Understanding Melanoma
- Ariana Madix, a 39-year-old actress known for being a cast member on “Vanderpump Rules,” beat melanoma seven years ago and isn’t shy to show off the large scar she obtained after getting the cancer removed off of her chest.
- “My scar is a constant reminder of my journey and allows me to raise awareness about sun protection and early detection of skin cancer!” she said in a recent Instagram post.
- Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
- Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.
- SurvivorNet experts recommend avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma. Additionally, tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided. Many dermatologists recommend using spray tans to reduce the risk of melanoma skin cancer.
Madix, who is known for her recurring appearance as a cast member of the Bravo reality television series “Vanderpump Rules” took to Instagram last week to share a “get ready with me” video of herself talking about her cancer journey and how she works to protect her skin.
Read MoreExplaining what led to her diagnosis, in the March 26th post, she said, “I had noticed a dark spot here [on her chest], but it was a few years before I decided to do anything about it.View this post on Instagram
“A major push for me to see the dermatologist came from my [Instagram] followers. I went to see a dermatologist and he immediately made me see a plastic surgeon.”
After she recounted having what her doctors thought was “just a mole” removed, she said, “I’m so glad that I went that day because it was not benign. It was melanoma.”
She explained further that once she received her diagnosis, she needed to have a large area of her chest, surrounding the mole, removed to make sure that the cancer was gone.
“Melanoma is not just a mole. I had a very large area of skin removed from my chest, as you can see, with my lovely scar … and my lymph nodes removed out from under my arm,” Madix continued.
“I was cleared … I get my regular skin checks now and I’m super grateful that I’m ok. Now, I just have this lovely scar across my chest.”
View this post on Instagram
Ariana Madix’s Cancer Journey
Ariana Madix was diagnosed with stage one melanoma in 2018 after years of raising concerns with various medical professionals about a spot near her shoulder.
“It was not the first time that I had asked a doctor about my spot, but it was the first time I could afford to see a dermatologist,” Madix, a cancer advocate, previously told SurvivorNet in an exclusive interview.
Time and time again, she was told her mole was “probably nothing” before getting her diagnosis. And the reason she didn’t see a specialist for so long was because she didn’t have health insurance.
“The idea of, ‘Oh, go get something checked [with a specialist]’ was not something that I could have shelled out a couple hundred bucks on,” she said.
View this post on Instagram
In the end, it was actually fans of “Vanderpump Rules” that really pushed Madix to see a specialist once she could afford it.
“I had people who were watching the show who were sliding into my DMs and who were like, ‘You might want to get that looked at. I’m a dermatologist in Michigan and this troubles me,’” Madix said. “That kind of added to my suspicions.”
Treatment for Madix consisted of surgery to remove her cancer as well as some surrounding lymph nodes. When melanoma spreads, it’s more likely to travel to nearby lymph nodes first. And a sentinel node is the first lymph node to which the cancer is likely to spread. A biopsy of this node carries important information related to the staging and prognosis of melanoma.
Sentinel Lymph Node Biopsy Provides Extra Precaution
Today, Madix remains cancer-free today and insists on living life the fullest. Hopefully, her cancer story will serve as a reminder for others to take care of their skin and understand the severity of a melanoma diagnosis.
“I really just want people to pay attention and to take it seriously,” Madix said. “Know that your skin is the largest organ in your body and it’s exposed to more things than most. It’s not just do I have a zit? There’s a lot more to it important sh*t that could make or break your life.”
Back on November 3, 2019, Madix shared a video clip of herself in the hospital, writing, “I’ve been debating posting this for so long but whatever! I’m doing it. Officially the spookiest thing I’ve ever experienced! A year ago, I wasn’t able to celebrate my favorite holiday [because] i had just undergone surgery for melanoma.
“Being told that cancer was living rent free on my body for years was scarier than any 80s slasher movie. Thankfully, I had an amazing doctor, the amazing @tomsandoval1 to take care of me, and (as you can see) the @kimpetras #TOTL album to keep me positive! moral of the story: If you’re unsure of something on your body, GET CHECKED and then GET CHECKED AGAIN!”
Learning More About Melanoma
Melanoma is the most dangerous form of skin cancer. It starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.
Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.
You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:
- The palms of your hands or soles of your feet
- On your eyes or mouth
- Under your nails
SurvivorNet experts recommend avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma. Tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided. Many dermatologists recommend using spray tans to reduce the risk of melanoma skin cancer.
The Melanoma Workup
Unlike other diseases, the workup for melanoma is pretty straightforward. For any skin lesions, your dermatologist will give you a head-to-toe visual examination to look for any other atypical moles or suspicious lesions.
If a growth warrants further evaluation, you might get a biopsy. And if advanced melanoma is found, you may need additional imaging and blood tests to help determine the best treatment plan.
Blood tests may include:
- Complete blood count (CBC): looks at the number and types of cells in your blood, including red blood cells, white blood cells, and platelets
- Comprehensive Metabolic Panel (CMP): measures the blood levels of certain enzymes, proteins, electrolytes, and minerals
- Lactate dehydrogenase (LDH): an enzyme that’s increased in many cancers
Imaging tests may include:
- CT scan: uses x-rays and a computer to create detailed images of your body
- PET scan: uses radioactive materials (called tracers) and a special camera to create pictures of areas inside the body where cancer may be growing
- MRI: Uses radio waves and magnets to create images of organs and tissues
A pathologist may also examine your tissue sample under a microscope to look for certain mutations. This is called biomarker testing, which helps determine the best treatment options for you. The BRAF mutation is the most common mutation found in melanoma tumors.
