I melanoma is the thinnest form of the disease with no spread. The diagnosis will be made following analysis of the original and therefore, although the doctor may suspect melanoma when the is performed, you won’t know for sure until the has been tested. This commonly takes two weeks. If the results confirm that it is melanoma, you will have a second operation to remove a wider area of skin ( ). This will usually be between 1cm and 2cm around where the melanoma was situated.
Your case will be discussed by a Local Skin Cancer Multi-Disciplinary Team (MDT), which includes a(skin doctor), a plastic surgeon, an (cancer doctor), a specialist nurse, a pathologist and a radiologist (x-ray/scan doctor) and possibly some other types of support staff.
After the removal of aIA melanoma you should have an initial follow-up appointment, where you will be shown what to look out for in future and to address any questions or concerns that you may have. You will also have two to four further appointments over the following year. If you have a thin melanoma of less than 1mm but there is ulceration or dividing cells (mitoses), you may be offered a . Your melanoma will be defined a 1B if the is clear or not needed.
With aIB melanoma, once treatment is complete you will usually be seen every three months for three years and then every six months for another two years.
I melanoma treatment is straightforward and usually involves removal of the skin around the melanoma to fully remove it. The type of surgery is usually one involving a direct closure with a linear or straight line scar. At sensitive sites, such as the face or hands, different options for reconstruction would be explained to you in order to enable you to complete the required treatment that suits your individual needs. For example, a local flap or may be a better option in some sites.
If your melanoma was diagnosed atI you are unlikely to have further recurrence, provided you have had sufficient tissue from around the melanoma removed. However where the thickness of the melanoma is 1mm or more, and if ulceration is present, there may be involvement of the lymph nodes. In this case you may be offered a . Please see the discussion of this form of on the II page and the link to ‘ ’ at the top of that page.
The following information should be used as part of a discussion with your healthcare professional about the most appropriate treatment for your melanoma. Patients should also be aware that they may not be suitable for all the diagnostic interventions and treatments outlined below. There may also be variation in access to some of these due to regional service variation and limited clinical evidence.
Local excision is where the abnormal mole or area of skin will be removed (‘excised’), and sent to a laboratory for testing. The excision is a relatively simple operation performed under local anaesthetic. This is essential to make the diagnosis of melanoma. The analysis of the biopsy typically takes two weeks and therefore there will be a short wait after the biopsy before the diagnosis is known.
As the majority of stage I melanomas are only on the upper layers of skin, almost all are cured by surgery and do not alter length of life.
Depending on the size of your melanoma, this procedure is relatively minor and can be performed under local anaesthetic. This will usually leave you with a linear scar at the site of the melanoma. If the area of skin involved is large, but suspicious, the doctor may take an initial small biopsy to make the diagnosis.
Subsequent excision always depends on the depth and margins of the tumour, once diagnosed. This second procedure is done at a second visit.
Like all surgery, excision of melanoma carries risks, including poor scarring, wound infection, scar opening up, bleeding and numbness.
More information on local excision can be found here.
Once the melanoma has been removed byand undergone analysis to make the diagnosis, you are likely to be offered a in order to try to ensure that cancerous cells are not still present in the skin surrounding the original preventing local recurrence. This surgical procedure, which could be under a local or a general anaesthetic, will remove a further area of skin around the first scar site. The size of the further excision will be subject to a discussion with your healthcare professional and recommendations will be made depending on the thickness of the melanoma.
is undertaken in order to prevent the cancer returning by seeking to ensure all the melanoma cells in the area where the melanoma was originally are removed. However, there remains debate about the recommended margins, in terms of the width, that should be removed and how this impacts on the chances of the melanoma returning. Trials are currently under way to look into appropriate margins. Your healthcare professional will discuss this with you before making a decision.
is usually a small operation. However, the doctor will use stitches to close up the skin that has been removed and as a result the skin may feel tight at first but this should subside as it stretches. The surgery will leave a scar and its severity will depend on the amount of skin removed, the surgical technique and the location of the excision. The scar will be larger than the scar from the original excision. Some can be more complex than others if the procedure requires a flap or to repair the wound.
Like all surgery,of melanoma carries risks, including poor scarring, infection, bleeding, pain and numbness. More specific would be explained by your surgeon according to the site involved.
More information on here.can be found
If your melanoma was diagnosed at stage I you are unlikely to have further recurrence once you have been treated. Although this is the case for most patients, those who have been treated for stage I melanoma are followed up to ensure the melanoma has not returned or spread, to identify new melanomas or other potential skin cancers and to offer support and education around the disease. Following consultation with your healthcare professional a follow-up plan should be put in place. The details of the plan should be agreed by you and your healthcare professional.
There are lots of sources of support and advice for people with melanoma and other types of cancer. If you speak to your professional about your needs – whether they be emotional, social, financial or practical – they can refer you to an appropriate key worker who can help you to find the support you need. For example, if you are struggling with household chores because you have been affected by your melanoma (e.g. when you’re recovering from an operation), social services might pay for someone to visit to help you out.
The biggest cancer charities in the UK are Cancer Research UK and Macmillan Cancer Support. Both have lots of information on their websites about coping with cancer, along with online communities where you can discuss your treatment with other people. Macmillan also has a phone line and provides face-to-face and financial support to people with cancer and their families.
Melanoma Focus is a national charity dedicated to providing a comprehensive source of information for the public and professionals, as well as lobbying, supporting education and funding research about melanoma. Melanoma Focus also has a helpline which can be found here.
Melanoma UK, The Myfanwy Townsend Research Fund and the Karen Clifford Skin Cancer Charity (Skcin) are also charities that provide support to melanoma patients, as well as fundraising and raising awareness of melanoma among the public and politicians.
With centres based in the grounds of 17 major NHS cancer hospitals across the UK, Maggie’s provides free practical, emotional and social support to people with cancer, as well as their families and friends. Centres without Maggie’s will have other support options in place which your clinical team will be able to tell you about.