Melanoma Guide page #1

Rules of Melanoma as a Disease

1. You have been given a diagnosis – NOT a death sentence

2. Melanoma survival statistics describe a ‘group’ of similar patients…. but they may have NOTHING to do with YOUR chance of survival

3. In advance Stage melanoma, there is NO one “RIGHT” answer (or “BEST” treatment) option for your melanoma

4. The BEST melanoma patient is an ACTIVE PARTICIPANT in his or her treatment (not a PASSIVE RECIPIENT)

"The ‘phases’ that most melanoma patients seem to go through (in this author’s opinion) are:
DISCOVERY, DIAGNOSIS and finally TREATMENT. These ‘phases’ very closely linked to physician visits when the information about melanoma diagnosis and treatment are shared with the patient. While superficial melanoma treatment is fairly straight forward, more advanced stages of melanoma (again in this author’s opinion) require more physician and patient interactions (“visits”) especially in the DIAGNOSIS and TREATMENT “phases”.

The following Question / Answer format will help you find the information you need about your diagnosis and treatment as well as provide you with links to important sites for more information on melanoma.

Important 1st Visit (Discovery Phase)
Questions to ask your Physician
Why do you think I have melanoma?
What is MY melanoma Stage ?
(Has it been determined?)
Do I need more tests to determine MY Stage ?
If I need more tests – what tests are they ?

Possible Tests that you may undergo:

CT Scan - looks for melanoma in abdomen (bowel + liver) and chest (lungs and lymph nodes)
PET Scan – looks for ‘metabolically active’ areas in the body which may be melanoma
MRI Scan – Used (primarily) to determine if the brain has any melanoma involvement
Bone Scan – uses radioactive material to find if any bone involvement with your melanoma
Blood Work – non-specific indicator that melanoma maybe involved in several organ systems
Sentinal Node Biopsy – looks for involvement of lymph nodes that melanoma may spread to from its primary siteUltrasound – use of sound waves to try to make a diagnosis of melanoma (usually in solid organs)

Simplified Staging Guide to Melanoma*

Stage 0
In situ melanoma
Stage I
No ulceration (<>Stage II > 4 mm depth (with or without ulceration)
Stage III- >Lymph node involvement
Stage IV- >Distant mets to skin, subcutaneous or lymph nodes; or mets to any visceral Organs (lung / liver / brain / bone / etc)

* American Joint Committee on Cancer Staging System for Cutaneous Melanoma J Clin Oncol 2001; 19:3548-3636. Lippincott Williams & Wilkins.