With early detection and treatment, melanoma can often be cured. If not found early, however, the cancer can grow deeper into the layers of the skin and metastasize, making it very difficult to treat.
In addition to the physical features that predict the risk of spreading, such as thickness, we also know that the biology of the tumor can change to an aggressive form in thinner melanomas. These can have a higher risk of spreading than originally determined by factors such as thickness or a sentinel lymph node biopsy. With the addition of the DecisionDx™-Melanoma tool, physicians will be able to more accurately assess a patient’s individual risk of metastasis to better treat and manage the disease.
When treating melanoma, your doctor’s primary goal is to remove all of the cancer. If the cancer is thin and has not spread, it is usually possible for your dermatologist to remove your melanoma during an office visit. Each patient’s melanoma is different, so based on your individual case, your doctor will perform one of the following:
If you are having your melanoma excised, your physician (dermatologist, plastic surgeon, general or oncological surgeon) will start by numbing your skin and surgically cutting out the melanoma as well as some of the surrounding skin (the “margins”).
In this type of excision, a Mohs surgeon, a dermatologist specially trained in surgical technique, begins by removing the visible part of the melanoma. Next, he or she removes the cancer cells one layer of skin at a time. This is done by preparing slides with a tissue sample and observing the cells under a microscope. A dye is used to better see the cells. This layer-by-layer approach continues until cancer cells are no longer detected.
When your melanoma is detected early, excision or Mohs may be all the treatment you need. This is because, in its earliest stage, the melanoma may have only grown in the outer layer of your skin (epidermis) and it is possible to remove it completely without subsequent procedures. This is referred to as melanoma in situ or Stage 0. With surgical removal, the cure rate is almost 100%. When melanoma begins to grow deeper into the skin, however, treatment becomes more complex. In this case, treatment may begin with excision, and continue with one of the following:
• Lymphadenectomy: Removal of lymph nodes
• Immunotherapy: Stimulating the patient’s immune system to attack the cancer cells
• Chemotherapy: Use of medicines or drugs to kill cancer cells
• Radiation therapy: Use of high-energy radiation to shrink tumors and kill cancer cells, usually in the form of X-rays, gamma rays, or charged particles