The known warning signs for malignant melanoma include the appearance of an evolving mole or freckle that is asymmetrical with uneven or notched edges. This mole has a large diameter of more than 6mm and maybe a different shade of color, either darker or lighter, compared to other moles (Cole, 2020). The mole on Mr. J’s face is growing larger, darker, and has changed to be “bumpy” in just a month. These symptoms, when compared against the warning signs, suggest that Mr. J has malignant melanoma.
Skin cancer progresses in five stages, stages 0 through to IV. At stage 0, the cancer is at its initial stage appearing on the uppermost layer of the skin and is known as “melanoma in situ”. At stage I, the cancer may be between 0-2 millimetres thick whereas at stage II, it increases its thickness to between 1-4mm and may or may not have ulcerations (ACS, 2019). For stages III and IV, the cancer has advanced to the lymphatic system with the former affecting nearby lymph nodes only. At stage IV, the cancer is in its final stage and has spread to distant lymph nodes and organs such as liver, brain, or lungs. The American Cancer Society further highlights that the stage at diagnosis indicates how far the cancer has already spread in the body. For Mr. J’s complaint of pain in the shin when he puts his feet up or sleeps can be deduced to cancer, having affected his lymphatic system and aggressively spreading towards distant organs. This enables the classification of his melanoma as advanced-stage cancer, hence the need for immediate medical intervention.
Melanoma can be treated using the following four methods. Surgery is the most common form of treatment involving the removal of the tumour, normal tissues around it, and nearby lymph nodes. The depth and width of skin to be removed depends on the thickness of the melanoma. Chemotherapy involves the use of drugs given in cycles to kill cancer cells. Immunotherapy is a cancer-treatment technique that involves adjustment of the body’s immune response while radiotherapy uses ionizing radiation to kill cancer cells. Treatment options are determined by the stage of cancer one is suffering from. Leonardi et al (2017) point that surgical excision has proven curative for the majority of patients with early-stage cancer, while those at stage III and IV have lower probabilities of sustained response to treatment. Therefore, as cancer progresses, the prognosis of recovery declines with each stage.
American Cancer Society. (2019). Melanoma Skin cancer stages. Retrieved from www.cancer.org/cancer/melanoma-skin-cancer-stages.html
Cole, G. W. (2020). Melanoma: Introduction to a deadly skin cancer. Retrieved from www.medicinenet.com/melanoma/article.htm#what_is_melanoma
Leonardi G. C., Falzone, L., Salemi, R., Zanghi, A., Spandidos, D. A., McCubrey, J. A., Candido, S. & Libra, M. (2018). Cutaneous melanoma: From pathogenesis to therapy (Review). International Journal of Oncology 52(4), 1071-1080. DOI:10.3892/ijo.2018.4287