Melanoma. Question - answer.
Melanoma is a malignant tumor of skin or mucous membranes that develops from atypical melanocytes (abnormal pigmented cells).
Melanoma is one of the most dangerous malignant tumors because it develops metastases in inner organs very early. Patients with metastases in inner organs usually die within a year.
The cause of all patients died from melanoma is metastases in the brain.
It is possible, though at the very beginning of the disease before the stage when cancer stem cells enter the circulatory system and eventually develop metastases. The problem is that 5-8% of melanomas give off cancer stem cells into the blood at the stage when tumor thickness is only 1 mm! But patients do not refer to the doctor with such melanoma size. Actually, most dermatologists and oncologists who examine a patient with melanoma of 1 mm or less consider it a pigmented nevus in half cases and say: “This is a nevus. If it doesn’t disturb you, nothing needs to be done, just visit the hospital periodically for examination.” However, melanoma potential for metastases increases twice with every millimeter of thickness. Thus, 20% of patients die after operation for melanoma of 1-2 mm, 40% of operated patients die if melanoma was 2-4 mm, and 75% of patients die if melanoma was over 4 mm thick. Unfortunately, half of all patients with melanoma refer to the doctor just when the tumor has 4-mm thickness or bigger. Surgical operation in this patient group results in dramatic outcomes.
What patients should know about melanoma
People’s belief about melanoma as a plant which can be removed with its roots is an absolute myth. Melanoma has no roots, but instead it has circulating tumor cells (CTC) which appear in the blood when the tumor grows from epidermis into derma. Surgical therapy can be radical ONLY BEFORE THE STAGE when melanoma releases CTC into circulatory system. But at such early stage the patient seldom refers to the doctor because melanoma looks like an ordinary flat black or brown nevus of 5-6 mm in diameter. It does not hurt, does not itch, does not yet disturb the patient in anyway. These are symptoms of advanced malignant process and the patient already has CTC in the circulatory system. If the tumor has already released CTCs in the blood, surgical removal of the tumor leads to CTC activation and transition from blood into tissues where they form metastases.
This happens because inhibitory effect of the primary tumor on CTCs has disappeared. That is why over half of patients after surgical excision of melanoma die from metastases! And it does not matter how big skin margins the surgeon excises – that does not prevent growth of metastases.
Photodynamic therapy can kill not only skin melanoma, but also CTCs in blood; therefore PDT is the first and yet the only method, that really cures melanoma of the skin and mucous membranes. However, there are several mandatory conditions for complete cure by PDT:
- Primary melanoma should not be exposed to any previous treatment. If melanoma was surgically excised or exposed to radiation therapy, CTCs have already activated and metastases have started growing.
- Melanoma should not be affected by mechanical trauma or chemical exposure.
- No melanoma metastases should be revealed in lymph nodes and inner organs.
- If the above conditions are fulfilled, PDT by Popov’s technology leads to complete cure of melanoma.