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Q: What information is there on when to have a skin mole removed from the back? ( Answered 5 out of 5 stars,   1 Comment )
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Subject: What information is there on when to have a skin mole removed from the back?
Category: Health > Conditions and Diseases
Asked by: ekim3-ga
List Price: $35.00
Posted: 20 Apr 2004 12:31 PDT
Expires: 20 May 2004 12:31 PDT
Question ID: 333242
I am looking for information on when a slightly irregular and
discolored mole of one-half and inch in length, located on the back,
should be removed and what are the chances of it developing into
malignant melanoma.  I am especially interested in research or other
information of the type a doctor would look at to know the current
thought and theory on this in the practice.
Answer  
Subject: Re: What information is there on when to have a skin mole removed from the back?
Answered By: crabcakes-ga on 20 Apr 2004 22:33 PDT
Rated:5 out of 5 stars
 
Hi ekim3,

 Very good question!  I?d like to precede my ?final? answer with this
?pre-answer?:  Any mole (also known as a ?nevi?) that changes shape,
size, color or appearance, or gives you concern, should be checked on
by a doctor.
http://www.cancerhelp.org.uk/help/default.asp?page=3012

Melanoma is a highly malignant form of skin cancer, usually beginning
in a mole. Melanomas stem from melanocytes- the cells that are
responsible for producing pigment, and can be examined by a doctor
using a kind of hand held microscope, called a dermoscope. However,
only a biopsy can accurately determine if a mole is cancerous. This
year, the American Cancer Society estimates there will be about 53,600
new cases of melanoma in the United States .
http://www.katesfoundation.com/resources/facts.htm

?Using data on the number of melanoma skin cancer cases each year and
the number arising from moles, researchers found the risk of any mole
turning into melanoma is small. The annual transformation rate of any
single mole was 0.0005 percent or less for both men and women under
age 40. That translates to about one case in 200,000. The
transformation rate rises significantly, however, for men over age 60,
to 0.003 percent, or one in 33,000. Still, the lifetime risk at age 20
of any mole developing into melanoma by age 80 is about 0.03 percent
(one in 3,164 for men and 0.009 percent (one in 10,800) for women.
Researchers believe these findings suggest there is a low risk of
moles turning into melanoma, especially in younger people, and say
excision of benign-appearing moles in people with no other associated
risk factors is of limited benefit
SOURCE: Archives of Dermatology, 2003;139:282-288
http://www.healthscout.com/news/1/8005786/main.html


?More than 77 percent of skin cancer deaths are from melanoma.
Advanced melanoma spreads to internal organs and may result in death.
One person each hour dies from melanoma. If detected in the early
stages, melanoma can usually be treated successfully. People in
southern regions, where the sunlight is more intense, are more likely
to develop melanoma than those in northern regions. Melanoma has also
been linked to excessive sun exposure in the first 10 to 18 years of
life. Other possible causes include genetic factors and immune system
deficiencies?
http://www.shadefoundation.org/updates.php


?Melan pigment is produced by these cells when exposed to sunlight as
part of the tanning process. Regular moles contain groups of
melanocytes. Melanoma begins when an individual melanocyte loses its
ability to regulate its own growth, like a copy machine with a broken
counting mechanism that continues to make copies even when you keep
pushing the stop button. With time the melanoma grows. The earlier you
find it and the thinner it is, the better the chance of complete
cure.?
http://www.cancer.med.umich.edu/learn/melinfo.htm
http://ww3.komotv.com/global/story.asp?s=1230296


Early detection is not always easy: Of all the moles in the United
States, only one in 20,000 to 200,000 is a melanoma, so searching for
an early-stage melanoma is a lot like looking for a needle in a
haystack. About half of melanomas occur in just 1 to 5 percent of the
population.
http://www.dukehealth.org/HealthPortals/cancer/tips/tip_20031104174043265

According to SkinSite, ?Most experts believe that atypical moles are
at higher risk of turning into melanoma as compared to normal
moles.Atypical moles should be removed immediately if they are
changing color, shape or size over a period of weeks to months. These
moles should also be removed immediately if they bleed or itch. These
signs all suggest that an atypical mole may have turned into a
melanoma.?
http://www.skinsite.com/info_atypical_moles.htm



