Treating Stage 1 To 2 Melanoma
Treating stage 1 melanoma involves surgery to remove the melanoma and a small area of skin around it. This is known as surgical excision.
Surgical excision is usually done using local anaesthetic, which means you’ll be awake, but the area around the melanoma will be numbed, so you will not feel pain. In some cases, general anaesthetic is used, which means you’ll be unconscious during the procedure.
If a surgical excision is likely to leave a significant scar, it may be done in combination with a skin graft. However, skin flaps are now more commonly used because the scars are usually less noticeable than those resulting from a skin graft.
Read more about flap surgery.
In most cases, once the melanoma has been removed there’s little possibility of it returning and no further treatment should be needed. Most people are monitored for 1 to 5 years and are then discharged with no further problems.
Exam By A Health Care Professional
Some doctors and other health care professionals do skin exams as part of routine health check-ups.
If your primary doctor finds any unusual moles or other suspicious areas, he or she may refer you to a dermatologist, a doctor who specializes in skin problems. Dermatologists can also do regular skin exams. Many dermatologists use a technique called dermoscopy to look at spots on the skin more clearly. A photo of the spot may be taken as well.
Regular skin exams are especially important for people who are at higher risk of melanoma, such as people with dysplastic nevus syndrome, people with a strong family history of melanoma, and people who have had melanoma before. If you have many moles, your doctor might advise taking full-body photos so your moles can be tracked over time and new ones can be seen more readily. Talk to your doctor about how often you should have your skin examined.
What Are Targeted Therapies
A targeted therapy is a drug that blocks the growth of cancer by interfering with specific molecules involved in tumour growth. This is different to non-specific treatments like chemotherapy that simply aim to kill rapidly dividing cells.
This new generation of drugs has resulted in a big improvement in melanoma treatment for patients with the spread of the disease to other organs.
Researchers have identified some of the key genetic mutations that drive the growth of melanoma in patients. These discoveries are opening new avenues for treatment options using drugs that selectively block activity of these driving mutations, known as targeted therapy.
The genetic mutations involved in melanoma development that have been discovered so far have interesting names. They include:
More mutations are continuing to be discovered.
Read Also: Does Amelanotic Melanoma Blanch When Pressed
The Stage Of Melanoma Depends On The Thickness Of The Tumor Whether Cancer Has Spread To Lymph Nodes Or Other Parts Of The Body And Other Factors
To find out the stage of melanoma, the tumor is completely removed and nearby lymph nodes are checked for signs of cancer. The stage of the cancer is used to determine which treatment is best. Check with your doctor to find out which stage of cancer you have.
The stage of melanoma depends on the following:
- The thickness of the tumor. The thickness of the tumor is measured from the surface of the skin to the deepest part of the tumor.
- Whether there are:
- Satellite tumors: Small groups of tumor cells that have spread within 2 centimeters of the primary tumor.
- Microsatellite tumors: Small groups of tumor cells that have spread to an area right beside or below the primary tumor.
- In-transit metastases: Tumors that have spread to lymph vessels in the skin more than 2 centimeters away from the primary tumor, but not to the lymph nodes.
What Is Radiation Therapy
After surgery your doctors may recommend radiation therapy to help improve your outcome.
Radiation therapy uses x-rays to kill cancer cells by damaging their DNA. Normal cells can repair damage to their DNA, but cancer cells are less able to do this and therefore die. The dead cancer cells are then broken down and eliminated by the bodys natural processes.
Since radiation therapy damages normal cells as well as cancer cells, treatment must be carefully planned to allow the normal cells to repair themselves and minimise side effects.
The total dose of radiation and the number of treatments you need will depend on the size and location of your melanoma, your general health and other medical treatments youre receiving.
The radiation used for cancer treatment can come from a machine outside your body or it might come from radioactive material placed in your body near the cancer cells.
Read Also: How To Identify Basal Cell Carcinoma
Treating Stage Iv Melanoma
Stage IV melanomas have already spread to distant lymph nodes or other areas of the body. Skin tumors or enlarged lymph nodes causing symptoms can often be removed by surgery or treated with radiation therapy.
Metastases in internal organs are sometimes removed, depending on how many there are, where they are, and how likely they are to cause symptoms. Metastases that cause symptoms but cannot be removed may be treated with radiation, immunotherapy, targeted therapy, or chemotherapy.
