One in five Americans will develop some type of skin cancer over the course of their lifetimes. With early detection and treatment, however, most skin cancers are completely curable. Early detection and treatment of any form of skin cancer is essential both to prevent the disease from spreading to other areas of the body and to achieving better outcomes.
The type of treatment a patient receives depends on the following:
- How deeply the melanoma has grown into the skin.
- Whether the melanoma has spread to other parts of the body.
- The patient’s health.
Surgery: When treating melanoma, doctors want to remove all of the cancer. When the cancer has not spread, it is often possible for a dermatologist to remove the melanoma during an office visit. The patient often remains awake during the surgical procedures described below. These procedures are used to remove skin cancer:
- Excision: To perform this, the dermatologist numbs the skin. Then, the dermatologist surgically cuts out the melanoma and some of the normal-looking skin around the melanoma. This normal-looking skin is called a margin. There are different types of excision. Most of the time, this can be performed in a dermatologist’s office.
- Mohs surgery: A dermatologist who has completed additional medical training in Mohs surgery performs this procedure. Once a dermatologist completes this training, the dermatologist is called a Mohs surgeon.
Mohs surgery begins with the Mohs surgeon removing the visible part of the melanoma. Next, the surgeon begins removing the cancer cells. Cancer cells are not visible to the naked eye, so the surgeon removes skin that may contain cancer cells one layer at a time. After removing a layer, it is prepped so that the surgeon can examine it under a microscope and look for cancer cells. This layer-by-layer approach continues until the surgeon no longer finds cancer cells. In most cases, Mohs surgery can be completed within a day or less. Mohs has a high cure rate.
When caught early, removing the melanoma by excision or Mohs may be all the treatment a patient needs. In its earliest stage, melanoma grows in the epidermis (outer layer of skin). Your dermatologist may refer to this as melanoma in situ or stage 0. In this stage, the cure rate with surgical removal is nearly 100%.
When melanoma grows deeper into the skin or spreads, treatment becomes more complex. It may begin with one of the surgeries described above. A patient may need more treatment. Other treatments for melanoma include:
- Lymphadenectomy: This is surgery to remove lymph nodes.
- Immunotherapy: Help the patient’s immune system fight the cancer (example: interferon injections).
- Chemotherapy: Medicine that kills the cancer cells (and some normal cells).
- Radiation therapy: X-rays kill the cancer cells (and some normal cells).
Other treatment that may be recommended includes:
- Clinical trial: A clinical trial studies a medicine or other treatment. A doctor may recommend a clinical trial when the treatment being studied may help a patient. Being part of a medical research study has risks and benefits. Before joining a clinical trial, patients should discuss the possible risks and benefits with their doctor. The decision to join in a clinical trial rests entirely with the patient.
- Palliative care: This care can relieve symptoms and improve a patient’s quality of life. It does not treat the cancer. Many patients receive palliative care, not just patients with late-stage cancer. When melanoma spreads, palliative care can help control the pain and other symptoms. Radiation therapy is a type of palliative care for stage IV (has spread) melanoma. It can ease pain and other symptoms.
This depends on how deeply the melanoma has grown into the skin. If the melanoma is properly treated when it is in the top layer of skin, the cure rate is nearly 100%. If the melanoma has grown deeper into the skin or spread, the patient may die.