Treating and Preventing Mucosal Melanoma in the Oral Cavity

Treating and Preventing Mucosal Melanoma in the Oral Cavity

Mucosal melanoma is an extremely rare and highly aggressive malignancy that originates in the mucous membranes of the oral cavity. It accounts for very few of the cases of melanoma, but anyway it is significant to know more about this pathology and realize how important early detection and timely treatment are.

Understanding Mucosal Melanoma

Mucosal melanoma is a type of melanoma that originates from melanocytes, the pigment-producing cells found in the mucous membranes. Unlike cutaneous melanoma, which grows on the skin, mucosal melanoma may occur in various parts of the body, including the nasal cavity, paranasal sinuses, and the oral cavity.

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Symptoms of Oral Mucosal Melanoma

Early detection of oral mucosal melanoma will enable treatment to have the best outcome. Among others, some common symptoms include:

• Discolored patches or growths: Such lesions can appear brown, black or reddish-purple on the gums, tongue, or other parts of the mouth.
• Bleeding or ulceration: Such lesions may easily bleed or become painful ulcers.
• Swelling or thickening of the mucosa: Swelling or thickening may occur in the affected area.

This should, therefore, not create panic in the reader's mind by making him understand that any discoloration of a lesion in the mouth does not suggest mucosal melanoma. More frequent dental checkups and early investigation of suspicious lesions are necessary for its diagnosis.

Aetiology and Risk Factors

The exact etiology of mucosal melanoma is still unknown, although several risk factors have been reported:

• Age: Mucosal melanoma does occur more frequently in elderly patients. The average age at diagnosis is approximately 70 years.
• Gender: Mucosal melanoma is very slightly more common in men than in women.
• Ethnicity: Individuals of a more highly pigmented skin type are more affected by mucosal melanoma.
• Weakened immune system: A person with a weakened immune system, say, suffering from HIV/AIDS or someone who has had an organ transplant, has a high risk of developing mucosal melanoma.

Treatment Options

Treatment decisions for oral mucosal melanoma are based on the stage of the cancer and the lesion location. The mainstay of treatment is surgical removal of the tumor, often combined with either radiation therapy or chemotherapy. In some cases, targeted therapy or immunotherapy can be used either to target genetic mutations or to enhance the immune system's response against cancer.

Surgical Treatment

Surgery is the most important modality for treating oral mucosal melanoma. The main thing in this kind of treatment line is the removal of the whole tumor with clear margins so that local recurrence decreases. Depending on size and location, partial or complete removal of the affected area might be entertained by the surgeon.

Radiation Therapy

In some cases, radiation therapy may be used after surgery to eliminate remaining cancer cells and reduce the risk of recurrence. It can also be applied as primary treatment for patients not candidates for surgery or that refuse surgical intervention.

Chemotherapy and Targeted Therapy

In some instances, chemotherapy or targeted therapy may be given in conjunction with surgery or radiation. Chemotherapy is systemic, involving putting drugs in the system to kill cancer cells in all parts of the body. Targeted therapy will focus on specific genetic changes that are driving the cancer's growth.

Prevention of Mucosal Melanoma

Although mucosal melanoma has no specific preventive measures, good oral hygiene and regular dental checkups can certainly help in the early identification of suspicious lesions. One should also keep oneself attentive to alterations in the appearance of oral mucosa and bring them into the notice of a health professional without any delay.

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Conclusion

Oral cavity mucosal melanoma is one of the very few and highly aggressive malignancies that need early diagnosis and timely initiation of treatment. Early detection of suspicious lesions can be made if there is awareness regarding the symptoms and risk factors, besides good oral hygiene and regular dental check-ups. One should, therefore, not hesitate to report to a healthcare professional in case of any changes in the oral mucosa.

Faqs

• 1. Is mucosal melanoma more aggressive than cutaneous melanoma?

  Yes, mucosal melanoma is generally more aggressive than cutaneous melanoma and has a poorer prognosis. This is due to the propensity to grow fast and metastasize to parts of the body.

• 2. What is the frequency of occurrence of mucosal melanoma in the oral cavity?

  Mucosal melanoma comprises approximately 1% of all cases of melanoma, and oral mucosal melanoma is even more uncommon, accounting for about 0.5% of all malignancies of the oral cavity.

• 3. Can mucosal melanoma be prevented?

  There are no specific preventive measures for mucosal melanoma; good oral hygiene and regular dental checkups can help in early diagnosis of any suspicious lesions.

• 4. What is the treatment for mucosal melanoma in the oral cavity?

  The main treatment for oral mucosal melanoma is surgical removal of the tumor, followed by, in some cases, radiotherapy, chemotherapy, or targeted therapy. All of the above depend on the extent of the cancer and the general health of the patient.

• 5. What is the prognosis for patients with oral mucosal melanoma?

  The prognosis for patients with oral mucosal melanoma is relatively poor, with a 5-year survival rate of about 25%. The keys toward better prognosis lie in early diagnosis and timely treatment.

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