Melanoma

Treatment options

Stage I and II melanoma

The most important factor in selecting the best treatment plan is the stage of your melanoma. More than 80 percent of melanomas are considered early-stage (Stage I or II) at the time of diagnosis, and the cure rate is highest for these melanomas. For many early-stage melanomas, surgical removal of the melanoma is the only treatment needed.

Stage IA, IB and IIA

Surgery (a wide surgical excision) is the initial treatment for Stage I-IIA melanomas. Lymphatic mapping and a sentinel lymph node (SLN) biopsy are recommended for melanomas that are 1 millimeter or thicker, or less than 1 mm thick with aggressive features. If the SLN is positive (contains melanoma cells), the stage will be reclassified as Stage III and a complete lymph node dissection is recommended. Additional treatment after surgery, such as chemotherapy or radiation therapy, has not been found beneficial for early-stage disease. Surgery alone leads to an excellent outcome for most people with these stages of disease.

Stage IIB and IIC

A wide surgical excision is also recommended for Stage IIB and IIC melanomas. Because these melanomas are thicker than earlier-stage melanomas, the width of the surgical margin is greater. An SLN biopsy is also recommended, and a complete lymph node dissection should be done if an SLN is positive. Immunotherapy with high-dose interferon alfa (Intron A) may be recommended after surgery for ulcerated melanomas more than 4 mm thick, even after a negative sentinel node biopsy. Side effects are common with interferon alfa and include chills, fever, aches and fatigue. Talk to your doctor about whether this treatment option is right for you, including your risk for recurrence and the benefits and risks of interferon after surgery for your specific diagnosis.

 

Skin self-exam – check yourself and your family

Patients and their loved ones play an important role in detecting melanoma. Unlike other cancers, melanoma of the skin can often be seen as it grows and has many defining traits. And because melanoma is the most aggressive form of skin cancer, early detection is critical.

A skin self-examination once a month is a great way to check for melanoma at home. And be sure you’re encouraging your family and friends to check themselves as well! To conduct a self-exam, use a mirror to examine your head, face, neck, chest and torso. If you have a lot of hair, use a blow dryer to move your hair while you check your scalp. Use a hand mirror to inspect the back of your neck, shoulders, upper arms, back, buttocks and legs. Don’t forget your hands, palms, feet, soles and nails. If you notice any moles or spots that change shape, size or color, make an appointment with a dermatologist. For more information on melanoma abnormalities, see the ABCDE chart here.

If your family is considered at high risk for familial melanoma, a regular examination by a dermatologist is typically recommended for each family member. Familial melanoma affects families with two or more first-degree relatives diagnosed with melanoma, and accounts for 5 to 10 percent of all melanoma cases. Other inherited factors, such as skin, hair and eye color, can also increase a person’s risk for melanoma. Children who are considered at high risk should start performing examinations at 10 to 12 years of age.

Free skin cancer screenings are offered in many areas through the American Academy of Dermatology’s SPOTme program. To find a free screening site near you, visit www.aad.org/spot-skin-cancer.

 

Additional Resources

 

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