Melanoma – Orange County, CA – UC-Irvine

Melanoma is an aggressive form of skin cancer arising from pigment producing cells called melanocytes. Melanocytes are mainly found in the skin, but can also be found in other areas of the body including the eyes, ears, and oral membranes. The incidence of melanoma continues to rise, not only in the US, but throughout the world. Melanoma has a worse prognosis than other forms of skin cancer with statistics showing that melanoma is the cause of 65% of deaths resulting from skin cancer.

Melanomas of the head and neck most commonly occur on the face, with the cheek being the most common site of occurrence. Men are twice as likely to develop melanoma in the head and neck region. Most cases of melanoma occur in older adults. The 5 year survival rate following diagnosis of melanoma in the head and neck region is 17% at 5 years and 5% at 10 years.

Risk Factors of Melanoma:

Before discussing the risk factors of melanoma, it’s important to understand that you can develop melanoma without having ANY risk factors, although this is rare, and you could potentially have, or be exposed to, several risk factors and NOT develop melanoma. For example, melanoma is more commonly seen in people with fair complexion BUT even those with darker skin can develop melanoma. This means that you should be more aware of any potential skin growths regardless of whether you have a risk factor or not. If you DO have one or more risk factors, you should also discuss them with one of our highly experienced, board-certified head and neck specialists. Risk factors of melanoma include:

• Fair skin that freckles and burns easily, does not tan, or tans poorly
• Light Colored Eyes, Blue Eyes, or Green Eyes
• Red or Blond hair
• Excess natural or artificial (tanning beds, etc..) sunlight exposure for long periods of time
• Exposure to environmental risk factors such as radiation or vinyl chloride
• History of blistering sunburns
• Having several moles yourself or a family history of unusual moles
• Family or personal history of skin cancer
• Being Immunocompromised (weakened immune system)
• Genetic changes linked to melanoma

Signs and Symptoms of Melanoma:

The most common warning sign for melanoma is a new mole or a mole that is changing. Our highly experienced Head and Neck Cancer specialists advise patients to know where they have moles on their skin. This will help spot an irregular mole in an irregular location early on which leads to a more favorable prognosis if it is diagnosed as skin cancer and treated.

The American Cancer Society developed the ABCDEs to serve as a simple guideline of early melanoma warning signs.

• Asymmetry: one half of the lesion is different than the other half.
• Borders:  irregular borders with ragged or blurred edges.
• Color: when the color is not uniform and/or noticeable white/red/blue discoloration is seen.
• Diameter: greater than 6mm diameter or any growth in a mole warrants an evaluation.
• Evolving: any mole that changes over time is a big warning sign, even if it doesn’t feature any other signs.

The ABCDE’s of melanoma are by no means a comprehensive guide of signs of melanoma. Any new growths on the skin that don’t look like the rest of the moles on your skin should be treated as a warning sign of skin cancer. Other warning signs of melanoma are:

• A persistent growth or sore
• Spread of pigment beyond the border
• Redness or swelling beyond the border
• Itchiness, tenderness, or pain in the area
• Scaling, oozing, or bleeding from a mole

Diagnosis of Melanoma at UC-Irvine:

As with most disorders the initial workup is key for patients with melanoma. The initial diagnostic workup of a patient suspected of having melanoma includes a detailed medical history and targeted physical examination. If melanoma is still suspected following the history and physical examination then a biopsy will have to be performed using a sample of the indicated area for histological examination.

Medical History: This will involve a candid discussion between patient and doctor, with the main focus being on the indicated area. One of our highly trained and experienced Head and Neck Cancer experts will ask questions including when the growth/mark first appeared on the skin, any changes in size or appearance, and any associated symptoms such as itching or bleeding will be discussed. Other key data includes any past history of skin cancer or exposure to risk factors of skin cancer (tanning, occupational sun exposure, etc…), as well as if there is any family history of skin cancer.

Physical Exam: Will target on the affected area noting the characteristics of the growth/mark including its size, shape, color, and texture. Any scaling or bleeding will also be an important sign for diagnosing a potential melanoma. Other areas of the body will also be inspected for the presence of similar growths/marks. Lymph nodes near the affected area will be palpated to see if they have enlarged or become more firm, a sign of cancer having spread to the nodes.

Biopsy: A biopsy is a quick technique used to remove a sample of the affected area for detailed laboratory analysis. For suspicious growths/marks, a biopsy is essential for adequate diagnosis and staging. The prognosis and treatment of melanoma depends on its thickness and severity, so the biopsy is the most important aspect for both diagnosis and treatment of melanoma.

Diagnostic Tests: Here at UC-Irvine, our dedicated Head and Neck Cancer specialists pride themselves on thorough evaluation of any patient suspected of having cancer. Because cancer can spread through tissue, through the lymphatic system, and through blood vessels, CT scans, PET scans, and blood tests may be performed to see if the cancer has spread to other areas of the body.

The results of all diagnostic tests, including the tumor biopsy, are analyzed to find out the stage of the melanoma. This allows a specific cancer treatment plan to be designed with your individual needs in mind.

Melanoma Treatment in Orange County, CA at UC-Irvine:

UC-Irvine’s highly regarded Head and Neck Department is equipped to offer the latest cancer treatments and care available today. From diagnosis to treatment to recovery, our experienced Head and Neck Cancer specialists are thoroughly trained and educated in the safest and most effective methods of treatment for melanoma including: excision techniques, radiation therapy, and chemotherapy.

Surgical Excision: Surgical removal of the tumor continues to be the mainstay of melanoma treatment. This may be achieved through various techniques, including skin grafting, where healthy skin from another part of the body is used to replace skin that is removed. Adjuvant chemotherapy may be recommended to kill any cancer cells left over following the surgery.

Chemotherapy: a treatment technique that utilizes medications to kill cancer cells or stop them from dividing. If given orally or intravenously, the anti-cancer medications enter the bloodstream and attack cancer cells throughout the body. Anti-cancer drugs can also be directly injected into the cerebrospinal fluid or a targeted area to specifically target cancer cells in those areas as opposed to throughout the entire body.

Radiation Therapy: cancer treatment utilizing radiation administered through a machine or radioactive substance to kill cancer cells or disrupt cell growth. External radiation therapy is administered by a machine which directs radiation beams towards areas affected by cancer. Internal radiation therapy is administered via injection of a radioactive substance directly into or near the site of cancer. As with other forms of treatment, radiation therapy is indicated only in certain stages of melanoma.

Immunotherapy: also referred to as Biotherapy, this treatment technique utilizes the patient’s own immune system to fight the cancer. Natural and/or synthetic medications may be used to treat the melanoma. Interferon and Interleukin-2 are commonly used in melanoma treatment to boost immune cell response to kill cancer cells and slow tumor growth.

Our renowned Head and Neck Cancer Research Department here at UC-Irvine is constantly involved in research and clinical trials on the latest cancer treatment options. Depending on your specific case, you may be eligible for additional treatment options which will be discussed with you at length if indicated.