In medicine, there is not "the malignant melanoma", but instead several, distinctively distinct subtypes. Malignant melanomas occur in decreasing numbers in the following forms:
- Superficial spreading melanoma (SSM) in 55-70% of all melanoma cases
- Nodular malignant melanoma (NMM) in 20-30%
- Lentigo maligna melanoma (LMM) in 10-15%
- Acrolentiginous melanoma (ALM) in 4-8%
- Amelanotic melanoma (AMM)
- as well as other rare special forms about 1%
Worldwide increase in cases of illness
Superficial spreading melanoma is the most frequently diagnosed malignant melanoma in this country. It is called "melanoma of intermittently sun-exposed skin" in the American-speaking world, suggesting that it is the form most associated with years of direct sun exposure. Globally, it is by far the most common melanoma of the "white" population and the one with the highest incidence.
Sick people are getting younger and younger
The average age at 51 is significantly lower than that of all other melanoma patients. The age range is usually between 30 and 70 years, but any age can be affected. The occurrence in children before the onset of puberty is extremely rare. At the moment it is becoming apparent that the average age of onset worldwide is falling noticeably - possibly as a result of lifestyle trends such as excessive sunbathing and solarium use, especially at a young age. Women are slightly more affected than men. In these cases melanoma develops particularly often on the lower extremities, in men preferably on the back.
"Colorful picture" typical of this form
The superficial spreading melanoma is often already over one centimeter in the diagnosis, the range in the determination of 2 mm to 15 cm (and more!) Is enough. Visually, this form can meet some or all of the criteria of the so-called ABCDE scheme: It is often asymmetrically shaped, irregularly colored with black, brown, red, gray or very light parts, blurred limited, often sublime. Often bleeding, itching and / or significant size changes are described within a relatively short time.
Early diagnosis is crucial
The word "superficially spreading" means that this melanoma form initially spreads superficially and horizontally, before it then penetrates into the depths. From this point on, the cancer cells can spread very quickly throughout the body by connecting to blood and lymph channels and form so-called metastases, ie secondary tumors. In malignant melanoma, these are particularly common in the lymph nodes (groin, armpits or neck) and other parts of the skin. Precisely for this melanoma form, it is crucial for the prognosis that the pigment change is detected and treated in good time before penetrating into the deep. With early diagnosis, the superficial spreading melanoma is almost 100% curable. As soon as lymph nodes are affected, the so-called 5-year survival rate (with which doctors usually estimate the prognosis of cancers) already drops to 10 - 50%! At advanced stages and removal of metastases in distant organ systems, life expectancy often lasts only a few months.
Author: Dr. med. Monika Steiner