Confirming melanoma: Treatment options
If the doctor suspects that a spot on the skin is
melanoma, she or he will perform a
biopsy—the only way to confirm or make a diagnosis of a
melanoma. The biopsy is often done in the doctor's office with local anethesia. The tissues are
reviewed by a pathologist who checks for the presence of
cancerous cells.
If the diagnosis is melanoma, the doctor needs to know the
stage of the disease before developing
treatment options. In
staging, the doctor wants to learn how
thick the tumor is, how deeply a melanoma has penetrated the skin, and if the cancerous cells have
spread to other parts of the body. Besides a physical exam, the doctor may order other tests like
x-rays or scans.
Stages of melanoma
- Stage 0. In stage 0, the melanoma cells are found only in the outer layer of skin cells and have not invaded deeper tissues.
- Stage I. Melanoma in stage I is considered thin. The tumor is no more than 1 millimeter (1/25 inch) thick. The outer layer of skin may appear scraped (an ulceration). Or, the tumor is between 1 and 2 millimeters (1/12 inch) thick, but there is no ulceration. The melanoma cells have not spread to nearby lymph nodes.
- Stage II. The tumor is at least 1 millimeter thick. The tumor is between 1 and 2 millimeters thick. There is ulceration. Or, the thickness of the tumor is more than 2 millimeters. There may be ulceration. The melanoma cells have not spread to nearby lymph nodes.
- Stage III. The melanoma cells have spread to nearby tissues. The melanoma cells have spread to one or more nearby lymph nodes. Or, the melanoma cells have spread to tissues just outside the original tumor but not to any lymph nodes.
- Stage IV. The melanoma cells have spread to other organs, to lymph nodes, or to skin areas far away from the original tumor.
- Recurrent. The term recurrent means that the cancer has come back after it has been treated. It may have come back in the original spot or in another part of the body.
Methods of treatment
Treatment for melanoma depends on the extent of the disease, the patient’s age and general
health, and other factors. Those with melanoma may have surgery, chemotherapy, biological therapy,
radiation therapy or a combination of treatments.
Melanoma patients may be treated by a team of specialists.The team may include a
dermatologist, surgeon, medical oncologist, radiation oncologist, and plastic surgeon (though not
necessarily all).
The physician should be able to describe treatment choices and discuss the results expected with each treatment option. The doctor and patient can work together to develop a treatment plan that fits the patient’s needs.