2. Fayed, Lisa. “ Causes and Risk Factors of Melanoma” cancer.about.com. Last updated April 26th 2006. Accessed December 6th 2010 < http://cancer.about.com/od/melanoma/p/melanomarisks.htm >
3. “How chemotherapy may affect your fertility?” macmillan.org.uk. Macmillan Cancer Support. Accessed December 7th 2010 < http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Sideeffects/Fertility.aspx>
4. Jordan, TS. “Cost of EBRT Radiation therapy for prostate cancer” eHow.com. Accessed December 9th 2010 < http://www.ehow.com/about_5646675_costs-radiation-therapy-prostate-cancer.html >
5. “Melanoma” Cancer.org. American cancer society. Accessed December 3rd 2010 < http://www.cancer.org/Cancer/SkinCancer-Melanoma/DetailedGuide/melanoma-skin-cancer-treating-radiation-therapy>
8. “Radiation Therapy: What are side-effects of the treatment?” ehealthmd.com. Health Information Publications. Accessed December 6th 2010 < http://www.ehealthmd.com/library/radiationtherapy/RT_effects.html >
9. Sherwood, Chris. “Advantages of chemotherapy” eHow. Accessed December 7th 2010 < http://www.ehow.com/about_4761914_advantages-of-chemotherapy.html >
10. “Skin Cancer in New York state 2009 report” New York state: Department of health. Accessed at December 9th 2010 < http://www.health.state.ny.us/statistics/diseases/cancer/skin/report/2009/>
![One World Essay- Melanoma <br />By Sana Samad<br />Can you ever imagine what it would be like if you knew that you had a limited amount of time in this world? Cancer is a type of disease that is caused by the uncontrolled cell distribution, which can develop into a tumor growing in a part of your body. There are different types of cancer, which are generally named by the organ affected. One of the worst cancers is called Melanoma, which is type of skin cancer. Although it’s one of least common cancers it is still a very deadly one that you want to watch out for. Melanoma, in particular is a very difficult cancer to spot on the skin. Which is why the symptoms are not really visible. There are a lot of things that people do that can increase their chances of developing melanoma. Doctors have come up with various therapies for melanoma. But some of them might be more harmful when compared to its effectiveness. <br /> Human skin has two layers. The epidermis is the outer layer of the skin and the dermis is the inner layer of the skin. Figure 1 shows that the deeper layer of the epidermis contains melanocytes that give skin color. Melanoma starts in the melanocytes when your skin is exposed to the sun. The melanocytes get damaged and thus result in the abnormal and uncontrollable growth of the cell creating a tumor. <br />1600200520700It can grow deep into the dermis, invading lymph nodes and spreading through the entire body.<br />Figure 1: Growth of melanoma (UCLA, 2010)<br />Determining how far the cancer has spread is called staging. There are 4 stages for melanoma. Stage 0 is confined to the epidermis, which is the top layer of the skin. Stage 1 and 2 is when the melanoma is confined to the skin but has increased in thickness. Stage 3 is when Melanoma has spread further towards the lymph nodes. Finally, stage 4 is when melanoma is extremely serious and has spread to the internal organs and to other lymph nodes. Melanoma although very serious in the internal body, has a very vague shape on the skin.<br />The symptoms for melanoma can be quite difficult to spot. This is because most of the time the only visible symptom is small mole on the surface of your skin but actually it has spread underneath your skin. Which is why the doctors have come up with a mnemonic device to detect melanomas. It is called “ABCDE”: It is a popular method used by most of the doctors for remembering the signs and symptoms of melanoma.<br />Asymmetrical : One half is unlike the other half<br />Border : around the mole there is an irregular border<br />Color: melanomas usually have multiple colors.<br />Diameter: moles greater than 6 mm are more likely to be melanomas <br />Enlarging: This is when the mole is evolving in size by getting bigger and bigger. Figure 2 below, shows the mole enlarging and spreading. <br /> Figure 2: Enlarging of mole (American Academy Dermatology, 2009)<br /> <br />There are many risk factors associated with melanoma. The largest risk factor is people tanning in the sun. People with lighter skin, burn easily causing their skin cells to be damaged. In fact, people with lighter skin are 20 times more likely to develop melanoma than people with darker skin. Figure 3 below, shows that in the USA Caucasians developed melanoma more than the African Americans. In some families with inherited melanomas, gene transformation greatly increases the risk of melanoma, as it passes from one generation to the next. Cells contain DNA that helps the cell function. However, DNA influences more than just how we look. Some genes contain instructions for controlling when our cells grow, divide, and die. Having a lot of moles on the body might cause the skin to develop melanoma too. In particular, being a Caucasian is a risk factor as the skin is exposed to sunny climate.<br />Figure 3: Melanoma being more common in whites than in blacks in the US (Department of health, New York, 2009)254000<br />Chemotherapy is a general term used for treatments that require using chemical drugs to kill cancer cells. Theses drugs might be used alone or in combination with another so that it can be more effective. Chemotherapy drugs travel through the bloodstream to all parts of the body. They attack dividing cancer cells, which have already spread beyond the skin to lymph nodes or other organs. One of the advantages of chemotherapy is the effectiveness it has on the cancer cells. Unlike other treatments where a surgery is focused on the part that tumor the grows, chemotherapy being a drug that can be injected, flows through the entire body, via the blood stream. This means that if there were other cancer cells that were spread or were missed by the doctor the drugs would most likely still kill them. <br /> Although chemotherapy is effective, a patient should always think twice before going for it, as there are some extremely serious long-term effects towards it. Since, chemotherapy attacks dividing cells it targets more towards the cancer cells they are constantly dividing but this means that the