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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

What to expect with melanoma

DEAR DOCTOR K: My doctor just discovered that I have melanoma, but didn’t really explain the treatment. Can you tell me what I’m in for?

DEAR READER: Melanoma is skin cancer that begins in the melanocytes – cells that give skin its color. Usually these cells first form a precancerous condition called a dysplastic mole. Then the cells turn cancerous and start to reproduce aggressively.

When that happens, the melanoma grows. Some of the cells also can shake loose from the tumor and spread throughout the body. When that happens, the cells first spread to the local lymph nodes, then on to the rest of the body. If melanoma has not spread, it can be cured.

If your melanoma appears in just one spot, it will be surgically removed. (The exact amount will depend on the size of the tumor.) The extra skin is removed because it can contain microscopic bits of the cancer.

In some cases, the doctor may perform a procedure during which the tumor is shaved away one thin layer at a time. This technique helps the doctor remove as little healthy skin as possible.

Your doctor may also want to check if the melanoma has spread to nearby lymph nodes. These small structures are part of the immune system. To check, your doctor may inject a radioactive liquid into the tumor. The liquid flows through the natural drainage pathway that connects the tumor to nearby lymph nodes.

The drainage path can be tracked. The first lymph node along the path is called the sentinel node. This node is removed and examined for cancer cells. If the sentinel node has no cancer, the other nodes are most often cancer-free. If cancer is found in the sentinel node, all the lymph nodes in the area will likely be removed.

In addition to surgery, treatments for melanoma include immunotherapy.

Newer drugs target specific genetic changes seen in people with certain forms of melanoma.

The sooner melanoma is identified and treated, the better. If you notice any moles with uneven color, an irregular border, or a border that changes over time, see your doctor.