Melanoma is a relatively rare type of skin cancer, and it’s by far the most deadly. In fact, although melanoma accounts for less than one percent of skin cancer cases diagnosed each year, it causes the majority of skin cancer-related deaths. Melanoma is associated with prolonged sun exposure and it’s also more common among people with a family history of the disease. Melanoma can develop anywhere on the body. Prompt treatment is the best way to ensure optimal outcomes and to decrease the risk of having the cancer spread or metastasize to other areas.
Melanoma must be treated surgically to remove the cancerous tissue, and sometimes to remove local lymph nodes if the cancer has spread. Sometimes, chemotherapy or radiation are also needed, especially if the cancer is very aggressive or has spread to the lymph nodes or other areas. Like other types of cancer, a comprehensive evaluation is needed to determine what stage the cancer is in so the most appropriate treatment can be provided.
Skin cancer surgery for melanoma typically uses a special technique called Mohs surgery, which was developed to preserve as much healthy tissue as possible. During Mohs surgery, the cancerous tissue is removed and immediately examined under a microscope, paying special attention to the edges or margins. If the margins are clear of cancer cells, the surgical site is closed with sutures and covered with a bandage. If cancerous cells are found on the margins, additional tissue is removed in that area and then reexamined under a microscope. Excisions continue until the margins are clear, indicating all the cancer has been removed from the site.The examination of tissue margins during surgery helps ensure all of the cancer is removed while avoiding the need for overly large excisions so scarring is minimized. Lymph nodes are also usually biopsied to help determine if the cancer may have spread elsewhere in the body. When a large amount of tissue must be removed, a skin graft may be needed to close the wound.