We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
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Cutaneous melanoma is a malign tumour located on the skin, usually black or coffee coloured. Some of the main risk factors include exposure to sunlight and freckles. They can develop on any part of the skin, but they are more frequent on men's chests and backs and women's legs. They are responsible for 65% of deaths due to skin cancer. Discovering and treating the illness in time is vital for stopping it spreading to other parts of the body.
Cutaneous melanoma is a cancer that originates in cells known as melanocytes. These cells produce melanin, which is why the tumours are usually coffee coloured or black, but they can also be pink, pale coloured or white. Overall, cutaneous melanomas represent approximately 1% of all tumours in both sexes, and every year 15 out of every 100,000 people are diagnosed, a figure that is increasing in nearly all European countries.
Cutaneous melanomas can develop on any part of the skin, but they are more frequent on the chest and back in men and the legs in women. The neck and face are other common sites. Having skin with a dark pigmentation reduces the risk of melanoma in these more common locations.
Melanomas are much less frequent than other types of skin cancer, but they are more dangerous, because they grow more quickly and they are very likely to spread to other parts of the body if they are not discovered and treated in time.
The first signs of a melanoma are as follows:
Melanomas do not always start with a freckle: they can also appear on normal-looking skin and can form on any part of the body. They very often appear on parts of the body that have been exposed to the sun, such as a person’s back, legs, arms or face. They can also occur on parts that have little exposure to sunlight, such as the soles of the feet, the palms of the hands and in the nail beds. These hidden melanomas are more frequent in people who have darker skin.
In Spain, the condition especially affects women, with an average initial-diagnosis age of 55, and men at an average age of 57. For white individuals, the incidence of cutaneous melanoma is increasing at an alarming rate, in all Cancer Registries. In Europe, it is the ninth most frequent cancer, with around 200,000 cases diagnosed every year. Although it only represents between 1.5 and 1.7% of skin cancers, it is responsible for 65% of deaths from skin cancer. This figure is stable in spite of the increased incidence, probably because of early diagnosis, which is the most important factor, and improvements in treatment.
The reason why melanoma occurs is unclear, although some risk factors have been identified, which should be taken into account:
It is usually diagnosed after observing a suspect freckle that presents alterations known as (1,2,3,4):
For this reason, if a new, unusual freckle is found, or a change is noted in an existing one, it should always be examined by a dermatologist, as early diagnosis is vital in this illness. The tests and procedures used to diagnose cutaneous melanoma include the following:
The recommendations for treatment depend on many factors, such as the thickness of the primary melanoma, the possibility that the cancer has spread or the presence of specific genetic changes in the melanoma cells, among others.
However, surgery is the main treatment against local and regional melanoma. It may also be an option for combating metastatic melanoma. If surgery is not an option, the melanoma can be called “unresectable”. In order to recommend a specific treatment plan, the doctors will take into account the state of the illness and the risk of relapse in each person. Subsequently, in accordance with the state, a systematic treatment can be indicated for a period of one year. In recent years, the treatment of melanomas that have spread extensively through the body has changed, as the newest forms of immunotherapy and targeted drugs have proven to be more effective than chemotherapy.
A complete physical examination must be conducted, including a general examination of the skin. The purpose of these tests is to identify risk factors and signs or symptoms that may indicate that the melanoma has spread beyond the original site. For most low-risk melanomas, less than 1 mm thick, it is generally unnecessary to carry out an additional search for metastasis or spreading.
In the case of people with high-risk melanoma, more exhaustive tests may be considered, including the following:
- Limiting exposure to ultraviolet rays.
- Avoid tanning booths.
- Protect children from the sun, to avoid sunburn.
- Pay attention to unusual freckles when examining your skin. If in doubt, it is always a good idea to make an appointment with a dermatologist, for a thorough check up.
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