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Important factors in determining risk
Exposure during childhood is a more important risk factor than exposure in adulthood. (This is seen in migration studies in Australia where people tend to retain the risk profile of their country of birth if they migrate to Australia as an adult). Fair and red-headed people are at greater risk.
Some other risk factors include the " Dysplastic naevus syndrome ", previous history of melanoma, and history of melanoma in the immediate family.
Diagnosis of melanoma requires expert knowledge, as early stages may look identical to harmless moles or not have any color at all. Signs and symptoms of melanoma may include:
Features that affect prognosis are tumor thickness in millimeters ( Breslow's depth), depth related to skin structures ( Clark's levels ), type of melanoma, presence of ulceration, presence of satellite lesions, and presence of regional or distant metastasis.
With regard to tumor thickness at the time of diagnosis: thin melanomas (<0.75mm) have a good prognosis, i.e. they can usually be cured by surgical excision alone; tumors of more than 4 mm thickness at the time of diagnosis are very often metastatic and can show very aggressive growth.
Complete surgical excision with adequate margins and assessment for the presence of detectable metastatic disease along with short and long term follow up is standard. In metastatic melanoma chemotherapy (15-20% respond to dacarbazine , also termed DTIC), immunotherapyImmunotherapy is a disease treatment based upon the concept of triggering the body's own natural defenses to fight off the disease, usually by stimulating the immune system either locally or systemically. Oncology represents one of the most actively resea (with interleukin 2 or interferonInterferons (IFNs) are natural proteins produced by the cells of the immune systems of most animals in response to a challenge by a foreign agents such as viruses, bacteria, parasites and tumour cells. Interferons belong to the large class of glycoprotein) as well as local perfusion are used by different centers. They can occasionally show dramatic success, but the overall success in metastatic melanoma is quite limited. Radiation therapyRadiation therapy (or radiotherapy is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). Although radiotherapy is often u is often used after surgical resection for patients with locally or regionally advanced melanoma or for patients with unresectable distant metastases. In research setting other therapies, such as gene therapyGene therapy is the insertion of genes into an individual's cells and tissues to treat a disease, and hereditary diseases in particular. Gene therapy typically aims to supplement a defective mutant allele with a functional one. Although the technology is, may be tested.