Diagnosis of melanoma is relatively uncommon and can only be confirmed after a full professional assessment, appropriate biopsy, histological examination and specialist interpretation. If your dermatologist or skin specialist suspects a melanoma they may remove the mole (excision biopsy) and send it for examination by a histopathologist (a specialist who examines tissue) to check whether it is cancerous.
A biopsy is usually carried out under local anaesthetic. If a melanoma is confirmed another operation is usually required, most often performed by a plastic surgeon or dermatologist to remove a wider area of skin.
Staging of melanoma
‘Staging’ is the process of determining the size / depth of the melanoma and if / how far it has spread. It is used to determine how serious the cancer is and how best to treat it.
When the melanoma is removed, the depth of the tumour will be examined. This is the depth (measured in mm) from the surface of the skin at which the cancer cells are present at the time of surgical excision.
The earliest stage melanomas are stage 0 (melanoma in situ), and then range from stages I (1) through IV (4). Some stages are split further, using capital letters (A, B, etc.).
As a rule, the lower the number, the less the cancer has spread and the higher the number, the more the cancer has spread. Within a stage, an earlier letter means a lower stage. Most melanoma are less than 1mm thick and are less likely to grow back or require further treatment.
Further tests and treatments.
Further tests will be carried out if there is a concern the cancer has spread into other organs, bones or bloodstream. Patients with melanoma will be cared for by a team of specialists that should include: a dermatologist, a plastic surgeon, an oncologist, a pathologist and a specialist nurse.
When helping patients decide on their treatment, the team will consider: the type of cancer, the stage of the cancer and the patient’s general health. The team will then recommend what they believe to be the best treatment option.
The NHS have further information on the treatments for the various stages of melanoma.