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Cancer Care Services

Diagnosis & Treatment

Melanoma

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How Is Melanoma Diagnosed?

Diagnosis

Early detection of melanoma can greatly increase the odds of successful treatment. A melanoma diagnosis can be determined with the following tests and procedures:

  • Physical exam. A doctor or dermatologist will check your skin and scalp for signs of unusually shaped moles or other signs of melanoma, and inquire about your personal and family history.
  • Mole mapping. NewYork-Presbyterian offers MoleMap photography to help track the growth of moles over time.
  • Biopsy. If a skin growth is suspicious, a small sample of skin tissue is removed and analyzed by a pathologist in order to determine the presence of cancer.

If cancer is detected in a biopsy, these additional tests may be used to determine the stage of melanoma:

  • Sentinel lymph node biopsy. For melanomas deeper than 0.8 mm, this type of biopsy can determine if it has spread to the lymph nodes.
  • CT scans can reveal if melanoma has spread to any internal organs.
  • MRI scans are used to see if melanoma has spread to the spinal cord or brain.
  • PET scan. This scan can detect the presence of melanoma in the lymph nodes or other metastasis throughout the body.

Genetic Counseling and Testing

If you have a family history of melanoma, you may benefit from meeting with a genetic counselor to discuss your risk of developing skin cancer and other malignancies. Genetic counselors can work with you to create a schedule of skin screenings and discuss other measures you can take, such as genetic testing, to reduce your risk of melanoma.

How is Melanoma Treated?

Treatments

It is crucial to seek treatment for melanoma as soon as possible. Treatment options often depend on the size of the melanoma mole, the cancer stage, your health, and your personal comfort levels.

Melanoma is traditionally treated with surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.

Cosmetically Sensitive Melanoma Surgery

Thin, early-stage melanomas maybe be removable in a doctor’s office. If the melanoma is thicker, our surgeons can make flaps from the skin near the tumor, or with skin grafts taken from another part of your body. This will achieve the same survival benefits with a much smaller scar.

For later-stage melanoma, surgery may be required to remove lymph nodes or other affected areas.

Chemotherapy

Chemotherapy uses powerful drugs to attack and kill cancerous cells. It can be administered through pill form or an IV drip.

For melanoma in an arm or leg, chemotherapy may be administered by an isolated limb perfusion (ILP). A surgeon will temporarily cut off blood flow through the affected limb, so that the chemotherapy can travel directly to the melanoma and surrounding area, sparing the rest of your body from exposure to the drugs.

Radiation therapy

Radiation treatments utilize high-powered beams to destroy cancer cells. Radiation therapy may be used in areas where melanoma wasn’t completely removed, or on any affected lymph nodes.

Immunotherapy for melanoma

NewYork-Presbyterian's cancer specialists have participated in pivotal studies evaluating novel immunotherapies for advanced melanoma—treatments that boost the power of the immune system to find and kill cancer cells.

Recently approved immunotherapies for metastatic melanoma include:

  • Nivolumab or pembrolizumab. These drugs bind to and block a molecule called PD-1, which shuts down the immune response. By inhibiting PD-1, nivolumab and pembrolizumab enhance the body's ability to detect and destroy cancer cells.
  • Ipilimumab. Similar to nivolumab, ipilimumab works by blocking a protein that shuts down the immune response—in this case, a protein called CTLA-4—thereby provoking an immune attack against melanoma cells.
  • Talimogene laherparepvec. Also called T-Vec, this is a genetically engineered herpes virus that is injected into tumors and specifically kills cancer cells.

Targeted melanoma therapies

Approximately 50% of cutaneous melanomas contain mutated versions of a gene called BRAF. If your melanoma has this mutation, you may be able to receive drugs that block a pathway activated by this mutation, such as vemurafenib, cobimetinib, dabrafenib, or trametinib. Since these drugs are taken orally (by mouth), you can take them at home. Your doctor will see you periodically to monitor your care.

Melanoma clinical trials

NewYork-Presbyterian has a robust portfolio of cancer clinical trials, including many studies evaluating promising new therapies and treatment combinations for advanced melanoma. Your doctor will let you know if you are eligible to participate in a clinical trial of an innovative therapy.

FAQs

FAQs

It depends on the type of melanoma. Some melanomas can spread quickly over a few weeks, other types can grow over a span of 10 years or more with no detectable symptoms.

Melanoma can present as a spot on the skin with an irregular border in which the edges are blurred, ragged, or notched. The spot can vary in color, with shades of black or brown, and patches of white, red, pink, or blue. The growth is usually wider than ¼ of an inch—around the size of a pencil eraser.

Some types of melanoma are fast-growing and can become life-threatening in six weeks. Other localized melanoma spread over a year or more.

While cancer of the skin is common, melanoma makes up approximately 1% of all skin cancer types. The lifetime risk for developing melanoma is closely related to a person’s ethnic origin and skin tone.

The five-year survival rate for a localized melanoma (Stage 0-II) is 99%. For melanoma that has regionally spread (Stage III) the five-year survival rate is 68%, and for metastatic melanoma (Stage IV) the five-year survival rate is 22.5%.

If detected early, melanoma has a cure rate of 99%.

Left untreated, melanoma can be deadly. It’s essential to protect your skin from the sun, and talk to your doctor about any signs or symptoms as soon as suspected.

Get Care

Trust NewYork-Presbyterian for Melanoma Treatment

NewYork-Presbyterian offers some of the most innovative cancer treatments in the nation. We are familiar with the signs and symptoms of melanoma, and will assemble a team of the best dermatologic oncologists, dermatologic surgeons, plastic surgeons, radiation oncologists, oncology nurses, nutritionists, and social workers to provide you with compassionate, individualized care.

A melanoma diagnosis can be frightening. From diagnosis to recovery, NewYork-Presbyterian is here to support you every step of the way. Contact us today for a personalized treatment plan.