Dealing with Melanoma

Melanoma doesn't have to be a death sentence

Idaho has the highest per capita rate of death from skin cancer in the nation and the 7th highest incidence.  For me, as a dermatologist, this makes the fight against melanoma very personal.  In dermatology, melanoma is public enemy #1.If your doctor just told you that you have melanoma, it doesn't necessarily mean that the first order of business is to make sure your life insurance is up to date.  Fortunately, even though more melanomas are being diagnosed than ever before, most are early.

Some Facts About Melanoma

Image via Wikipedia The deeper a melanoma is, the more likely it is to have spread by the time that it is diagnosed.  There is something called a Breslow's depth and generally melanomas less than 1mm in depth are considered early and the survival rates are in the high ninety percentile.  Most of the melanomas diagnosed in North Idaho are in situ melanomas.  In situ means that the melanoma is still in the upper part of the skin known as the epidermis.  The next step beyond a in situ melanoma would be a melanoma with a Breslow's depth of 0.1 or 0.2 mm.  There are all kinds of terms bantered about concerning melanoma such as the stage or Clark's level, but the Breslow's depth is the most useful information concerning survivability of melanoma.  An in situ melanoma has no Breslow's depth and is basically 100% curable.  All of this information is obtained from a biopsy reading by a dermatopathologist.  Though many medical providers have experience with melanoma, a board-certified dermatologist working in concert with a trained dermatopathologist can provide the best assurance that a suspicious lesions will be diagnosed and handled correctly. 

Treatment of Melanoma

The most important treatment for a melanoma is surgical excision.  Sometimes this is combined with a technique called a sentinel node biopsy, where tissue from a lymph node is removed for examination.  If a melanoma is deeper than 1mm a sentinel biopsy can help determine prognosis more accurately.  Unfortunately, some individuals want to do "everything possible" and want to get a sentinel node biopsy whatever the depth of their melanoma.  There is no firm evidence that removing a lymph node or having a sentinel node biopsy is a cure.  The best cure is early detection and excision of a melanoma, but the sentinel node biopsy is a useful information that helps the patient receive the appropriate treatment for a deeper melanoma, especially great than 1mm in Breslow's depth.  North Idaho Dermatology has extensive experience in diagnosing and treating melanomas.  When needed we involve other local professionals and Kootenai Medical Center, especially when a sentinel node biopsy is an appropriate option.

Melanoma Myths

There are a couple of prevailing myths about melanoma that I hear a lot.  It is important that these myths are exposed and dispelled:

MYTH: If a melanoma is biopsied, the cells can break off and spread the cancer all over the body.

FACT: Research has shown that biopsying a melanoma is the best way to diagnose.  If cancerous cells are going to migrate, they do so in a complex process of metastasis; a biopsy isn’t the catalyst for spread of melanoma

MYTH: Sun exposure doesn't causes melanoma

FACT: Melanoma has many risk factors, but decades of research and experience show that sun and other UV exposure is one of the greatest risk factors, and can exacerbate other risk factors.  People with the following characteristics have the highest risk for melanoma:

• Fair complexions that burn or blister easily
• Blond or red hair
• Excessive sun exposure during childhood and teen years, blistering and sunburns before age 18
• Family history of melanoma
• More than 100 moles or more than 50 if you are under 20 years of age.

However, anyone can be diagnosed with melanoma.

Dr. Stephen D. Craig is a board-certified dermatologist and the owner of North Idaho Dermatology in Coeur d'Alene, Idaho.