Learning that you have been diagnosed with melanoma – the most serious type of skin cancer – is a life-changing moment. After all, skin cancer is cancer. You may have left your dermatologist’s office with some handouts, or maybe you are reading this to learn more about what happens next.
Step 1: Determining the stage of your melanoma
Your dermatologist will use the information from the initial skin exam and biopsy to determine the stage of your melanoma. The following table gives you a very simple explanation of the stages. Each stage can have sub-stages, but your dermatologist will explain more about your individual stage.
- Stage 0 – Melanoma is in the outer layers of the skin. Treatment in this stage often cures the patient of melanoma.
- Stage I – Melanoma is in the outer layers of skin (epidermis) and sometimes the upper part of the inner layers (the dermis). A cure is often possible.
- Stage II – Melanoma is found in the outer layers of skin and in the lower layers of the dermis. The likelihood of a cure is still good.
- Stage III – The cancer cells have spread beyond the skin and are found in a lymph node(s) or lymph vessel(s) closest to where the melanoma began. Treatment will be aggressive.
- Stage IV – The cancer has spread beyond the closest lymph nodes to one or more parts of the body. Treatment will be aggressive, and survival rates can be as low as 15%
Step 2: Treatment
The goal of treatment for any stage of melanoma is to remove all of the cancer. While each patient’s treatment plan will vary depending on their stage of melanoma, these are common treatment options:
- Surgery – If your melanoma was detected early, surgery may be the only treatment needed for you. A dermatologist can often perform this type of surgery during an office visit while you remain awake. During surgery, your dermatologist will remove any remaining tumor and extra skin around the site. In the earliest stages, surgery often cures melanoma.
- Medication – Because melanoma can spread quickly, many treatment plans include more than one treatment. When melanoma is more widespread, treatment may begin with medication used to shrink the melanoma tumor before surgery. After surgery, another treatment may be given to kill any remaining cancer cells.
- Lymph Node Biopsy – If it’s likely the cancer has spread, surgery becomes more complex. A surgeon may remove the melanoma along with the first lymph node to which the cancer may have spread. Removing this lymph node is a type of biopsy called a sentinel lymph node biopsy. This type of surgery and biopsy must be performed in a hospital, and you receive anesthesia to make you unconscious.
When melanoma grows deeper into the skin or spreads, treatment options become more aggressive. It may begin with one of the options described above, but additional treatments may include:
- Lymphadenectomy: Surgery to remove lymph nodes
- Immunotherapy: Treatment that helps the patient’s immune system fight the cancer
- Targeted therapy: Drugs that can temporarily shrink the cancer
- Chemotherapy: Medicine that kills the cancer cells
- Radiation therapy: X-rays that kill the cancer cells
Step 3: Lifelong follow up
Melanoma can return or spread even after treatment. Anyone who has had melanoma has a higher risk of recurrence. Your dermatologist will determine how often he/she will want to see you. Every 3 months is common in the beginning and may eventually lengthen to every 6 months or once a year.
Monthly self-skin checks are vital to early diagnosis of skin cancer. You know your skin better than anyone else and will notices changes. Alert your dermatologist to any changes you may be noticing.