Melanoma Procedure

Melanoma is a cancer that develops in melanocytes, the cell pigments present in the skin. It can be more serious than the other forms of skin cancer because it may spread to other parts of the body (metastasize) and cause serious illness and death. Because most melanomas occur on the skin where they can be seen, patients themselves are often the first to detect many melanomas. Early detection and diagnosis are crucial. Caught early, most melanomas can be cured with relatively minor surgery.

 

Factors that raise one's risk for melanoma include the following:
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The most common symptoms of melanoma are spots, moles or irregular colored patches on the skin. It is more accurately known as the ABCDE’S
  • Asymmetry: One half of the mole is different from the other half.
  • Border irregularity: The spot has borders which are not smooth and regular but uneven or notched.
  • Color: The spot has several colors in an irregular pattern or is a very different color than the rest of one's moles.
  • Diameter: The spot is larger than the size of a pencil eraser.
  • Evolving: The mole is changing in size, shape, color, or overall texture. This may also include new bleeding.
It is best to approach a dermatologist in case of any unusual spot detections as earlier the diagnosis , better the cure.

Most doctors diagnose melanoma by examining the spot causing concern and doing a biopsy. A skin biopsy refers to removing all or part of the skin spot under local anesthesia and sending the specimen to a pathologist for analysis. Patients showing higher signs of melanoma are recommended to take  MRIs, PET scans, CT scans, chest X-rays.

 

Treatments for melanoma include:
  • Surgery- The entire melanoma is cut out, along with a border (margin) of normal-appearing skin.
  • Chemotherapy, which uses medicines to stop or slow the growth of cancer cells.
  • Immunotherapy, which uses medicines to help your body's immune system fight the cancer.
  • Targeted therapy with inhibitors-These are medicines that inhibit, or prevent, cancer cells from growing by blocking signals in the cell. 

Melanoma can spread (metastasize) to other parts of the body, where it can cause tumors. Melanoma can come back after treatment. This is called Recurrent melanoma.

 

  • Looking for recurrence. Recurrence of tumor is highly individualized and varies from person to person.
  • Participating in outdoor activities before 10:00 AM or after 4:00 PM.
  • Wearing long sleeves and pants.
  • Using a broad-spectrum sunscreen with an SPF of at least 30.
  • Wearing UV-protective sunglasses.
  • Wearing a hat.

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Melanoma Procedure

Melanoma is a cancer that develops in melanocytes, the cell pigments present in the skin. It can be more serious than the other forms of skin cancer because it may spread to other parts of the body (metastasize) and cause serious illness and death. Because most melanomas occur on the skin where they can be seen, patients themselves are often the first to detect many melanomas. Early detection and diagnosis are crucial. Caught early, most melanomas can be cured with relatively minor surgery.

 

Factors that raise one's risk for melanoma include the following:
  • Caucasian (white) ancestry
  • Fair skin, light hair, and light-colored eyes
  • A history of intense, intermittent sun exposure, especially in childhood
  • Many moles (more than 100 moles).
  • Large, irregular, or "funny looking" moles.
  • Close blood relatives -- parents, siblings, and children -- with melanoma.

Symptoms

The most common symptoms of melanoma are spots, moles or irregular colored patches on the skin. It is more accurately known as the ABCDE’S
  • Asymmetry: One half of the mole is different from the other half.
  • Border irregularity: The spot has borders which are not smooth and regular but uneven or notched.
  • Color: The spot has several colors in an irregular pattern or is a very different color than the rest of one's moles.
  • Diameter: The spot is larger than the size of a pencil eraser.
  • Evolving: The mole is changing in size, shape, color, or overall texture. This may also include new bleeding.
It is best to approach a dermatologist in case of any unusual spot detections as earlier the diagnosis , better the cure.

Diagnosis

Most doctors diagnose melanoma by examining the spot causing concern and doing a biopsy. A skin biopsy refers to removing all or part of the skin spot under local anesthesia and sending the specimen to a pathologist for analysis. Patients showing higher signs of melanoma are recommended to take  MRIs, PET scans, CT scans, chest X-rays.

 

Treatment

Treatments for melanoma include:
  • Surgery- The entire melanoma is cut out, along with a border (margin) of normal-appearing skin.
  • Chemotherapy, which uses medicines to stop or slow the growth of cancer cells.
  • Immunotherapy, which uses medicines to help your body's immune system fight the cancer.
  • Targeted therapy with inhibitors-These are medicines that inhibit, or prevent, cancer cells from growing by blocking signals in the cell. 

Risks

Melanoma can spread (metastasize) to other parts of the body, where it can cause tumors. Melanoma can come back after treatment. This is called Recurrent melanoma.

 

After Procedure

  • Looking for recurrence. Recurrence of tumor is highly individualized and varies from person to person.
  • Participating in outdoor activities before 10:00 AM or after 4:00 PM.
  • Wearing long sleeves and pants.
  • Using a broad-spectrum sunscreen with an SPF of at least 30.
  • Wearing UV-protective sunglasses.
  • Wearing a hat.

