Melanoma is a type of skin cancer that, if detected early, can be cured. Melanoma begins in certain cells in the skin called melanocytes. When skin is exposed to the sun, melanocytes produce more pigment, causing the skin to tan or darken. Benign (not cancerous) clusters of melanocytes are called moles. Moles are very common and most people have between 10 and 40 of these brown, tan, or black areas on the skin. Moles can be flat or raised. They are usually round or oval and smaller than a pencil eraser. Melanoma occurs when melanocytes become malignant. Often the first sign of melanoma is a change in the size, shape, or color of an existing mole. It may also appear as a new, abnormal, or "ugly-looking" mole. In general, the prognosis for this cancer is best predicted by the thickness of the melanoma. Melanoma is not contagious. Research does prove that ultraviolet radiation from the sun causes skin damage which can lead to melanoma. Having two or more relatives who have had this disease is a risk factor because melanoma sometimes runs in families. People who have had one or more severe, blistering sunburns as a child or teenager are at increased risk for melanoma. Melanoma occurs more frequently in people who have fair skin that burns or freckles easily. To help prevent melanoma, people should avoid exposure to the midday sun. Also, sunscreen with a 15 or higher sun protection factor (SPF) can help prevent sunburn.

Thinking of your ABCD's can help you to remember what to watch for in detecting melanoma. Asymmetry is where the shape of one half of the mole does not match the other. The border or the edges are ragged, notched, or blurred. The color is uneven. Shades of black, brown, and tan may be present. Diameter is a change in the size.

The Sunbelt Melanoma Trial (SBMT), a nationwide, multi-center clinical trial, was organized in July of 1997 by surgeons at The University of Louisville to more clearly define patients most likely to benefit from interferon. Interferon, a cancer-fighting drug and a substance already present in small amounts in the body, is expensive and may have significant side effects. Recent scientific data has confirmed that treating patients with melanoma cells in their lymph nodes with interferon improves their cure rate. Mobile Infirmary became involved in SBMT to more clearly define the patients most likely to benefit from interferon. Eligibility criteria includes melanoma greater than one millimeter in thickness and age less than 70. According to local investigator B. Scott Davidson, M.D., during the first 12 months of the trial 15 patients were enrolled in the Sunbelt Melanoma Trial underway at Mobile Infirmary Medical Center.

Treatment for a melanoma depends on the extent of disease, the patient's age, general health, and other health factors. If a doctor suspects that a spot on the skin is melanoma, the patient will need to have a biopsy. If a large area of tissue is removed, a skin graft may be done at the same time. For this procedure, a doctor uses skin from another part of the body to replace the skin that was removed. The doctor may also take out nearby lymph nodes, which are small, bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells.

Minimally invasive (meaning a small incision) technology has been used by surgeons at Mobile Infirmary Medical Center since 1996 in patients with melanoma. This process, called sentinel lymphadenectomy, involves the injection of a radioactive tracer near the melanoma site followed by a small incision over the lymph nodes closest to the melanoma. Then, using a special scanning device, surgeons are able to identify at a very early stage the one lymph node where the melanoma would most likely spread. A larger operation is performed if the lymph node contains cancer cells. Detection of this spread at an early stage may help identify patients who are most likely to benefit from interferon and avoid treatment in those who will not benefit.

The department of cancer services at Mobile Infirmary Medical Center is committed to providing quality, state-of-the-art care for patients with melanoma and remains on the forefront of clinical research.

If you would like more information regarding the Sunbelt Melanoma Trial or have any questions, please call Mobile Infirmary Medical Center's research services department at (251) 435-4452.