• Exposure to solar ultraviolet rays : the total dose of UV rays received is cumulative and defines the carcinogenic risk . A history of sunburn as well as the fact of sunbathing with difficulty accentuate sensitivity to ultraviolet rays (which is the case of phototypes I and II ). The lighter your eyes, skin and hair, the greater the risk of melanoma.
• Depletion of the solar capital: from a certain moment, the natural capacity of the cutaneous cells is altered and mutations take place.
• The use of tanning booths: artificial tanning is thus one of the confirmed risk factors for melanoma, particularly in people who started before the age of 35.
• Occupational exposure: outdoor work with intermittent exposures and without adequate protection, radiation exposure among healthcare professionals, contact with certain chemical substances.
• Personal and/or family history (first-degree relative having had cutaneous melanoma) of skin cancer.
• A significant number of moles (more than forty): any mole that no longer resembles the others must alert.
• Certain pathologies and immunosuppressive treatments

It is important to know that the vast majority of cutaneous melanomas develop on skin that does not show any lesions or particular spots , that is to say skin that appears to be completely healthy. This supports the importance of a regular examination once a year by a specialist dermatologist. Any new appearance of a suspicious brown spot -type lesion should therefore alert people to the risk of melanoma.

More rarely, melanoma will develop from a mole already present on the body. Any change in their appearance ( mole that increases in size or shape, changes color, thickens) should prompt a quick consultation.

Self-examination for any patient at risk is of paramount importance. It is recommended to do it every 3 months. This self-examination is based on the ABCD rule:

• A: Asymmetry
• B: Jagged edges
• C: Uneven color
• D: Increasing diameter

During your consultation with your dermatologist in Paris , a clinical examination of your skin is carried out as well as a dermoscopy in order to study the lesion.

If the suspicion is confirmed by this examination, excision of the lesion under local anesthesia will make it possible to carry out a microscopic and then anatomopathologic examination. The result affirms or invalidates the diagnosis of melanoma. The type of melanoma is then determined in order to decide on the therapeutic approach.

The treatment of melanoma involves dermatological surgery : this is the treatment of choice for early-stage melanoma .

A second local and large excision aims to remove a safety margin around the lesion in order to avoid the risk of recurrence. Following your treatment, a personalized follow-up is scheduled.

At Clinique Skin Marceau, the price of melanoma skin surgery is between €450 and €700. The exact estimate is given to you before any treatment.