Melanoma is a health condition with a long history, dating back to early records in the 5th century BC. The following is a short summary of the prominent historical events.
In approximately the 5th century BC, Hippocrates was the first to record a description of melanoma, which he described as melas, meaning dark, and oma, meaning tumor, in Greek.
There is some archaeological evidence of melanoma in the skeletons of pre-Columbian mummies in Peru, radiocarbon dated to be approximately 2400 years old, thus approximately the 4th century BC.
Initial Practice and Findings
John Hunter was the first man recorded to operate on a patient with melanoma, performing the first successful excision of a melanoma tumor in 1787. At the time, he did not know exactly what it was and described it as a “cancerous fungous excrescence.” It was not until many years later, in 1968, that the preserved tumor was examined under a microscope to determine that it was metastatic melanoma.
Rene Laenec was the first to distinguish melanoma as a disease separate from others in 1804, with the term melanose. In 1820, William Norris was the first to observed the heterogenic nature of some melanoma tumors. The term melanoma was introduced in 1838 by Sir Robert Carswell.
In 1826, Thomas Fawdington wrote that the medical profession was quite in the dark as to the remote and existing causes of melanoma. For this reason, it was necessary to confess the incompetency of knowledge at this time, leaving revelations about the governing principles of the disease to future investigators. At this time, anesthesia and antiseptic agents had not yet been introduced, and knowledge about DNA and the development of cancer did not exist.
Progression of Knowledge
Samuel Cooper was the first to formally acknowledge in 1844 that advanced melanoma was untreatable and that “the only chance for benefit depends on early removal of the disease”. Even today with continue research and development, this statement remains true.
In 1892, Herbert Snow expressed the benefits of removing the tumor and surrounding glands as a method of prophylaxis. He believed that the excision of the tumor alone was an ineffective treatment and, wherever possible, the lymph glands should be removed, as they are quick to receive the infective protoplasm.
In 1905, William Handley analyzed the lymphatic spread of secondary melanoma on a woman’s leg, which formed the basis of a case study for the disease. He suggested the surround subcutaneous tissue and lymph nodes should be removed, which guided the surgical treatment for melanoma for the proceeding 50 years.
Etiology and Genetic Involvement
In 1956, Henry Lancaster made the initial connection between ultraviolet radiations from exposure to sunlight to increased incidence on melanoma. This idea was supported by the work of Lancaser and Nelson, who demonstrated that the characteristics of the skin had an impact on melanoma development, including:
- Skin color
- Hair color
- Eye color
- Reaction to the sun
The risk of melanoma was markedly increased in individuals with fair skin exposed to high levels of ultraviolet radiation, such as in Australian and New Zealand.
Following this classification of various stages of disease progression was introduced and several medications have been approved for use in the treatment of melanoma.
Current Knowledge and Future Challenges
At this point in time, we have a relatively good understanding of the melanoma, in that we know it is caused by ultraviolet radiation and results from malignancy of melanocytes. It is understood that some individuals are at higher risk of melanoma due to skin characteristics and polymorphisms in the melanocortin receptor-1 (MC1R) or CDKN2A genes.
However, the precise mechanism of the progression a melanocyte into melanoma remains unknown and, as a result, methods of prevention are limited. This area is an appropriate subject for future research.