To help you remember what to watch for in moles, think of the ABC?s :

A for Asymmetry
B for Border irregularity
C for Color variation
D for Diameter

If you have a mole that begins to grow suddenly, especially if one
side grows faster than the other, have it checked by a doctor. If the
outer edge of a mole becomes fuzzy and irregular, have it checked. A
normally brown mole that starts turning black, red, grey, blue, tan or
white means it needs to be checked! Other things to watch for are
moles that become itchy, moles that bleed or ooze, and moles that get
thicker than they were previously. Upon reaching the age of 20, moles
that increase in size, especially over 1 centimeter(1 centimeter =
0.394 inches)

The mole you described is larger than this, irregularly shaped, and
discolored. Keep in mind this does NOT indicate it IS melanoma, but it
does indicate that it should be examined by a doctor, and she/he will
determine if  a biopsy is indicated.
http://www.dermatology.org/molemelanoma/watch.html

You can see pictures of moles using the ABCD system here:
http://www.melanoma.com/melanoma/diagnosing/look/index.jsp

See 19 more examples here:
http://www.dermatology.org/molemelanoma/watch2.html


Melanomas are almost always caused by exposure to the sun, and the
most common site for melanomas are the legs, in a woman, and the on
the back for men. However, melanomas can develop just about anywhere,
and have been seen on the soles of feet.

http://web.ukonline.co.uk/ruth.livingstone/little/melanoma.htm#guide



Risk Factors:

From the American Cancer Society:
·Having moles, especially dysplastic nevi (atypical moles) or
congenital melanocytic nevi
·Having fair skin 
·Having a family history of melanoma 
·Being immunosuppressed 
·Having excessive exposure to ultraviolet (UV) radiation 
·Being over age 50. (However, younger people (ages 20 to 30) can be
diagnosed with melanoma and melanoma is one of the most common cancers
in people under age 30.)
http://www.personalmd.com/news/skin_cancer_013100.shtml




Treatment:
 
Diagnosing:
The following are tests a doctor may order when diagnosing melanoma: 
·?CT Scan - looks for melanoma in abdomen (bowel + liver) and chest
(lungs and lymph nodes)
·PET Scan ? looks for ?metabolically active? areas in the body which
may be melanoma
·MRI Scan ? Used (primarily) to determine if the brain has any melanoma involvement
·Bone Scan ? uses radioactive material to find if any bone involvement
with your melanoma
·Blood Work ? non-specific indicator that melanoma maybe involved in
several organ systems
·Sentinal Node Biopsy ? looks for involvement of lymph nodes that
melanoma may spread to from its primary site
·Ultrasound ? use of sound waves to try to make a diagnosis of
melanoma (usually in solid organs)
From Melanoma.org
http://www.melanoma.org/PatientInfo.jsp


Chemotherapy
?Chemotherapy is a cancer treatment that uses drugs to stop the growth
of cancer cells, either by killing the cells or by stopping the cells
from dividing. When chemotherapy is taken by mouth or injected into a
vein or muscle, the drugs enter the bloodstream and can reach cancer
cells throughout the body (systemic chemotherapy). When chemotherapy
is placed directly in the spinal column, a body cavity such as the
abdomen, or an organ, the drugs mainly affect cancer cells in those
areas.?
In treating melanoma, chemotherapy drugs may be given as a
hyperthermic isolated limb perfusion. This technique sends anticancer
drugs directly to the arm or leg in which the cancer is located. The
flow of blood to and from the limb is temporarily stopped with a
tourniquet, and a warm solution containing anticancer drugs is put
directly into the blood of the limb. This allows the patient to
receive a high dose of drugs in the area where the cancer occurred.
http://www.cancer.gov/cancerinfo/pdq/treatment/melanoma/patient/#Section_135


Surgery:
Eighty-five percent of melanomas are curable by surgical removal.