It’s important to remember that many atypical skin lesions are not cancer. So don’t worry if your doctor finds something that looks a bit strange it may just be a benign growth. If you have any concerns about the findings, be sure to talk with your doctor.
What Are the Symptoms of Melanoma?
The most important thing to look out for when it comes to finding melanoma is a new spot on your skin or a spot that is changing in size, shape, or color, SurvivorNet’s medical experts say.
When you check your skin, use the acronym ABCDE as your guide:
- Asymmetrical moles: If you drew a line straight down the center of the mole, would the sides match?
- Borders: Is the mole irregular or jagged?
- Colors: Are there multiple distinct colors in the mole?
- Diameter: Is the mole larger than 6 millimeters (mm), about the size of a pencil head eraser?
- Evolution: Has the mole’s color, shape, or size changed over time?
RELATED: The Genetic Mutation That Drives Many Metastatic Melanomas
If you answered “yes” to any of these questions, our experts say it’s time to see your dermatologist for a skin check.
WATCH: How do you perform a skin check using the ABCDEs?
Melanoma Treatment Options
Melanoma treatment has come a long way. Survival rates have risen dramatically, thanks to a “treatment revolution,” say SurvivorNet’s experts. With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today have a much better chance of living a long and healthy life than ever before.
If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer should lead to a cure. The question is typically not whether you’ll get surgery, but which kind you’ll have.
WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma
For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.
In general, stage I melanoma surgery consists of the simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.
The removal of stage II and III melanomas are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes, and possibly to other organs. Where the cancer is will dictate your treatment.
After surgery, the removed tissue and lymph nodes will go to a specialist called a pathologist, who will measure the melanoma and find out if it has clear margins. Having clear margins means the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.
Once your cancer spreads, treatment gets a little more complicated, but there are still ways to stop it. New treatments have vastly improved the outlook for people with metastatic, or stage IV, melanoma.
Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy. So, with many more choices, there is no standard treatment. Treatment will vary based on your condition and whether there is recurrent disease.
Research has found that immunotherapy drugs such as Keytruda (pembrolizumab) and Opdivo (nivolumab) helped some people live longer. Combining immunotherapy drugs Yervoy (ipilimumab) and Opdivo (nivolumab) has also extended survival. Opdivo (nivolumab) + relatlimab is a new therapy option added to the National Comprehensive Cancer Network guidelines in 2022. The combination of two immunotherapies is called Opdualag.
For those with the BRAF mutation, targeted drugs which shrink or slow the tumor can be a good option. This could include a combination of drugs, such as:
- Zelboraf (vemurafenib) and Cotellic (cobimetinib)
- Braftovi (encorafenib) and Mektovi (binimetinib)
- Tafinlar (dabrafenib) and Mekinist (trametinib)
- Zelboraf (vemurafenib) and Cotellic (cobimetinib) can also be combined with atezolizumab.
“Every patient is different and every situation is different,” says Dr. Anna Pavlick, medical oncologist at Weill Cornell Medicine. She emphasized that “there is no cookie-cutter recipe,” for treating stage IV melanoma.
RELATED: There Is No “Cookie Cutter Recipe” for Treating Stage Four Melanoma
Dr. Pavlick also notes the importance of personalized care and treatment. “It really is a matter of looking at the tools we have so that we can pick the right tools to give the patient the best outcome.”
So, while there is no one-size-fits-all approach to treating metastatic melanoma, your doctor will work with you to develop a treatment plan that is tailored to your individual situation. Advances in research and technology are making the fight against metastatic melanoma more hopeful than ever.
Five Ways to Protect Yourself From Skin Cancer
Skin cancer can happen to anyone and develop at any time of year. It tends to occur on parts of the body that see more sun like the face, head, neck and arms, but it can also develop anywhere, including places like the bottoms of your feet, your genitals and the inside of your mouth.
If you’re wanting to minimize your risk of developing skin cancer, check out these tips from Dr. Dendy Engelman, a board certified dermatologic surgeon at Shafer Clinic Fifth Avenue
RELATED: Top 5 Ways to Protect Your Skin From Skin Cancer
- Avoid sun during peak hours: 10 a.m. to 2 p.m.
- Wear a wide brimmed hat and sunglasses to protect the tops of our heads, the tops of our ears and the delicate area around the eye.
- Wear at least SPF 30 sunscreen and make sure to reapply every two hours or after excessive sweating or swimming.
- Have yearly skin checks (with a professional) because it’s difficult to evaluate areas all over the body.
- Avoid tanning beds. There are no “good” tanning beds, and they can significantly increase your risk of skin cancer.
In addition, make sure to prioritize skin protection all year round. People often focus on things like sunscreen use solely in the summer, but our experts know skin damage can happen at any time of the year.
Which Sunscreen Should I Choose To Prevent Cancer?
“My patients ask me all the time, ‘Do I really need sunscreen every day, all year round?’ The answer is yes,” Dr. Engelman told SurvivorNet.
“People think they only need sun protection when they’re in the bright, warm sunshine. But the reality is, we can get sun damage at any time throughout the year, even in the cold, wintry months. Think about when you go skiing. That’s a very high risk. Even though it’s cold, our skin should be protected.”
Questions to Ask Your Doctor
If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests some of the following to help you on your cancer journey.
- What type of skin cancer do I have?
- What treatment options exist for my type of melanoma?
- Will insurance cover this treatment?
- Would treatment through a clinical trial make sense for me?
- What resources exist to help manage my anxiety because of this diagnosis?
Cancer Research Legend Urges Patients to Get Multiple Opinions
Contributing: SurvivorNet Staff
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