I just got diagnosed with melanoma. Now what?
Living in Phoenix, Arizona, is unique as we have some of the best weather and special activities such as golf, hiking, and other outdoor sports. But unfortunately, there is a catch. As a state, we have one of the highest rates of skin cancer, including melanoma. Melanoma is a type of skin cancer that can be serious if not caught early. Therefore, it is essential to be aware of the warning signs of melanoma and to see a healthcare provider if you notice any changes in your skin. The most common warning signs of melanoma include:
- A new mole or a change in the appearance of an existing mole. Melanomas often look different from other moles and may be asymmetrical, have irregular borders, or have multiple colors.
- A mole that is larger than a pencil eraser.
- A mole that is itchy, painful, or bleeds.
- A spot on the skin that looks different from the surrounding skin. Melanomas may be flat or raised and darker or lighter than the surrounding skin.
It’s important to note that these warning signs can also occur with other types of skin cancer, and not all melanomas have these characteristics. Suppose you have any concerns about a mole or spot on your skin. In that case, it is always a good idea to see a healthcare provider for an evaluation. Early detection and treatment of melanoma can improve the chances of a successful outcome.
Diagnosis of melanoma
Melanoma is typically diagnosed through a physical examination of the skin, a review of the patient’s medical history, and one or more diagnostic tests. Here are some standard diagnostic tests that may be used to diagnose melanoma:
- Skin biopsy: A skin biopsy involves removing a sample of skin tissue for examination under a microscope. This is the most accurate way to diagnose melanoma and is usually the first step in the diagnostic process.
- Dermatoscopy: Dermatoscopy is a non-invasive technique that uses a unique device to magnify and illuminate the skin. It can examine moles and other skin lesions and may help identify melanoma or other skin cancers.
- Blood tests: Sometimes, a healthcare provider may order blood tests to help diagnose melanoma or determine the cancer stage. These tests may include liver function tests, blood cell counts, and other laboratory tests. This is usually performed for advanced cases of melanoma.
- Imaging tests: If a healthcare provider suspects melanoma has spread beyond the skin, they may order imaging tests such as CT scans, PET scans, or MRIs to help determine the extent of cancer. This is usually performed for advanced cases of melanoma.
If melanoma is diagnosed, the healthcare provider will also stage cancer to determine the extent of the disease and guide treatment decisions. This may involve additional tests, such as lymph node biopsies or imaging studies.
It’s important to note that not all skin cancers are melanoma, and other conditions can cause similar symptoms. Therefore, a healthcare provider will consider several factors when diagnosing melanoma, including the appearance of the lesion, the patient’s medical history, and the results of diagnostic tests.
Staging of melanoma
Once you have been diagnosed with melanoma with a skin biopsy, the next most important step is to stage the skin cancer. Melanoma is staged based on the extent of the tumor and how far it has spread. Staging is essential in determining the appropriate treatment and predicting the patient’s prognosis (outlook). There are several different staging systems for melanoma. Still, the American Joint Committee on Cancer (AJCC) staging system is the most common.
The AJCC staging system for melanoma consists of five stages, numbered 0 to IV. Stage 0 refers to melanoma in situ, which means the cancer is still confined to the top layer of skin (the epidermis). Stage IV refers to advanced melanoma, which means cancer has spread beyond the skin to other organs or lymph nodes.
Here is a brief overview of the stages of melanoma:
- Stage 0: Melanoma in situ
- Stage I: The melanoma is less than 1 millimeter thick and has not spread to nearby lymph nodes.
- Stage II: The melanoma is more than 1 millimeter thick or has spread to one nearby lymph node.
- Stage III: The melanoma is more than 1 millimeter thick and has spread to one or more nearby lymph nodes or to nearby skin or tissues.
- Stage IV: The melanoma has spread to distant organs or lymph nodes.
Staging is usually determined through a physical examination, a patient’s medical history review, and one or more diagnostic tests, such as a skin biopsy, imaging tests, or blood tests. It’s important to note that the cancer stage can change over time as the tumor progresses or responds to treatment.
The cure rate for melanoma depends on several factors, including the cancer stage at diagnosis, the patient’s overall health, and the effectiveness of the treatment. Melanoma generally has a higher cure rate when caught early before it has had a chance to spread to other body parts.
According to the American Cancer Society, the 5-year survival rate for people with melanoma that has not spread beyond the skin (stage 0 to II) is about 92%. This means that about 92% of people with early-stage melanoma are alive 5 years after diagnosis. For people with stage III melanoma, the 5-year survival rate is about 63%. For people with stage IV melanoma, the 5-year survival rate is about 15%.
