If You Have Melanoma Skin Cancer

If you or someone you know has just been diagnosed with melanoma skin cancer, this short guide can help. Find information on melanoma skin cancer here.

Melanoma is a kind of skin cancer that starts when skin cells called melanocytes grow out of control. Melanocytes normally make a brown pigment called melanin, which helps protect the body from the UV rays of the sun.

Melanomas can sometimes start in other parts of the body as well, such as in an eye or on the inside of the mouth, but this is much less common.

Melanoma cells can sometimes spread to other parts of the body if they’re not treated. This spread is called metastasis. Even if melanoma spreads to another organ, the cancer cells there are still melanoma cells.

Ask your doctor to use this picture to show you what part of your skin the cancer started in.

Other types of skin cancer

There are many types of skin cancer.

Basal cell and squamous cell skin cancers are much more common than melanoma and don’t often spread to other parts of the body. Melanoma is more deadly because it is more likely to spread to other parts of the body.

There are also many other types of skin cancer, but these are not common. Ask your doctor if you have questions about the type of skin cancer you have.

Questions to ask the doctor

• Why do you think I have cancer?
• Is there a chance I don’t have cancer?
• Would you please write down the kind of cancer you think I might have?
• What will happen next?

How does the doctor know I have melanoma?

A new spot on your skin or a spot that’s changing in size, shape, or color may be a warning sign of melanoma. If you have any of these changes, have your skin checked by a doctor.

The doctor will ask you questions about when the spot on your skin first showed up and if it has changed in size or the way it looks or feels. The rest of your skin will be checked. During the exam your doctor will check the size, shape, color and texture of any skin changes. The doctor might also do special types of exams to look deeper into the skin without needing to cut into it.

If signs are pointing to melanoma, more tests will be done.

Tests that might be done

Biopsy: In a biopsy, the doctor removes the abnormal area of skin to check it for cancer cells. A biopsy is the only way to tell for sure if you have skin cancer and what kind it is. There are many types of skin biopsies. Ask your doctor what kind you will need. Each type has pros and cons. The choice of which type to use depends on your own case.

Lab tests of biopsy samples: If melanoma is found, lab tests might be done on the cancer cells to see if they have certain gene changes. This might affect your treatment options.

Chest x-ray: This test may be done to see if the melanoma has spread to your lungs.

Ultrasound: This test uses sound waves and their echoes to make pictures of the inside of your body. Ultrasound might be used to look at lymph nodes (small collections of immune cells) near the tumor to see if the cancer has spread there.

CT or CAT scan: This test uses x-rays to make detailed pictures of your insides. A CT scan may be used to see if nearby lymph nodes are swollen or if organs like the lungs or liver have spots that might be from the spread of melanoma. If any spots are found, a CT scan might be used to guide a needle into the spots to do a biopsy.

MRI: This test uses radio waves and strong magnets instead of x-rays to make detailed pictures of your insides. It's very good for looking at the brain and spinal cord. This test can help show if the cancer has spread.

PETscan: PET scans use a special kind of sugar that can be seen inside your body with a special camera. If there’s cancer, this sugar shows up as “hot spots” where the cancer is found. This test can help show if and where the cancer has spread. Sometimes the pictures from a PET scan might be combined with those from a CT scan (known as a PET/CT scan).

Questions to ask the doctor

• What tests will I need?
• Who will do these tests?
• Where will they be done?
• Who can explain them to me?
• How and when will I get the results?
• Who will explain the results to me?
• What do I need to do next?

How serious is my cancer?

If you have melanoma, the doctor will want to find out how far it has spread. This is called staging. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.

The stage describes the growth or spread of the melanoma through the skin. It also tells if it has spread to other parts of your body.

Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number means a more advanced cancer. Be sure to ask the doctor about the stage of your cancer and what it means for you.

Questions to ask the doctor

• How far has the melanoma spread into my skin?
• Has it spread anywhere else?
• What is the stage of my cancer?
• Would you explain to me what the stage means in my case?
• How does the stage affect my treatment options?
• What will happen next?

What kind of treatment will I need?

There are many ways to treat melanoma. The main types of treatment are:

• Surgery
• Radiation
• Immunotherapy
• Targeted therapy
• Chemotherapy

Many early-stage melanomas can be treated with surgery alone. More advanced cancers need other treatments.

