Melanoma

Melanoma is a serious form of skin cancer where normal skin cells change into abnormal cancerous cells and rapidly grow out of control. Melanoma can occur anywhere on the body and when left untreated, it can spread to other organs inside the body. The risk for melanoma is higher with a family history of melanoma.

Melanoma most often presents as a brown or black lesions. The abnormal features of melanoma are described in the acronym ABCDE:

• Asymmetry – one half of the lesion looks different than the other half
• Border – the border of the lesion has a jagged or uneven edge
• Color – the lesion has different colors or a mix or colors
• Diameter – the lesion is larger than the eraser on the end of a pencil
• Evolution – the size, color, or shape has changed over time

If you have a lesion that fits any of the categories listed above, show it to your dermatologist. If your dermatologist is concerned about a lesion, they will do a skin biopsy to confirm a diagnosis of melanoma.

What is the treatment?

The treatment for melanoma varies based on the stage, or severity, of melanoma found.

• Surgery: Most melanomas are surgically excised with appropriate margins to ensure removal of the entire skin cancer. The specimen removed is sent to a dermatopathologist for confirmation that the entire skin cancer is removed.
• Mohs Micrographic Surgery: This is a tissue-sparing procedure in which the cancer is excised in layers to confirm negative margins. A Mohs surgeon has the necessary equipment to process the tissue and confirm negative margins prior to closing the wound. The patient will have confirmation the entire skin cancer has been removed before the surgeon begins to close the wound with sutures, repairs it with a skin graft or flap, or allows the wound to heal on its own through second intention. This is the preferred method of treatment for large cancers or tumors on cosmetically sensitive areas like face, ears, scalp, fingers, toes and sometimes neck.
• Immunotherapy: When a melanoma has spread to other parts of the body beyond the skin, medications that boost certain aspects of the body’s immune system can be used to stop progression of the melanoma.
• Targeted therapy: When a melanoma has spread to other parts of the body beyond the skin, doctors can use specific medications that work to treat cancer by blocking a specific protein or molecule.
• Radiation & Chemotherapy: These are two methods of treatment used to kill cancer cells in melanoma that has spread to other parts of the body.

How can melanoma be prevented?

• Stay out of the sun between 10 AM and 4 PM
• Wear sunscreen and reapply it every 90 minutes
• Wear sun protective clothing
• Do not use tanning beds. Tanning beds increase the risk of melanoma.

After treatment of the melanoma, your dermatologist might order follow-up imaging tests if necessary and recommend that you have full body skin exams regularly to check the for recurrence of the treatment melanoma or new melanomas. If you have a personal or family history of melanoma or concerning lesions that fit the ABCDE categories, our dermatologists can evaluate you and determine the best course of treatment.