·Local excision: Taking out the melanoma and some of the normal tissue around it. 
·Wide local excision with or without removal of lymph nodes. 
·Lymphadenectomy: A surgical procedure in which the lymph nodes are
removed and eximined to see whether they contain cancer.
·Sentinel lymph node biopsy: The removal of the sentinel lymph node
(the first lymph node the cancer is likely to spread to from the
tumor) during surgery. A radioactive substance and/or blue dye is
injected near the tumor. The substance or dye flows through the lymph
ducts to the lymph nodes. The first lymph node to receive the
substance or dye is removed for biopsy. A pathologist views the tissue
under a microscope to look for cancer cells. If cancer cells are not
found, it may not be necessary to remove more lymph nodes.
http://www.cancer.gov/cancerinfo/pdq/treatment/melanoma/patient/#Section_135


Moh's surgery
Mohs surgical technique is a precise, tissue sparing procedure,
utilizing a microscope to examine each growth layer. The surgeon
visually examines each layer through the microscope, excising layers
of cancerous layers, as well as a margin of healthy nearby tissue. The
risk that melanoma may metastisize (spread) is dependant on its depth
of growth into the surrounding healthy tissue. Mohrs technique allows
the surgeon to remove a melanoma down to the last layer.
University of Michigan
http://www.cancer.med.umich.edu/learn/melinfo.htm
"Since Mohs is the only method now in use that checks the majority of
the surgical margins for residual tumor cells, it may provide a better
chance of getting rid of the tumors and preventing them from
recurring," says Dr. Washington. "At the same time, it conserves
tissue."
http://www.pslgroup.com/dg/2480E.htm
and
http://www.siteman.wustl.edu/patient/specialized_cc/skin_treatment.shtml

Melanomas that have not spread beyond the site at which they developed
are highly curable.
http://ww3.komotv.com/global/story.asp?s=1230296


Radiation
Radiation therapy may be used to treat melanoma, but it usually does
not cure melanoma, used instead to alleviate bone pain caused by
melanoma that has spread.
?External radiation therapy uses a machine outside the body to send
radiation toward the cancer. Internal radiation therapy uses a
radioactive substance sealed in needles, seeds, wires, or catheters
that are placed directly into or near the cancer. The way the
radiation therapy is given depends on the type and stage of the cancer
being treated.?
http://yalenewhavenhealth.org/library/healthguide/IllnessConditions/topic.asp?hwid=hw206439
Immunotherapy
?One type of therapy that has recently been successful in treating
advanced melanoma is immunotherapy. This type of therapy is based on
the concept of controlling a tumor by strengthening the body's natural
defenses against it. Immunotherapy for many types of cancer is in the
investigational phase. But researchers at the University of Pittsburgh
Cancer Institute (UPCI), a UPMC Health System program, developed an
immunotherapy for melanoma that undwerwent 15 years of testing across
the United States and was approved by the federal Food and Drug
Administration (FDA). The FDA-approved treatment available at UPCI
uses a drug called interferon alfa.
At UPCI, interferon alfa is used as a standard treatment aimed at
preventing melanoma relapse after surgery in patients with deep
primary tumors or with cancer that has spread to the lymph nodes.?
http://www.upmc.edu/healthmed/services/Cancer/Melanoma/Treatment.htm#Immunotherapy


According to Cancer Centers of America, immunotherapy stimulates the
body?s own immune response to cancer cells, enhancing the ability to
repair some of cancer?s damage.
http://www.cancercenter.com/melanoma/biotherapy-immunotherapy.cfm



Chemoimmunotherapy
Chemoimmunotherapy is the use of anticancer drugs combined with
biologic therapy to boost the immune system to kill cancer cells, and
is fairly new.

