Melanoma Symptoms & Treatment

Skin cancer is definitely the most common form of cancer. However, what comes next depends very much upon your type of skin cancer. Unlike basal cell cancer and squamous cell skin carcinoma (which are more common and can be removed completely), melanoma or worse, metastatic melanoma (stage IV), is the most dangerous type of skin cancer.

We know skin cancer diagnosis and treatment can be a confusing and overwhelming process. That’s why we offer you the support of a nurse navigator to help get questions answered, connect you with resources and education, identify any barriers to timely care and refer you to additional support services as needed.

Malignant melanomas are aggressive skin tumors. Left alone, they will continue to metastasize (grow) and spread from the lymph nodes to other organs of the body. However, if caught early, melanoma prognosis can be excellent and curable along with surgical treatment.

Most melanomas present with rapidly changing, dark pigmented skin lesions. Patients may complain about bleeding. Some melanomas could be amelanotic or non pigmented. Melanomas can also develop on a preexisting nevus. Sometimes melanomas can be running in families. Less frequently melanomas can present on mucosal surfaces.

• Melanoma (in situ and invasive) of the head and neck, torso as well as selected mucosal melanomas
• Merckel cell carcinoma, a rare type of skin cancer
• Invasive squamous cell carcinoma, the second most common type of skin cancer

Most of the time, if your dermatologist finds a suspicious skin lesion, he or she can perform a direct biopsy and provide a diagnosis. Your biopsy will be reviewed by our dedicated dermatopathologist who has undergone specialized training. After collecting enough, your case is presented in our multidisciplinary team tumor board meetings.

During this presentation, each case is carefully and individually reviewed focusing on presenting symptoms, exam findings, pathology slides, laboratory findings. We occasionally decide to obtain additional studies to help clarify diagnostic dilemmas. At the end of each presentation our multidisciplinary team agrees on the next best step in further work-up or management.

We determine melanoma is at an advanced stage when a larger number of tumor cells have already traveled to regional nodes or distant sites. A non-surgical or surgical biopsy will determine the exact advancement. Our interventional radiologists perform most of these procedures.

Those with melanomas limited to just regional lymph nodes are still candidates for surgeries called regional lymph node dissections. Those who have other sites of metastatic melanomas can still undergo surgery based on the number and location of tumor sites. Those with single or limited sites of melanoma benefit the most from surgery.

Most patients with sentinel node positive or stage 4 melanomas will be receiving adjuvant systemic therapy under the guidance of our dedicated medical oncologist. External beam radiation is also being used in well selected cases. Certain patients will receive systemic therapy prior to a surgical intervention. These are complex decisions made during discussions between patient and providers as well as tumor boards. For selected patients, clinical studies are also available. For those with stage 4 melanoma, symptoms like pain, bleeding and obstruction can be targeted to improve overall quality of life.