Melanoma (Skin Cancer) - Diagnosis

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What was the stage of your melanoma when it was diagnosed?

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How is melanoma diagnosed?

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.

The biopsy report may show any of the following:

  • A totally benign condition requiring no further treatment, such as a regular mole
  • An atypical mole which, depending on the judgment of the doctor and the pathologist, may need a conservative removal (taking off a little bit of normal skin all around just to make sure that the spot is completely out).
  • A thin melanoma requiring surgery
  • A thicker melanoma requires more extensive surgery or extra tests in which the lymph nodes are examined. Removing lymph nodes causes physical problems even when there is no tumor present and, for that reason, is not recommended for thinner melanomas.

Some doctors are skilled in a clinical technique called epiluminescence microscopy (also called dermatoscopy or dermoscopy). They may use a variety of instruments to evaluate the pigment and blood vessel pattern of a mole without having to remove it. Sometimes the findings support the diagnosis of possible melanoma, and at other times, the findings are reassuring that the spot is nothing to worry about. The gold standard for a conclusive diagnosis, however, remains a skin biopsy.

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See what others are saying

Comment from: Skywilson, 45-54 Female (Patient) Published: October 09

Four years ago I had a mole that scabbed and fell off. It was diagnosed as melanoma and had spread to one lymph node. Stage 3B. After many surgeries and a mega dose of interferon it recurred in the same spot while still taking immunotherapy. For the last four years I have been diligent on my follow up appointments and my scan schedule. My last Brain MRI was one year ago. In the course of two weeks while on vacation, I started having more intense headaches, some vision blurriness and a little confusion on my surroundings. I attributed this to jet lag and fatigue. When I returned home the symptoms didn't get any better. I went to the emergency room (ER) thinking I was having a stroke. An MRI showed a metastatic melanoma lesion the size of two golf balls in my right temporal lobe. Four weeks ago surgeons removed the entire lesion but some of my brain went with it. I have kicked melanoma three times and I will continue to fight until I can't. I am hoping that's the end of it. It's a horrible disease and does what it wants. It does not follow the natural progression of disease state like other cancers. It's unpredictable and sneaky. For those of us who keep fighting, congrats on your hard work, for those of us grieving someone they lost to melanoma, my heart goes out to you.

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Comment from: Debbie, 45-54 Female (Patient) Published: August 03

At age 33 I had a small bleeding mole removed from under my left breast. It was melanoma, I had a wide excision and all margins came back clear. No other treatment. Twenty two years later, I now have stage 4 metastatic malignant melanoma. You are never cured of this disease. Don't let your guard down.

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