The treatment plan that’s best for you will depend on:

• The stage of the cancer
• The results of lab tests on the cancer cells
• The chance that a treatment will cure the melanoma or help in some way
• Your age and overall health
• Your feelings about the treatment and the side effects that come with it

Surgery

Surgery is a main treatment for most melanomas. It can often cure early-stage melanomas. There are different kinds of surgery. The type that’s best for you depends on how large the melanoma is and where it is. Ask your doctor what type of surgery you will have and what to expect.

Side effects of surgery

Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. If you have problems, let your doctors know. Doctors who treat people with melanoma should be able to help you with any problems that come up.

Radiation treatments

Radiation uses high-energy rays (like x-rays) to kill cancer cells. Radiation is not usually used to treat the main spot on the skin, unless surgery can’t be done for some reason. But radiation may be used after surgery to help keep the melanoma from coming back. It might also be used if the cancer has spread.

If your doctor suggests radiation treatment, be sure you know what its purpose is.

Side effects of radiation treatments

Side effects of radiation depend on the part of the body that’s treated. The most common side effects of radiation are:

• Sunburn-like skin changes where the radiation is given
• Hair loss where the radiation enters the body
• Feeling very tired (fatigue)

Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect.

Immunotherapy

This treatment boosts your own immune system to attack the melanoma cells. Many types of immunotherapy can be used to treat advanced melanoma. These drugs may be given into a vein, given as a shot, or taken as pills.

Side effects of immunotherapy

Immunotherapy can cause many different side effects, depending on which drug is used. Some of these drugs might make you feel tired, sick to your stomach, and cause fever, chills, and rashes. Most of these problems go away after treatment ends.

There are ways to treat most side effects from immunotherapy. If you have side effects, talk to your cancer care team so they can help.

Targeted drugs

Targeted therapy drugs may be used for some advanced melanomas. These drugs affect cancer cells more than normal cells in the body. They may work even if other treatment doesn’t. They may cause fewer side effects.

Chemo

Chemo is short for chemotherapy – the use of drugs to fight cancer. The drugs may be given into a vein or taken as pills. These drugs kill fast growing cells like cancer cells. Chemo might be used to treat advanced melanoma, often after other treatments have been tried. Chemo is given in cycles or rounds. Each round of treatment is followed by a break.

Side effects of chemo

Chemo can make you feel very tired, sick to your stomach, and cause your hair to fall out. But these problems go away after treatment ends.

There are ways to treat most chemo side effects. If you have side effects, talk to your cancer care team so they can help.

Clinical trials

Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better.

Clinical trials are one way to get the newest treatment. They are the best way for doctors to find better ways to treat melanoma. If your doctor can find one that might be right for you, it’s up to you whether to take part. And if you do sign up for a clinical trial, you can always stop at any time.

If you would like to learn more about clinical trials that might options for you, start by asking your doctor if your clinic or hospital conducts clinical trials. See Clinical Trials to learn more.

What about other treatments I hear about?

When you have melanoma, you might hear about other ways to treat it or treat your symptoms that are not standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether it’s a vitamin, a diet, or anything else.

Questions to ask the doctor

• What treatment do you think is best for me?
• What’s the goal of this treatment? Do you think it could cure the cancer?
• Will treatment include surgery? If so, who will do the surgery?
• What will the surgery be like?
• Will I need other types of treatment, too?
• What’s the goal of these treatments?
• How soon do we need to start treatment?
• What should I do to be ready for treatment?
• Is there anything I can do to help the treatment work better?
• What side effects could I have from these treatments?
• What can I do about side effects that I might have?
• Is there a clinical trial that might be right for me?
• What about special vitamins or diets that friends tell me about? How will I know if they are safe?
• What’s the next step?

What will happen after treatment?

 After treatment is over, it will be important to check your skin for any new signs of cancer. It will also be very important to protect yourself from getting too much sun.

For years after treatment, you will see your cancer doctor. Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back.

At first, your visits may be every few months. Then, the longer you’re cancer-free, the less often the visits are needed.

Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.

You can’t change the fact that you have cancer. What you can change is how you live the rest of your life – making healthy choices and feeling as good as you can.