Finding out You Have Melanoma: What You Can Expect
Melanoma, or cancer of the skin, occurs when pigment cells in the skin become malignant. It can occur on any skin surface. Since the 1970s, cases of melanoma have increased by 126 percent. The increase is attributed to more unprotected exposure to the sun’s harmful rays. But survival rates have been improving, probably because of the many public awareness campaigns that have been developed over the years. People are still trying to get that tan, but they also know that it’s risky, and they seem to know it’s important to get suspicious looking moles and other lesions checked out by doctor early on.
If you know you have melanoma, you’ve probably already had a biopsy that confirmed the diagnosis. Now comes the hard part—figuring out the treatment that’s right for you.
Your doctor has to learn the “stage” your melanoma is in before talking with you about treatment. The stage depends on how thick the tumor is, how deeply it’s gone into the skin and whether the melanoma cells have spread to other parts of the body. Other factors that determine your treatment include your age and your overall health, among others.
In its early stages, melanoma spreads sideways. It’s confined to the top layers of skin. That’s when it’s easiest to treat. As the melanoma progresses, it begins to grow downwards, eventually coming into contact with lymph nodes and blood vessels. The thicker the tumor gets, the more likely it is to spread to distant sites in the body through the blood vessels it comes in contact with.
Like other types of cancer, melanoma is classed in stages:
- Stage 0: The cancer cells are in the outer layer of skin only.
- Stage 1: The tumor is thin, 1 millimeter or less, and has not spread to lymph nodes.
- Stage 2: The tumor is between 1 and 2 millimeters thick, but the cells have not spread.
- Stage 3: The cells have spread to nearby tissues or lymph nodes.
- Stage 4: The cells have spread to other organs, lymph nodes or to areas far away from the tumor site.
Melanoma that’s detected in the early stages has a survival rate of 95 percent. Survival rates decrease when the cancer has spread, or metastasized, to other parts of the body. Your doctor will talk to you about your specific prognosis, but remember that there are a lot of factors that play a role, including your age and your general health status.
Common melanoma treatments
Before you start your treatment, you may want to get a second opinion. Some insurance plans even require it. There are different ways to do this. Your doctor may be able to recommend someone, or there may be an approved list from your insurance plan. Nearby hospitals or medical schools can also probably refer you to a specialist. You could also try the National Cancer Institute’s Cancer Information line at
Almost always, surgery is a part of treatment to remove the melanoma cells. When the cancer has spread to nearby lymph nodes or other nearby sites, chemotherapy, immunotherapy (drugs that boost your immune system) and/or radiation therapy will probably also be part of the treatment. If a large area around the tumor has to be removed, it may also be necessary to perform a skin graft. This entails taking skin from another area of the body to help cover the wound.
Common side effects of chemotherapy include nausea and vomiting, temporary hair loss, diarrhea, weight loss, fatigue, anemia and depression. The symptoms are typically more likely and more severe the longer your treatment lasts and the stronger your medication is. Less common side effects can include infection, liver or kidney damage, allergic reactions and trouble concentrating and remembering.
Questions to ask your doctor about your treatment
Be sure to ask your doctor lots of questions about your melanoma treatment. In fact, your doctor will probably give you a lot of information, but it’s hard to take it all in the first time. You may need to ask the same thing more than once, and that’s okay. Here are the kinds of things you need to make sure you know, and the kinds of questions you should ask:
- What stage is my cancer in?
- Why are you recommending the treatment you think is best for me?
- How will I feel after surgery?
- How will I control my pain?
- Will I need a skin graft or plastic surgery later on? Will I have a scar?
- How soon after surgery will I be able to get back to my normal routine?
- What exactly will you be doing during the surgery?
- Will I need more treatment after surgery?
- What should I do if I experience side effects from chemotherapy or radiation?
After you’re treated for melanoma, it’s extremely important to keep up with the scheduled follow-up visits your oncologist recommends. This will help ensure early detection of any return of the cancer.
The American Cancer Society; The American Society of Clinical Oncology; The Centers for Disease Control and Prevention; The National Cancer Institute.