It’s important to note that these survival rates are estimates and do not consider individual differences in patient characteristics, such as age, overall health, and other factors that can affect the prognosis. Survival rates also do not reflect advances in treatment that may improve outcomes over time.
It’s worth noting that melanoma can be a severe and potentially life-threatening condition. Still, early detection and treatment can significantly improve the chances of a successful outcome. Therefore, it is essential to be aware of the warning signs of melanoma and to see a healthcare provider if you have any concerns about a mole or spot on your skin.
Treatment of melanoma
The treatment of melanoma depends on the stage of cancer, the location of the tumor, and the patient’s overall health. Melanoma treatment options may include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy.
Surgery is the most common treatment for melanoma and is usually the first line of treatment. Surgery aims to remove the cancerous tissue and a margin of healthy tissue around it to reduce the risk of cancer returning. The type of surgery will depend on the size and location of the tumor.
Chemotherapy is a cancer treatment that uses medications to kill cancer cells. It is usually used for advanced melanoma or melanoma that has spread to other body parts.
Radiation therapy uses high-energy beams to kill cancer cells. For example, it may treat melanoma that has spread to the lymph nodes or other body parts or reduce the risk of cancer returning after surgery.
Targeted therapy is a type of cancer treatment that targets specific abnormalities in cancer cells. For example, it may be used to treat advanced melanoma or melanoma that has returned after treatment.
Immunotherapy is a cancer treatment that helps the body’s immune system recognize and attack cancer cells. It may be used to treat advanced melanoma or melanoma that has returned after treatment.
The specific treatment plan for a patient with melanoma will depend on several factors, including the stage of cancer, the patient’s overall health, and the treatment goals. At Phoenix Surgical Dermatology Group, Dr. Ramin Fathi will work with the patient to develop a personalized treatment plan that considers the patient’s individual needs and preferences.
Gene expression profiling
We employ state-of-the-art techniques at Phoenix Surgical Dermatology Group to diagnose and manage skin cancers such as melanoma. One such test is called gene expression profiling. Gene expression profiling is a laboratory test that looks at the activity of specific genes in a tissue sample. For example, gene expression profiling in melanoma may help classify cancer and predict the patient’s prognosis (outlook).
Gene expression profiling can be used to identify specific patterns of gene activity that are associated with different types of melanoma. For example, some ways of gene activity may be associated with more aggressive forms of cancer. In contrast, others may be related to a better prognosis.
Gene expression profiling may be used in conjunction with other diagnostic tests, such as a skin biopsy, to help determine the stage of cancer and guide treatment decisions. It may also be used to monitor the treatment response and identify potential targets for new therapies.
Gene expression profiling is a complex and specialized test typically performed in a laboratory. Therefore, it requires specialized equipment and expertise. Nevertheless, the test results may be used with other clinical and laboratory data to guide the management of the patient’s cancer.
Mohs surgery for melanoma
Phoenix Surgical Dermatology Group is one of the only practices in Phoenix, Arizona, performing Mohs surgery for melanoma. Mohs surgery for melanoma has shown superior outcomes to standard surgical excision, including improved 5-year overall survival. Mohs micrographic surgery (also known as Mohs surgery) is a specialized surgical technique used to treat certain types of skin cancer, including melanoma. It is named after the surgeon who developed the method, Dr. Frederic Mohs.
Mohs surgery is a precise and specialized procedure that involves removing thin layers of skin tissue one at a time and examining them under a microscope to ensure that all cancerous cells have been removed. It is often used for skin cancers located in difficult-to-treat areas or for cancers with a high risk of recurrence, such as melanoma.
Mohs surgery is typically performed on an outpatient basis and involves the following steps:
- The surgeon removes a thin layer of cancerous tissue and examines it under a microscope to identify any remaining cancerous cells. In the case of melanoma, a specialized stain known as MART-1 is used to help identify cancerous cells. This technique is only used in advanced Mohs surgery centers, such as Phoenix Surgical Dermatology Group.
- If cancerous cells are present, the surgeon removes another layer of tissue and repeats the process. This continues until all of the cancerous cells have been removed.
- Once the cancerous tissue has been completely removed, the surgeon closes the wound with stitches or using skin from another body part.
Mohs surgery has a high success rate and is often used to treat melanoma and other types of skin cancer. It is generally considered a safe procedure, although it may be associated with certain risks and complications, such as infection, scarring, or bleeding. Therefore, discussing the potential benefits and risks of Mohs surgery with a healthcare provider is essential before deciding if it is right for you.
Overall, the treatments and prognosis for melanoma have improved over the last decade. Phoenix Surgical Dermatology Group is proud to be a practice dedicated to providing cutting-edge care for melanoma. If you or a loved one was recently diagnosed with melanoma, don’t hesitate to contact our office at 480-666-5568 to schedule a consultation.