Melanoma stage determines treatment plan: Advice from an expert

While melanoma is much less common than other types of skin cancer, it is the most serious because it is more likely to metastasize, or spread, to other parts of the body.

Melanoma starts in the melanocytes, which are cells that make the pigment that gives skin its color. The first signs of melanoma are often either a change in an existing mole or the development of a new pigmented or unusual-looking growth on the skin.

The ABCDE guide helps you determine if a mole or a spot may indicate melanoma or another type of skin cancer:

• A is for asymmetrical shape. One half is unlike the other half.
• B is for border. Look for moles with irregular, notched or scalloped borders.
• C is for color. Look for growths that have changed color, have many colors or have uneven color.
• D is for diameter. Look for new growth in a mole larger than 1/4 inch (about 6 millimeters, or the diameter of a pencil eraser).
• E is for evolving. Watch for moles that change in size, shape, color or height, especially if part or all of the mole turns black. Moles may also evolve to develop new signs and symptoms, such as itchiness or bleeding.

If you notice any of these signs, make an appointment with your primary care clinician or a health care professional.

A few types of tests are used to diagnose melanoma. The first is a punch biopsy performed with a circular blade pressed into the skin around the suspicious mole.

Another technique is called an excisional biopsy, which uses a scalpel to remove the entire mole and a very tiny bit of normal skin around it. It’s also important to have a total skin exam at the initial diagnosis because some patients will have a second primary melanoma found at the same time.

Once melanoma is diagnosed, your care team will determine the extent of the cancer by measuring its thickness, identifying whether it has spread to the lymph nodes and looking for signs of cancer beyond the skin. If there’s a chance the cancer could spread to nearby lymph nodes, you might need a sentinel node biopsy.

During this procedure, dye is injected into the area where your melanoma was removed and flows to the closest lymph node or nodes. Those lymph nodes, called the sentinel lymph nodes, are removed and tested for cancer cells.

Understanding the stage of melanoma will help your health care team create a treatment plan. Melanoma treatment often starts with surgery to remove the cancer.

The treatment for thinner melanomas generally removes the melanoma with a margin of tissue, typically 1 to 2 centimeters of normal tissue. If the sentinel lymph node biopsy determines that the cancer has spread or your melanoma grows deeper into the skin, active surveillance with imaging, additional surgery and/or systemic treatment may be recommended.

Other treatments include radiation therapy and systemic therapy. Recent advancements have significantly improved the prognosis for patients diagnosed with melanoma.

These include targeted therapies, an approach that uses medicine that attacks specific chemicals in cancer cells, and immunotherapies, which use medicines that help the body’s immune system to kill cancer cells. Either option might be recommended for selected patients. Some patients also may benefit from systemic therapy before an operation.

Clinical trials have led to recent advancements in melanoma treatment because physician-scientists can test new and better approaches. Efforts are being made to enhance the accessibility and ease of patient participation in clinical trials.

While melanoma is a serious form of skin cancer, you can reduce your risk. Exposure to ultraviolet (UV) light is considered the leading cause of melanoma.

UV light comes from the sun and tanning lamps and beds. You can reduce your risk by avoiding tanning beds, wearing broad-spectrum sunscreen with SPF 30 or higher, avoiding sun exposure during peak hours (10 a.m.–3 p.m.) and wearing sun protective gear outdoors. Use about 1 ounce of sunscreen and reapply every two hours, or more if you’ve been sweating or swimming.

2025 Tribune Content Agency, LLC.

While melanoma is much less common than other types of skin cancer, it is the most serious because it is more likely to metastasize, or spread, to other parts of the body.

Melanoma starts in the melanocytes, which are cells that make the pigment that gives skin its color. The first signs of melanoma are often either a change in an existing mole or the development of a new pigmented or unusual-looking growth on the skin.

The ABCDE guide helps you determine if a mole or a spot may indicate melanoma or another type of skin cancer:

• A is for asymmetrical shape. One half is unlike the other half.
• B is for border. Look for moles with irregular, notched or scalloped borders.
• C is for color. Look for growths that have changed color, have many colors or have uneven color.
• D is for diameter. Look for new growth in a mole larger than 1/4 inch (about 6 millimeters, or the diameter of a pencil eraser).
• E is for evolving. Watch for moles that change in size, shape, color or height, especially if part or all of the mole turns black. Moles may also evolve to develop new signs and symptoms, such as itchiness or bleeding.

If you notice any of these signs, make an appointment with your primary care clinician or a health care professional.

A few types of tests are used to diagnose melanoma. The first is a punch biopsy performed with a circular blade pressed into the skin around the suspicious mole.

Another technique is called an excisional biopsy, which uses a scalpel to remove the entire mole and a very tiny bit of normal skin around it. It’s also important to have a total skin exam at the initial diagnosis because some patients will have a second primary melanoma found at the same time.

Once melanoma is diagnosed, your care team will determine the extent of the cancer by measuring its thickness, identifying whether it has spread to the lymph nodes and looking for signs of cancer beyond the skin. If there’s a chance the cancer could spread to nearby lymph nodes, you might need a sentinel node biopsy.

During this procedure, dye is injected into the area where your melanoma was removed and flows to the closest lymph node or nodes. Those lymph nodes, called the sentinel lymph nodes, are removed and tested for cancer cells.

Understanding the stage of melanoma will help your health care team create a treatment plan. Melanoma treatment often starts with surgery to remove the cancer.

The treatment for thinner melanomas generally removes the melanoma with a margin of tissue, typically 1 to 2 centimeters of normal tissue. If the sentinel lymph node biopsy determines that the cancer has spread or your melanoma grows deeper into the skin, active surveillance with imaging, additional surgery and/or systemic treatment may be recommended.

Other treatments include radiation therapy and systemic therapy. Recent advancements have significantly improved the prognosis for patients diagnosed with melanoma.

These include targeted therapies, an approach that uses medicine that attacks specific chemicals in cancer cells, and immunotherapies, which use medicines that help the body’s immune system to kill cancer cells. Either option might be recommended for selected patients. Some patients also may benefit from systemic therapy before an operation.

Clinical trials have led to recent advancements in melanoma treatment because physician-scientists can test new and better approaches. Efforts are being made to enhance the accessibility and ease of patient participation in clinical trials.

While melanoma is a serious form of skin cancer, you can reduce your risk. Exposure to ultraviolet (UV) light is considered the leading cause of melanoma.

UV light comes from the sun and tanning lamps and beds. You can reduce your risk by avoiding tanning beds, wearing broad-spectrum sunscreen with SPF 30 or higher, avoiding sun exposure during peak hours (10 a.m.–3 p.m.) and wearing sun protective gear outdoors. Use about 1 ounce of sunscreen and reapply every two hours, or more if you’ve been sweating or swimming.

2025 Tribune Content Agency, LLC.