Melanoma Cancer Diagnosis & Detection
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The first goal of your Cancer Treatment Centers of America (CTCA) team is to conduct a complete evaluation of your disease status. This may include a review of previous pathology and biopsy results. Your team may also use an array of sophisticated imaging and lab tests to develop the appropriate treatment plan and to monitor your progress throughout therapy.
Biopsy for Melanoma
Potential melanomas are usually first examined visually. Your doctor or dermatologist may use a special microscope or magnifying lens to examine the suspicious spot more closely, a process called dermatoscopy. They may also take a digital or photographic image of the spot.
The next step is to remove a piece of the suspicious growth for examination by a laboratory, where they will look for cancerous cells. In many cases, your doctor will remove the whole growth. During this procedure, your doctor will numb the area before removing a tissue sample. There are several different biopsy methods, but an excisional biopsy in which the doctor removes the entire growth is generally preferred in cases where melanoma cancer is suspected.
If melanoma is diagnosed, your doctor may also perform some tests to determine whether or not the cancer has spread beyond the skin. The first place melanomas usually spread is to nearby lymph nodes, so your doctor may feel to see if any lymph nodes are enlarged. They may also take a biopsy of any suspicious lymph nodes. During surgery, your surgeon may perform a sentinel lymph node biopsy, in which they remove a lymph node close to the melanoma and send it to the lab for further examination.
Imaging Tests for Melanoma
There are also a number of imaging tests your CTCA doctor may perform to detect if the melanoma cancer has spread. These include:
- Chest X-ray – A standard x-ray may be used to determine if the melanoma has spread to the lungs.
- Computed Tomography (CT) Scan – A CT scan is a special type of x-ray that generates three-dimensional, cross-sectional images throughout the body. Unlike a normal x-ray, CT scans can create detailed images of the internal organs, like the liver and lungs.
- Magnetic Resonance Imaging (MRI) – MRI is also used to examine the soft tissues within the body, but unlike x-rays and CT scans, an MRI uses radiofrequency waves and powerful magnets to generate the images, so there is no radiation used. MRI is particularly useful for looking at the brain and spinal cord.
- Positron Emission Tomography (PET) Scan – This imaging technique is used to look at metabolic activity within different organs of the body. A radioactive dye, usually a form of glucose, is injected, and a special camera is used to take a picture of radioactive areas within the body. Because cancer cells are growing rapidly and are often more metabolically active compared to normal cells, they absorb more of the radioactive glucose. PET scans are very sensitive, but they do not show much detail, so they will often be performed in combination with a CT scan (called PET/CT).
- Bone Scan – A bone scan may also be performed to see if the cancer has spread to the bones, but this test is rarely used in melanoma cancer cases.
Tumor Molecular Profiling for Melanoma
Tumor molecular profiling may also be performed by your doctors at CTCA to determine if certain forms of chemotherapy drugs are likely to more effective for you.
We’ll test a tissue sample for the presence of a variety of enzymes and genetic mutations to identify which therapies are likely to be more effective. This helps doctors to predict whether the melanoma cancer cells in your body will respond to the drug, and allows them to select the appropriate therapy for each patient. This valuable information helps to avoid unnecessary side effects from a treatment that is unlikely to work.
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