The treatment of widespread melanomas has changed in recent years as newer forms of immunotherapy and targeted drugs have been shown to be more effective than chemotherapy.
Immunotherapy drugs called checkpoint inhibitors such as pembrolizumab or nivolumab are typically the first drugs tried, especially in people whose cancer cells do not have BRAF gene changes. These drugs can shrink tumors for long periods of time in some people. Ipilimumab , a different type of checkpoint inhibitor, is not typically used by itself as the first treatment, although it might be combined with nivolumab or pembrolizumab. This slightly increase the chances that the tumor will shrink, although itâs also more likely to result in serious side effects, which needs to be considered carefully. People who get any of these drugs need to be watched closely for serious side effects..
Itâs important to carefully consider the possible benefits and side effects of any recommended treatment before starting it.
How Is Melanoma Diagnosed
If you have a mole or other spot that looks suspicious, your doctor may remove it and look at it under the microscope to see if it contains cancer cells. This is called a biopsy.
After your doctor receives the skin biopsy results showing evidence of melanoma cells, the next step is to determine if the melanoma has spread. This is called staging. Once diagnosed, melanoma will be categorized based on several factors, such as how deeply it has spread and its appearance under the microscope. Tumor thickness is the most important characteristic in predicting outcomes.
Melanomas are grouped into the following stages:
- Stage 0 : The melanoma is only in the top layer of skin .
- Stage I: Low-risk primary melanoma with no evidence of spread. This stage is generally curable with surgery.
- Stage II: Features are present that indicate higher risk of recurrence, but there is no evidence of spread.
- Stage III: The melanoma has spread to nearby lymph nodes or nearby skin.
- Stage IV: The melanoma has spread to more distant lymph nodes or skin or has spread to internal organs.
Recommended Reading: Does Skin Cancer Burn And Itch
There Are Three Ways That Cancer Spreads In The Body
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Unusual Moles Exposure To Sunlight And Health History Can Affect The Risk Of Melanoma
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Risk factors for melanoma include the following:
- Having a fair complexion, which includes the following:
- Fair skin that freckles and burns easily, does not tan, or tans poorly.
- Blue or green or other light-colored eyes.
- Red or blond hair.
Being White or having a fair complexion increases the risk of melanoma, but anyone can have melanoma, including people with dark skin.
See the following PDQ summaries for more information on risk factors for melanoma:
Don’t Miss: Soderstrom Skin Cancer Screening
Faq Frequently Asked Questions
Author: Jonathan Meddings BMedLabSc First answered: 22 Sep 2014Last reviewed: 17 Oct 2018Rating: 4.3 out of 5Votes: 1516 Category: Melanoma
All Health& ‘s health information is accredited by international standards and approved by our world-class Health& Medical Advisory Board.
Always ask your doctor or healthcare provider any questions you may have regarding a medical condition. In case of emergency, call your doctor or dial 911 , or dial 112 , or dial 000 immediately.
Quick Answer: How Small Can Melanoma Be
While its ideal to detect a melanoma when it is small, its a warning sign if a lesion is the size of a pencil eraser or larger. Some experts say it is also important to look for any lesion, no matter what size, that is darker than others.
Can melanoma be smaller than six millimeters?
- Its a fact that melanoma can be well under six millimeters, and in fact, can be only one millimeter in diameter. The ABCD rules for melanoma certainly do not apply to all such skin cancers. Some dermatologists even refer to very small melanomas as micromelanomas, meaning, they are much smaller than a pencil eraser .
Don’t Miss: Does Amelanotic Melanoma Blanch When Pressed
Is Stage 4 Melanoma A Death Sentence
Stage 4 melanoma used to be a death sentence. The disease doesnt respond to radiation or chemotherapy, and patients survived, on average, less than a year. But over the last decade, doctors are successfully using a new approach, one significantly different than the treatment options available for the last 150 years.
Treating Stage Ii Melanoma
Wide excision is the standard treatment for stage II melanoma. The width of the margin depends on the thickness and location of the melanoma.
Because the melanoma may have spread to nearby lymph nodes, many doctors recommend a sentinel lymph node biopsy as well. This is an option that you and your doctor should discuss.
