Melanoma is a serious type of skin cancer that can be dangerous if not found early. Diagnosis rates have increased over the last two decades. Therefore, it’s important to alert your doctor as soon as you know of any concerning changes to your skin. If you or a loved one are at risk of developing melanoma or have been diagnosed with it, early detection is key, when treatment can be easier. At the OSUCCC – James, our experts use the latest methods to screen for and diagnose melanoma. This helps ensure the best possible treatment outcomes.
Screening for melanoma
Skin cancer screening exams can help find melanoma at its earliest stage when the chances for treatment are greatest. These tests are usually done when you’re healthy and have no specific symptoms. Regular skin cancer screenings, especially for those who may be at high risk, ensure that any potential skin cancers are identified and addressed promptly, leading to better health outcomes.
Skin cancer screening overview
During a skin cancer screening, an OSUCCC – James provider will conduct a thorough examination of your skin and lymph nodes — you'll change into a gown and the doctor will examine your skin. Lymph nodes are glands under the skin that are located in the neck, armpit, and groin areas. This involves a visual inspection of your skin, including moles, pigmented areas or other areas of concern, to look for signs of melanoma or other skin cancers. The provider may use a special tool to examine suspicious areas more closely. If your doctor discovers any concerning skin issues, they’ll discuss them with you at that time and inform you of next steps, including whether they’ll take a biopsy.
Melanoma screening guidelines
Currently, there are no recommended screening guidelines for melanoma. If you’re at risk, your doctors will determine how frequently you should have a skin examination. If you have any risk factors for melanoma, you should regularly examine moles and other skin lesions and follow up with your doctor.
OSUCCC – James dermatologists and melanoma specialists regularly offer screening clinics to help detect potential skin cancers as early as possible. Additionally, our clinics focus on monitoring those who are at increased risk for melanoma and other skin cancers.
Melanoma diagnosis
If your doctor suspects that you might have melanoma, they’ll need to diagnose it.
Melanoma usually is detected when a mole or pigmented area of skin changes or looks abnormal. If melanoma is suspected, your OSUCCC – James specialists may conduct one or more of the following tests to form a diagnosis:
Physical exam
As mentioned, a skin exam is an important part of skin cancer screening, but it also can help your doctor confirm a skin cancer diagnosis. During the skin exam, an OSUCCC – James skin cancer expert examines the skin for signs of abnormal moles, birthmarks or other pigmented areas. The doctor will analyze the size, color, shape and texture of any mole, mark or pigmented area. During this exam, your doctor may take a biopsy, which includes the removal of a concerning area for further testing. A complete skin exam also includes a check of the main lymph node areas in the body — this includes the neck, the armpits and the groin area.
Biopsy
During a biopsy, a piece of tissue or tumor is removed so that a specially trained OSUCCC – James pathologist can examine the cells under a microscope for any signs of cancer, including melanoma. The cells may also be analyzed for certain genetic changes that indicate the specific subtype of melanoma, which helps your specialists choose the most effective, personalized treatment options for you.
Early melanoma cells can resemble noncancerous cells, so it’s important to accurately diagnose the cells under the microscope. A second opinion with the OSUCCC – James pathology team can provide important information so that you and your cancer team can select the most appropriate treatment options.
Tests used to stage melanoma
If you’re diagnosed with melanoma, staging the tumor is just one of many ways OSUCCC – James melanoma experts can determine the size and exact location of the melanoma and what type of treatment(s) you might need.
The following tests may be used to stage melanoma. Exactly which tests are appropriate for each individual is based on a number of factors which your doctor will discuss with you:
Lymph node mapping and sentinel lymph node biopsy
A specially trained OSUCCC – James surgical oncologist, using special dyes injected into the skin, removes only the first lymph node or nodes in which melanoma could spread. The lymph node samples are then analyzed by an OSUCCC – James pathologist under the microscope for signs of cancer.
In some situations it may be important to check for melanoma in parts of the body that your doctor cannot easily examine at the bedside.
Computed tomography (CT) scan
A CT scan is an X-ray test that produces detailed, cross-sectional images of your body. This imaging test allows doctors to see inside your body and identify any abnormalities. It can help determine the size, location, and if melanoma has spread. In some cases, a special contrast dye may be used to help enhance the visibility of any melanomas on a scan.
Positron emission tomography (PET) scan
A PET scan uses a small amount of injected radioactive tracer mixed with glucose to identify cancer cells in the body. The PET scanner rotates around your body and a special imaging camera displays images of these cells brighter than those of normal, healthy cells.
Magnetic resonance imaging (MRI) scan
An MRI uses a high-powered magnet and radio waves to produce detailed images of the body. A special substance is injected into a vein before the test, and that substance will collect around areas with cancer cells. A computer then translates the radio waves into a detailed picture to help the OSUCCC – James specialists determine if a tumor is present.
Blood chemistry analysis
A blood sample is taken and measured for certain substances in the blood. An enzyme called lactate dehydrogenase is found in higher levels than normal in people who have melanoma.
Assigning a melanoma stage
Once the melanoma staging test results are available, your doctor will be able to assign a stage. Staging the tumor is just one of many ways your OSUCCC – James melanoma experts can describe the amount and location of your cancer, as well as if it has spread, and it can help them choose the most effective, personalized treatment options for your particular cancer.
The staging classification remains the same throughout treatment.
Stage 0
Abnormal melanocytes (cells that create pigment, called melanin, in the skin and eyes) are found in the epidermis (outer layer of skin). These abnormal melanocytes may become cancerous and spread into nearby normal tissue. Stage 0 is also called melanoma in situ.
Stage I
The melanoma is only growing in the skin layers, and it is thin. Stage I is divided into stages IA and IB.
Stage IA
The tumor is not more than one millimeter thick, or about the thickness of a dime.
Stage IB
The tumor is either:
- Not more than one millimeter thick and has ulceration; or
- More than one millimeter but not more than two millimeters thick, with no ulceration.
Stage II
The melanoma is still only growing in the skin layers, but it is thicker than Stage I. Stage II is divided into stages IIA, IIB and IIC.
Stage IIA
The tumor is either:
- More than one millimeter but not more than two millimeters thick, with ulceration; or
- More than two millimeters but not more than four millimeters thick, with no ulceration.
Stage IIB
The tumor is either:
- More than two millimeters but not more than four millimeters thick, with ulceration; or
- More than four millimeters thick, with no ulceration.
Stage IIC
The tumor is more than four millimeters thick, with ulceration.
Stage III
The tumor may be any thickness, with or without ulceration.
One or more of the following is true:
- Cancer has spread to one or more lymph node(s).
- Lymph nodes may be joined together (matted).
- Cancer may be in a lymph vessel between the primary tumor and nearby lymph nodes.
- Very small tumors may be found on or under the skin, not more than two centimeters away from where the cancer first started.
Stage IV
Cancer has spread to other places in the body, such as the lungs, liver, brain, bone, soft tissue or the gastrointestinal (GI) tract. Cancer may have spread to places in the skin far away from where it first started.
If you’ve been diagnosed with melanoma, or you would like a second opinion, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.
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