This University of Chicago study concludes that some patients may
achieve long term benefits from chemoimmunotherapy.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1634924&dopt=Abstract



Preventing Melanoma:

"Because skin cancer is avoidable and often highly curable with early
detection, a few simple rules will usually help avoid any serious
problems. First, avoid sun exposure. If your occupation or other
obligation forces you to be in the sun, wear a sun block that is
specifically labeled as blocking UV-B (ultraviolet-B) and preferably
also UV-A light rays, which are the most damaging to the skin.
This is especially important in white persons who easily burn from the
sun and rarely tan. Remember skin cancer risk increases proportionally
with lifetime cumulative sunlight exposure, so protect your children
from the sun as well.?
http://www.personalmd.com/news/skin_cancer_013100.shtml

Vaccine
Melacine is a melanoma vaccine: See an informative slide show here:
 http://www.fda.gov/ohrms/dockets/ac/02/slides/3838s1_03_corixa/sld001.htm

Melacine is available in Canada. ?The vaccine is administered as a
two-shot vaccination once a week for five weeks, with a two-week
break, and then a repeat of the weekly vaccinations for five weeks.
Patients who respond may receive therapy of one vaccination per month
for six months followed by less frequent maintenance vaccinations.?
http://www.corixa.com/default.asp?pid=product_detail&ID=27

Canvaxin melanoma vaccine is currently being studied in the US. (This
website was updated 3/3/2004)
http://www.cancervax.com/about/company.htm


Research:

Replacing Immune Cells Shrinks Tumors in Patients with Melanoma
http://www.mpip.org/topframeset.shtml?http://newscenter.cancer.gov/pressreleases/melanomavaccine.html



This MelanomaWeb  site has a very well done animated (Java)
illustration of  one of its current research project (only the first
one is active right now):
http://www.melresproj.com/index-02.html

?To date, Interferon-alpha treatment is one of the leading treatments
for melanoma. However,
given its often severe medical side effects, high-dose
Interferon-alpha treatment remains somewhat controversial.?

?Gene chips are developed that could revolutionize the way
pathologists diagnose melanoma and atypical nevi (moles). These chips
are outstanding research tools because they provide
the researchers with a way to listen to the ?talk? of tumor cells.
Each chip contains 60,000 gene fragments, or tests for 5,000 breaks in
the genetic code. Scientists  still need to learn how to deal with the
data avalanche, and new disciplines are springing up that have to be
brought to the field. Selected genes can be tracked as the melanoma
cells migrate through an experimental animal using sophisticated
optical imaging techniques?
Melanoma Research Foundation

http://www.melanoma.org/newsletters/FinalMRF1-25-03.pdf

Cancer Consultants has a page of links to melanoma research, covering all stages.
http://www.cancerconsultants.com/patient_new/center_news.php?article=melanoma_news_intro


You can see 6 upcoming melanoma research projects on this Melanoma.org site. 
http://www.melanoma.org/ResearchAndGrants.jsp?body=mrfRecipients



Clincal Trials for Melanoma:
http://cancer.gov/clinicaltrials


Examples of Melanomas:

You can see pictures of moles using the ABCD system here:
http://www.melanoma.com/melanoma/diagnosing/look/index.jsp

See 19 more examples here:
http://www.dermatology.org/molemelanoma/watch2.html


To participate in the Melanoma Research Registry:
http://www.huntsmancancer.org/5175.html



Finally, your doctor MAY have a copy, or access to a copy of this
Melanoma Research Journal-it has a hefty price!
http://www.lww.com/product/0,0,0960-8931,00.html

Additional Information:

Melanoma Patients Information Page
http://www.mpip.org/
Cancer.gov
http://www.cancer.gov/cancer_information/cancer_type/melanoma/


Hope this helps you, ekim3! If any part of my answer is unclear,
please request an Answer Clarification, before rating. This will allow
me to assist you further, if possible.

(This information in this answer is informational in nature only, and
in no way is an attempt to diagnose or treat.)

Regards,
crabcakes


Search Terms:
Melanoma moles
percent moles result melanoma
newly developed melanoma treatment
ekim3-ga rated this answer:5 out of 5 stars
Thanks for the very complete and excellent answer!

Comments  
Subject: Re: What information is there on when to have a skin mole removed from the back?
From: crabcakes-ga on 21 Apr 2004 09:10 PDT
 
Thank you for the stars! Glad to have been of assistance~
Regards,
crabcakes

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