Major risk factors for melanoma

Melanoma is the 20th most common cancer in the world. The number of new cases of melanoma expected in 2020 is about 301.7 thousand, in 2040, according to forecasts, this figure will increase to 466.9 thousand. 12.7 cases per 100,000 population.

Melanoma causes approximately 60,000 deaths each year. Find out in the article on estet-portal.com

about the causes, features of the course and development of this disease, as well as the main methods of treating skin cancer.

Melanoma in the structure of oncological diseases

It should be noted that melanoma is an extremely dangerous type of malignant neoplasm: according to the international organization Skin Cancer Foundation, in the United States, melanoma accounts for less than 4% of skin cancer cases and at the same time more than 30% of deaths as a result of dermatological neoplasms.

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According to other data, this tumor is the cause of more than 75% of deaths due to skin cancer. The most important, according to some authors, and the only non-genetic risk factor for melanoma is ultraviolet (UV) radiation, which leads to the formation of reactive oxygen species under the influence of UV rays of type A and / or DNA mutations under the influence of UV rays of type B.

Meta-analyses of observational studies have found that intermittent sun exposure and a history of sunburn play a particularly important role in the development of melanoma, but chronic exposure (eg, during work) is usually a protective factor (but not in very fair skinned individuals) .

Immune function of the skin to guard the health and order of the body

Melanoma pathogenesis

Melanoma, like other malignant neoplasms, arises and progresses through the accumulation of genetic mutations leading to uncontrolled cell proliferation and invasive growth. In most cases, the genesis of skin melanomas has the character of a linear process that begins with the appearance of precursor foci (benign melanocytic nevi, dysplastic nevi), and gradually passes through the stages of malignancy from melanoma in situ to metastatic melanoma of varying degrees of aggressiveness.

It should be noted that it is also possible to develop a tumor directly from transformed melanocytes.

Among all human malignancies, melanoma has one of the highest mortality rates due to its metastatic potential. Although complete resection of localized melanomas is curative in almost all cases, the survival of patients with metastatic melanoma is quite low: the average life expectancy after diagnosis varies between 6-11 months.

Skin cancer metastasis

Metastasis is a complex process in which the state of blood supply and lymph flow plays an important role. Thus, a high degree of vascularization is associated with the progression of melanoma. Skin melanoma can metastasize in various ways, affecting surrounding tissues, lymph nodes and internal organs. Mucosal melanomas are characterized by a higher frequency of metastasis than skin (about 12%) or ocular melanomas (3%).

So, in the study by G. Grozinger, metastasis was recorded in 58% of patients with mucosal melanoma.

The ways and timing of skin melanoma metastasis are well studied. In primary melanomas of the skin, in about half of patients, metastasis begins with regional lymph nodes. In turn, distant metastases are more characteristic of melanomas of the mucous membranes.

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Melanomas of the skin were recorded in most organs and tissues, including in areas atypical for other solid tumors. The most typical localization of single distant metastases are lungs (about 25% of cases), brain (14%), liver (5%) and distant lymph nodes (about 10% of cases).

Disseminated metastasis occurs in one third of cases. These findings are supported by autopsy studies in which the typical site of metastasis was the lung, rarely ? liver and brain. It is worth noting that in primary skin melanoma with distant metastasis, patients with lung metastases have a better prognosis than patients with single metastases to other sites or disseminated metastasis.

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Medical treatment of melanoma

Recently, the prognosis for patients with metastatic melanoma has been very poor, with a 5-year survival rate of about 6% and a median survival time of − 7.5 months. Currently, there is a steady decline in mortality from melanoma. This trend is strongly correlated with the introduction of BRAF kinase inhibitors into clinical practice in 2011.

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BRAF kinase inhibitors − small molecules that can be divided into 2 types. Type I drugs (vemurafenib, dabrafenib, encrafenib) stabilize the kinase in its active conformation by binding to the ATP-binding site, whereas type II BRAF kinase inhibitors are non-competitive, that is, they bind to the hydrophobic site adjacent to the ATP-binding pocket. The difference in the type of stabilization is accompanied by a difference in inhibitory activity. Although type II inhibitors were thought to have greater BRAF inhibitory potential, these agents have not met expectations in the treatment of melanoma.

This group of drugs has made progress in the treatment of skin cancer, in particular melanoma. Read about the main drugs and methods of treating melanoma in the following article on estet-portal.com. Stay with us and be aware of the latest discoveries in the world of aesthetic medicine!

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