Health News and Information

Because of the different behavior of melanomas at different ages it is believed some hormonal influence may play a part. Any change in a mole should arouse suspicion. The changes to watch for are if the mole enlarges, or itches, or bleeds, or ulcerates or if changes in its pigment get darker or even lighter.

Experts do differ about the correct initial treatment of the suspicious mole, and even when dealing with an established melanoma.

Some doctors would initially remove the suspicious mole leaving a normal area of skin around it then close the wound.

Should examination of the mole reveal it is malignant then a second operation is performed where a large section of skin is removed.

Some surgeons go further and remove the mole, a large area of skin and the skin which leads to the nearest draining lymph glands.

Because the common spread of melanoma is by the draining lymph channels to the lymph glands, these glands are removed as well.

Some surgeons believe this should be done in the one operation. Because the wide separation between the skin cannot be joined together by stitches, a skin graft is necessary.

Other surgeons believe their results to be as good by carrying out the primary removal of the melanoma and only the lymph glands if they show evidence of involvement such as by enlargement.

The difference in opinion arises because of the unpredictable behavior of melanomas.

It has now become common to use the cytotoxic drugs as well. These are drugs which kill the cancer cells present at a distance from the original site.

Treatment in the past was unsatisfactory and the outlook for melanomas poor. But, as with most cancers, the treatment has dramatically improved over recent years.

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Other factors in the environment are exposures to viruses. The hepatitis  virus may cause cancer of the liver in Africans exposed both to this virus and to another toxin. The Epstein-Barr virus may cause a cancer of the lymphoid tissue in Africans and cancer of the nose and throat in Chinese.

There are some cancers which may be due only to environmental factors. In this second group are tumors of the stomach and large bowel, the prostate, ovary, breast, womb and cervix and some tumors of the kidney and bladder.

This group forms about 40 per cent of male cancers and 60 to 70 per cent of female cancers. Some believe most of these cancers are due to exposure to industrial chemicals, others think they are mainly due to lifestyle.

Perhaps only about 6 per cent of cancers can be shown definitely to be due to work exposure.

The third group is mainly cancers of children and no association can be found with external factors, not that they may not exist.

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