Status: 06/15/2023 10:49 a.m
Malignant melanoma is the most dangerous skin cancer. Discovered in time based on its symptoms, black skin cancer has a good chance of being cured. Even in the advanced stage, the treatments are more successful.
About every 50th person in Germany will develop a malignant melanoma in the course of their life. Experts assume that the number will continue to rise and that more and more young people will become ill. In the case of skin cancer, a distinction is made between the light and black form. Black skin cancer (malignant melanoma) is particularly dangerous because it spreads in the body at an early age.
What is malignant melanoma?
Malignant melanoma is a malignant skin tumor that develops from the pigment cells (melanocytes) of the top layer of the skin. It can either develop from an existing mole or form spontaneously on healthy skin. Melanomas can occur on any part of the body – including the eyes, between the toes or in the genital area, i.e. also in places where the sun does not reach. Black skin cancer occurs most frequently between the ages of 45 and 60.
Further information
5 Min
Black skin cancer cases are increasing. Which skin marks can be dangerous? When does it make sense to go to the doctor? 5 mins
ABCDE rule: What are the symptoms of black skin cancer?
The earlier black skin cancer is discovered, the better the chances of recovery. That’s why you should keep a close eye on your skin and take any abnormalities, changing moles or pimples that won’t heal to your doctor as soon as possible. In the case of conspicuous liver spots, the so-called ABCDE rule can help you to make your own initial assessment:
Asymmetry: uneven, asymmetrical shape. A new dark patch of skin is unevenly shaped, i.e. not evenly round, oval or oblong. It is also possible that the shape of an existing patch of skin has changed.
BLimitation: washed out, jagged or uneven and rough edges. A dark patch of skin has blurred contours or grows frayed into the healthy skin area.
Ccoloring: different colorings, lighter and darker areas in a pigment mark. Look for a spot that is not evenly colored but mixed with pink, gray, or black dots. It indicates a malignant melanoma and should always be examined by a doctor. The same goes for crusty toppings.
DDiameter: The diameter is more than five millimeters at the widest point. Moles larger than five millimeters in diameter or hemispherical in shape should be checked. Attention: There are also melanomas that are smaller than five millimeters.
EElevation: If a mole is more than a millimeter above the level of the skin and its surface is rough or scaly, this can also be a sign of skin cancer. (Source: German Cancer Society)
EDevelopment: The E also stands for the important criterion of development. If a pigment spot changes, grows, becomes irregular, itches or even bleeds, it should be examined by a doctor. (Source Hamburg Cancer Society)
The “ugly duckling rule” also helps to identify suspicious pigments. A dark spot that looks somehow different from all other skin marks should be checked.
Treatment: In the early stages healing through surgery
If left untreated, the disease is potentially fatal. A melanoma is still harmless on the upper skin layer – but as soon as it begins to grow deeper, into the dermis, cancer cells can detach. The danger: The tumor cells can spread through the blood in the body, metastases form and the chances of recovery are reduced. Cancer cells can affect any organ in the body. Brain metastases are particularly feared.
If the cancer is discovered in time, it is surgically removed. If the cancer has not yet spread, those affected are considered cured after the operation. This is the case for about two-thirds of those affected.
If the cancer has demonstrably already spread in the body and complete removal of the metastases is not possible, the treatment is much more complex. While a few years ago a very short life expectancy was to be expected with advanced cancer, immunotherapy has fundamentally changed this. In addition to surgery, radiation and drug therapies, it is one of the established forms of treatment. According to the Cancer Information Service, the therapy responds to between a quarter and a third of those affected.
Immunotherapy increases life expectancy
Because cancer cells are constantly changing, the immune system doesn’t pay attention to the bad cells and stays dormant. The cancer can spread undetected. The so-called checkpoint signals of the cancer cells play a decisive role here. They affect the body’s immune response. This is where immunotherapy comes in: So-called immune checkpoint inhibitors are used. With the help of antibodies, they block the signals from the cancer cells. Now the body’s own defenses can take up the fight against the cancer cells and render them harmless – the immune system is awakened again. In this way, healing is possible even in the advanced stage.
