Melanoma

If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.

After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.

Melanomas are grouped into the following stages:

Stage 0 (Melanoma in situ): The melanoma is only in the top layer of skin (the epidermis).

Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.

Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.

Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.

Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.

There are several tests your doctor can use to stage your melanoma. Your doctor may use these tests:

Sentinel Lymph Node Biopsy: Patients with melanomas deeper than 0.8 mm, those who have ulceration under the microscope in tumors of any size or other less common concerning features under the microscope, may need a biopsy of sentinel lymph nodes to determine if the melanoma has spread. Patients diagnosed via a sentinel lymph node biopsy have higher survival rates than those diagnosed with melanoma in lymph nodes via physical exam.

Computed Tomography (CT) scan: A CT scan can show if melanoma is in your internal organs.

Magnetic Resonance Imaging (MRI) scan: An MRI scan is used to check for melanoma tumors in the brain or spinal cord.

Positron Emission Tomography (PET) scan: A PET scan can check for melanoma in lymph nodes and other parts of your body distant from the original melanoma skin spot.

Blood work: Blood tests may be used to measure lactate dehydrogenase (LDH) before treatment. Other tests include blood chemistry levels and blood cell counts.

Your melanoma treatment will depend on the stage of the melanoma and your general health.

Surgery is usually the main treatment for melanoma. The procedure involves cutting out the cancer and some of the normal skin surrounding it. The amount of healthy skin removed will depend on the size and location of the skin cancer. Typically, surgical excision (removal) of melanoma can be performed under local anesthesia in the dermatologist's office. More advanced cases may require other types of treatment in addition to or instead of surgery.

Treatments for melanoma:

Melanoma Surgery: In the early stages, surgery has a high probability of being able to cure your melanoma. Usually performed in an office, a dermatologist numbs the skin with a local anesthetic and removes the melanoma and margins (healthy surrounding skin).

Lymphadenectomy: In cases where melanoma has spread, removal of the lymph nodes near the primary diagnosis site may be required. This can prevent the spread to other areas of your body.

Metastasectomy: Metastasectomy is used to remove small melanoma bits from organs.

Targeted cancer therapy: In this treatment option, drugs are used to attack specific cancer cells. This “targeted” approach goes after cancer cells, leaving healthy cells untouched.

Radiation Therapy: Radiation therapy includes treatments with high-energy rays to attack cancer cells and shrink tumors.

Immunotherapy: immunotherapy stimulates your own immune system to help fight the cancer.