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Ask Dr. Gott 10/10
Melanoma the most serious skin cancer
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    DEAR DR. GOTT: I am concerned about a family member who was diagnosed with melanoma. Could you please write a column with advice concerning its treatment? I read your column every day and really respect your opinion and knowledge.
    DEAR READER: Melanoma is the most serious form of skin cancer. It develops in the cells that produce melanin, which is responsible for skin coloration. It most often affects the skin but can also occur in the eyes, or rarely, internal organs.
    Melanomas usually occur on areas that are repeatedly exposed to sunlight, such as on the face, arms, legs or back. Less commonly, they can form on the palms of the hands, soles of the feet or even fingernail beds.
    The most common early sign of melanoma development is a change in an existing mole or the appearance of a new, unusual-looking growth. Normal moles are generally uniformly colored (tan or brown), symmetrical in shape (an oval or circle), have a distinct border between it and the skin, and can be up to a quarter inch in diameter (rarely larger).
    Moles that may indicate melanoma often have one or more of the following: irregular shape, change in color or texture, increase in size, are itchy, scaly, bleed or ooze, and the pigment may spread beyond the border of the mole.
    The cause of melanoma is unknown, but ultraviolet light from the sun and tanning beds and lamps greatly increase the risk of developing this form of cancer. It is important to keep an eye on all existing moles and watch for new ones. Most moles develop by age 20, but, on occasion, new, harmless ones may appear. People with a family or personal history of abnormal skin lesions or skin cancer should be screened annually by a dermatologist.
    Early-stage melanomas can usually be cut out and require no other treatment (except regular follow-up and screenings). In this instance, the melanoma, a small border of the normal skin around it and the skin layer beneath it are removed. The outlook is best when the cancer is small and confined only to the skin.
    For larger melanomas that have spread beyond the skin, treatment depends on the size, location, amount of spread and the individual. Some lesions can be excised, which may relieve symptoms, perhaps for years. Others may require chemotherapy, radiation or immunotherapy.
    Clinical trials are new therapy studies that have yet to be approved for melanoma treatment. People who enroll in such trials have an opportunity to try evolving therapies. No treatment is guaranteed, and the full range of potential side effects is unknown.
    Prevention includes avoiding the sun between 10 a.m. and 4 p.m., when solar rays are the strongest, wearing sunscreen year-'round with a sun protection factor (SPF) of at least 15, wearing protective clothing and a broad-brimmed hat when out of doors, and avoiding tanning beds.
    Some medications can increase sun sensitivity. If you are on a medication that makes you more sensitive to sunlight, take extra precautions when outside. If any questions remain, speak with your physician or an oncologist.
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