Melanoma is the most deadly of the common types of skin cancer. This cancer is almost always curable if caught early in its course. However, if left unmonitored, this type of cancer will spread to the lymph nodes and then to different sites within the body. These usually arise from pigmented (brown) moles from the body. As the melanomas grow, there are usually visible changes that can lead to the suspicion of a mole being cancerous. Some of these changes include:
A- Asymmetry – the mole is not symmetric
B- Borders – the borders of the mole are irregular
C- Color – there is variation in the color within the mole
D- Diameter – is usually greater than ¼ inch (although they can be less)
E- Evolution- changes within a mole
If you note one or more of these findings within a mole, we can help you determine the likelihood of the mole being cancerous and may recommend biopsy of the lesion.
Melanomas are graded by the thickness of the cancer. Early melanomas (less than 1mm thick) usually are considered to have a very low potential to spread and are therefore treated primarily with wide local excision. As the melanoma gets deeper, the risk of lymph node metastases increases we recommend evaluation of the lymph nodes near the tumor site. We can perform a sentinel node biopsy at the time of the surgery to evaluate the regional lymph nodes for spread. This is done through a small incision and has relatively small risk to the patient.
If there is any spread of the melanoma, we must enlist the assistance of other medical providers. Surgical and medical oncologists are involved in cases that show evidence of spreading.
We have a good deal of experience of the removal of melanoma and will work with each patient and thoroughly explain each step. Often, the reconstruction of the defect requires advanced techniques to minimize the appearance of the scars. This varies greatly by location.
After removal of a melanoma, patients will need close follow up for at least two years. This is usually done with a combination of visiting us and a dermatologist. After two years, continued follow up with a dermatologist is needed indefinitely, but at a decreased frequency.