If an SLNB is done and does not find cancer cells in the lymph nodes, then no further treatment is needed, although close follow-up is still important.
If the SLNB finds that the sentinel node contains cancer cells, then a lymph node dissection will probably be done at a later date. Another option might be to watch the lymph nodes closely by getting an ultrasound of the nodes every few months.
If the SLNB found cancer, adjuvant treatment with an immune checkpoint inhibitor or targeted therapy drugs might be recommended to try to lower the chance the melanoma will come back. Other drugs or perhaps vaccines might also be options as part of a clinical trial.
Don’t Miss: Stage 3 Basal Cell Carcinoma Survival Rate
The Following Stages Are Used For Melanoma:
- Stage IA: The tumor is not more than 1millimeter thick, with or without ulceration.
- Stage IB: The tumor is more than 1 but not more than 2 millimeters thick, without ulceration. Enlarge Stage I melanoma. In stage IA, the tumor is not more than 1 millimeter thick, with or without ulceration . In stage IB, the tumor is more than 1 but not more than 2 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.
- Stage IIA: The tumor is either:
- more than 1 but not more than 2 millimeters thick, with ulceration or
- more than 2 but not more than 4 millimeters thick, without ulceration. Enlarge Stage IIA melanoma. The tumor is more than 1 but not more than 2 millimeters thick, with ulceration OR it is more than 2 but not more than 4 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.
Stage III is divided into stages IIIA, IIIB, IIIC, and IIID.
Melanoma Symptoms And Signs
Melanoma is a type of skin cancer that forms in pigment-forming cells . Melanoma is the most serious type of skin cancer. Rarely, melanomas can be found in other areas of the body that contain pigment-forming cells, including the eye, the tissues around the brain and spinal cord, or the digestive tract. Melanomas of the skin produce changes in the appearance of the skin, but these changes can sometimes be seen with other skin conditions. The characteristic symptoms include a change in an existing mole or new mole with asymmetric borders, uneven coloring, increasing size, scaling, or itching. Melanomas are typically not painful. It is always important to seek medical advice when you develop a new pigmented spot on the skin or have a mole that is growing or changing.
Recommended Reading: What Is The Most Aggressive Skin Cancer
Eczema Or Atopic Dermatitis
Different types of swelling of the skin are classified as eczema. Symptoms include dry, itchy, and scaly skin, as well as rashes on the face or wrists and ankles.
Doctor Dyah Novita Anggraini explained, The trigger for eczema is unknown and difficult to cure. Therefore, the trigger factors must be avoided.
Eczema conditions should be regularly managed. Avoid scratching the itchy skin as it can worsen eczema and cause inflammation.
Treatment can be done with drugs prescribed by a dermatologist. Skin creams can be given to control itching. Then, the use of hypoallergenic products for skin and hair is also recommended.
It Is Not Only About Moles
Melanoma is a malignant tumor that develops from melanocytes, which are cells responsible for the production of dark pigment in the skin. People believe that melanoma always develops from a nevus . However, only one in five melanomas is formed in the area of a mole. In 80% of cases, the tumor occurs spontaneously on the unchanged skin of the body and face, as well as on the palms, feet, and even under the nails. People often say that a new mole appeared, referring to a neoplasm.
However, not every growing mole or another skin defect turns out to be a melanoma. There are many benign neoplasms that do not require radical intervention, for example, papillomas or warts.
A dermatologist will examine moles and other suspicious skin areas under multiple magnification with a simple and informative method of skin examination called dermatoscopy. If the doctor performing dermatoscopy notices signs of growth and inflammation, he will refer the patient to an oncologist. who will then take further decisions.
Recommended Reading: Does Skin Cancer Make You Lose Hair
Treatment Of Stage I Melanoma
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage I melanoma may include the following:
- Surgery to remove the tumor and some of the normaltissue around it. Sometimes lymph node mapping and removal of lymph nodes is also done.
- A clinical trial of new ways to find cancercells in the lymph nodes.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
There Are Different Types Of Treatment For Patients With Melanoma
Different types of treatment are available for patients withmelanoma. Some treatments arestandard , and some are being tested inclinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Recommended Reading: What Is The Most Aggressive Skin Cancer