other cells that are normally dividing have a high risk of being killed too. And most of the time chemotherapy drugs tend to kill the white blood cells, making the body weak against the other common diseases. This weakens the body as it no longer immune to the germs that the body has to face through when exposed to them, and thus results in a lot of sickness. Chemotherapy can also cause infertility to men and women. In women, chemotherapy causes the ovaries to stop producing eggs, which leads to vaginal dryness. This can be either temporary or permanent depending on the type of chemotherapy being done. As for men’s infertility, it is more serious because it reduces the number of sperm they can produce or their ability to reach and fertilize a women’s egg during sexual intercourse. Being infertile is not a very familiar situation that people usually find themselves in and can be very serious, which leads me to an important social issue. <br />The fact that you won’t be able to reproduce anymore is an important factor of chemotherapy that will socially affect an individual’s life. Chemotherapy although very effective has a very drastic drawback of getting infertile. If a woman is going for this therapy, there is a chance that she might get infertile and this one decision of hers will effect her spouse in numerous ways. Her husband might want to have a life with her, but the fact that his wife will never be able to reproduce after the treatment will put him in a dilemma. Their social life will be ruined, just because they don’t have anything to relate too. Their relationship as a couple will be strongly affected. Important decisions will have to be taken by the couple. This could even result in divorces because once the husband knows that his wife is no longer infertile, his dreams might shatter and he might have no reason to continue his life with her. But remember, chemotherapy is ONE of the many melanoma treatments, there are other treatments like radiation therapy that works in a completely different way.<br />Radiation therapy uses high-energy rays to kill cancer cells. External beam radiation therapy focuses radiation from outside the body on the skin tumor. Radiation therapy is not often used to treat the original melanoma that started on the skin. In some cases it may be given as an adjuvant to surgery in the area where lymph nodes were removed, especially if they contained cancer cells. Radiation therapy does not cure cancer but instead helps shrink the tumor. It is an extremely effective treatment for melanoma because it controls the symptoms of the tumor. And, unlike other treatments where the attacking concepts are focused on the whole body, radiation therapy aims at the main part where the tumor is growing, which makes the therapy more effective. <br />Conversely, this therapy has negative aspects too. Radiation therapy has some short-term side effects like feeling tired, lack of energy, and causes hair loss. It also causes nausea, vomiting, and loss of appetite. Another very important disadvantage of radiation therapy is the fact that it might also cause the recurrence of the cancer in the place that radiation was given in. Symptoms might not be seen until 20-30 years after the treatment but the earliest signs might be visible in the 5th year after the treatment. And after that the situation gets worse because the patient can’t take any more radiation as the tissues can’t absorb any more of the radiation given. These are all effects that will eventually decrease, but the main disadvantage of radiation therapy is that it is awfully expensive. This is chiefly because of the special equipments hospitals use to cure cancer. The radiation used, the heavy equipments, the facilities provided, with effective equipments are all the reasons why Radiation therapy is expensive. When a person gets cancer he/she on a particular stage has to undergo the radiation therapy and with an average cost of $20-25,000 people may not be able to afford it. This leads to an important economic issue.<br />With the global economy having a downfall, it is not possible for a person with an average amount of salary to pay such a high price for radiation therapy. The fact that so many have to take it should actually reduce the cost because it is so expensive. Even if the people can pay, they will have difficulty paying the bills in the future, as this is an extremely expensive treatment. From the time the patient is diagnosed until the treatment is done, the average cost ranges from $20,000 to $30,000. Despite the cost, radiation therapy is very important for cancer patients and puts them in a dilemma. What do people with a low salary do? Is this cost fine for the worldwide population, which consists of people with an average pay? Will people just go with less effective treatment? Or will they pay for this therapy and struggle to pay back the money later?<br />In conclusion, melanoma is a deadly cancer and the earlier it is acted against it the better it is. If it has already spread to the lymph nodes and the internal organs then the real question comes up, which treatment will actually help reduce this cancer? And so after justifying one of the 2 most important cancer treatments, it would seem that radiation therapy would be the most effective option. It will cost a lot and it will be a struggle for a person with a low salary but is it an issue of health? Or is it an issue of money. It is up to the patient to weigh the advantages and disadvantages and see which one will be more effective. Couples might not care about the fact that chemotherapy can cause infertility, as they are ready to adopt, but they don’t want to go for radiation therapy because they might have the fear of the recurrence of the cancer. The treatment a patient wants to do depends mainly on their thoughts and what goes well for them. However, they need to go through the treatments with their doctor and discuss it thoroughly so that the treatment they choose should be effective. In the future, the patients decision should not make them regret as to something they should not have done because at the end cancer is a very serious disease that has very low chances of people surviving. <br />BIBLIOGRAPHY:<br />,[object Object]](https://image.slidesharecdn.com/melanomaessay-110208223138-phpapp01/85/Melanoma-essay-1-320.jpg)