According to a study, a combination of two immune checkpoint inhibitors (PD1 blockers and CTLA-4 blockers) has proven to be particularly effective. According to the latest findings, young patients also benefit from immunotherapy. However, there can be severe side effects due to a strong immune system. Skin rashes, diarrhea or changes in the liver are typical side effects.
Prevention: The risk factor is UV radiation
Even though treatment options are constantly improving, preventing skin cancer remains very important. The most important risk factor is UV radiation. Even minimal radiation can be enough to cause melanoma to develop. Strong exposure to the sun during childhood and adolescence plays a particularly important role. Because this is how pigment moles are formed. Therefore, one should avoid the sun, no matter what skin cancer risk one carries. The Federal Office for Radiation Protection has compiled tips. Visiting the tanning salon also increases the risk of skin cancer – according to the German Cancer Society, once a month for a year means an increase of at least 75 percent.
Who is at increased risk of skin cancer?
According to an Australian study, people with darker skin, brown hair and eyes, fewer moles and a family history of skin cancer are at low risk. The danger increases with the number of liver spots. The German Cancer Society provides the following information:
There is an increased risk of skin cancer
more than 100 small moles at least 5 large, atypical-looking moles and 50 or more normal-looking moles at least 5 atypical-looking moles from families with a high incidence of malignant melanoma if you have a history of melanoma
Genetic predisposition also plays a role. If several individual risk factors come together, the risk increases by a factor of 120. This includes:
light skin type reddish or blond hair tendency to freckles tendency to sunburns relatives with malignant melanoma
Detecting skin cancer: From the age of 35 you are entitled to screening
From the age of 35, the statutory health insurance companies pay for a check-up with a reflected-light microscope (dermatoscope) every two years. Some health insurance companies also pay for early detection before the age of 35 or annually – instead of every two years. It is therefore worth asking the health insurance companies.
Regular digital dermatoscopy in people at risk
It is often very difficult to detect melanomas early and reliably, especially in people with a high risk, as they develop more frequently. According to experts, they should therefore be checked at least once a year – preferably using digital dermatoscopy. Those affected are photographed with a full-body scanner. These photos are saved and software marks changes to previous recordings. Moles that have changed are suspicious.
With the help of this follow-up, the doctor can more easily detect new or growing moles and moles – and recognize malignant changes earlier. However, the digital examination is not paid for by statutory health insurance companies. Depending on the effort and the number of moles, the costs can be well over 100 euros.
Artificial intelligence improves early detection
In addition, artificial intelligence is increasingly being used to examine the skin. AI programs have been fed a huge number of images and diagnoses and learn to recognize connections that a human would not see. The software can use photos to calculate a value that indicates the probability that the mole is cancer. In combination with experienced dermatologists, early detection and follow-up can be further improved.
Skin cancer screening is still little used
Germany is the only country to have introduced skin cancer screening. But not even a third of the people who are entitled to a medical check-up actually use it. Many do not even know that they are entitled to this health insurance benefit. In addition, there are not enough dermatologists in many regions.
However, it has not been scientifically proven whether screening reduces the total number of fatal diseases. It could also play a role that the quality of the examination and counseling should be improved: too often the examination of the genital region is neglected and the participants are rarely asked to do regular self-examination. However, for every single person in whom a melanoma is discovered at an early stage, the screening option has been worthwhile.
Experts on the subject
skin cancer center
At the hospital 1
21614 Buxtehude
Executive Physician
Clinic and polyclinic for skin diseases
Sauerbruchstraße
17475 Greifswald
Senior Physician
Clinic and polyclinic for skin diseases
Sauerbruchstraße
17475 Greifswald
Seestrasse 4
17429 Bansin
Further information
White skin cancer is more common than black. However, if the disease is detected in time, the chances of recovery are good. more
UV rays from the sun can be dangerous, especially in summer. Why is that and how can you protect yourself? more
Any exposure to the sun increases the risk of skin cancer. With the right protection, you can enjoy the summer. more
This topic in the program:
Visit | 06/20/2023 | 8:15 p.m