FAQ Section

1) What is melanoma?

Melanoma is a serious form of skin cancer marked by the uncontrolled growth of cells that produce pigment in our body. Melanomas may appear suddenly and are found most frequently on the face, neck, upper back, and legs but can occur anywhere on the body.

2) What causes melanoma?

The most common cause of melanoma is excessive exposure to ultraviolet radiation of the sun, genetic factors, and immune system deficiencies. Childhood sunburns and sun exposure are linked with malignant melanoma. 

3) Can melanoma be cured?

If detected in the early stages, surgical removal can cure the disease. Dermatologists advise routine self-examination of the skin to detect changes in appearance, particularly changes in existing moles or spots.

4) Can melanoma be prevented?

Yes. Because overexposure to ultraviolet light is considered to be the main cause of malignant melanoma, skin doctors recommend the following precautions:

  • Avoid peak sunlight hours when the sun's rays are most intense.
  • Apply a sunscreen.
  • Wear protective clothing during prolonged periods in the sun.

5) What is is the best treatment method for melanoma?

Named after its inventor, Dr. Frederic Mohs, Mohs surgery is a microscopic surgical procedure that is used to remove skin cancer like melanoma. Thin layers of skin are surgically removed and processed by horizontal sectioning, and If melanoma cells are detected within the tissue margins, the cancer is then mapped and another layer or stage is taken, and the process is repeated until there is no cancer within the tissue margins.

6) Is Mohs a good treatment for Melanoma?

Numerous studies have shown that Mohs micrographic surgery is simply the best way to check a surgical margin to ensure the melanoma is completely removed so there is less chance of any cancer cells to return. In these studies, Mohs surgery had the highest cure rate for melanoma removal and proved to be most useful in removing recurrent skin cancers.

There are several aspects of the Mohs Surgery that make the procedure both unique and superior to other methods of treating skin cancer.

  • Highest cure rate among skin cancer treatments.
  • Compared to other skin cancer treatments, chances of errors are less.
  • Increases accuracy of skin cancer removal.
  • It has immediate results.
  • Decreases the amount of healthy tissue removed.
  •  Minimizes surgical risks and scarring.
  • Performed under local anesthetic.
  • Can be less expensive than other treatments.
  • Can result in quicker recovery.

7) Is Mohs surgery the most cost-effective treatment option?

Because of Mohs' high success rate, most patients require only a single surgery, which usually includes the repair of the wound as well. Other methods might need extra operations and pathology readings in order to repair the wound and to treat cancer if it is not completely removed, and each of these additional surgeries and pathology readings would require separate fees. A single Mohs surgery procedure includes all of these into one fee, making it the most cost-effective treatment for skin cancer.

8) What are the possible complications?

Although a very safe and effective surgical treatment for skin cancer, like any surgery or procedure, Mohs surgery has some possible risks and complications, they are generally outweighed by the benefits. Common risks of the surgery are not only limited to swelling and bruising. Scarring is also a possibility with any surgery and a wound can be sometimes slow to heal. Numbness and tingling can be present for weeks or for months, but they will usually resolve. Some rare risks include excessive infection, bleeding, paralysis, and pain. The surgery can minimize both these surgical risks and scarring because the procedure keeps the wound as small as possible by removing very little healthy tissue.  

9) What is reconstruction?

Mohs surgery will create a wound when the cancer is removed, and more cancer there is, the wider or deeper the wound will be. Reconstruction involves closing the wound after the cancer is surgically removed by Mohs, and the type of reconstruction will depend on if the wound is in an optimal location or difficult location, and if the wound is small or large.

10) How long does Mohs surgery take?

Although Mohs surgery can take longer than other procedures to perform, improvements in technology, such as automated staining of tissue samples, have made the procedure quicker. While it is difficult to predict exactly what timeframe to expect for each Mohs surgery procedure, the entire surgery usually lasts several hours. Seldom, clearing the tumor and repairing the defect can take the better part of a day. 

11) What areas are treatable?

Mohs micrographic surgery is used to treat skin cancers primarily on the face where there is not a lot of extra skin to spare and where scars can be more pronounced. Researches have shown that Mohs surgery is the best option for treatment of skin cancer on the nose, lip, eyelid, and ear. The Mohs surgery is also highly recommended for cancers that are likely to return, have already recurred or have ill-defined borders that make the true area of cancer hard for the surgeon to see.

12) Why does your melanoma need to have Mohs surgery?

Mohs surgery has the highest cure rate. It is appropriate for most skin cancers and especially suitable for skin cancer that is in an area where it is important to preserve healthy tissue for a necessary functional and cosmetic result. It is also used to treat cancer that was removed previously and has come back, cancer that Is located near scar tissue, cancer that does not have clearly defined edges, and cancer that is growing rapidly or uncontrollably.