Melanomas diagnosed early are confined to the upper skin layers and have no evidence of spread. They are treated with surgical excision, which is generally all that is required. In situ Melanoma (Stage 0) is localized to the outer layer of skin (the epidermis) and has the best prognosis.
Stage I Melanoma has invaded the next layer of skin (the dermis). In both Stage 0 and Stage I Melanomas, the physician surgically removes any remaining tumor plus a surrounding “safety margin” of normal tissue around and under it. The amount of skin removed depends on the thickness and location of the tumor. The margins are sent to the lab to make sure they are cancer-free. If so, no further surgery is necessary.
Dr. Ratner may sometimes recommend removal of melanoma by surgical excision with complete peripheral and deep margin control with permanent sections. This procedure is done in stages to remove the cancer cells in layers while sparing healthy tissue and leaving the smallest possible scar. One layer at a time is removed and examined until the margins are cancer-free, after which the defect may be repaired.
If a melanoma measures 0.75 mm or more in thickness or has other traits such as ulceration, it is more likely to spread to the lymph nodes. In these cases, Dr. Ratner refers patients to a Surgical Oncologist for sentinel lymph node biopsy, which is generally performed at the same time as the surgery to remove the primary tumor. If melanoma is found in the sentinel node, further evaluation and treatment may be required to ensure that all cancer cells are removed.
Melanomas in their later stages can spread beyond the original tumor, reaching the lymph nodes and/or distant organs. New immunotherapies and targeted therapies have helped many patients with these more advanced melanomas, providing them with improved survival and quality of life. These therapies, including immunotherapy, immune checkpoint inhibitors, targeted therapies and combination treatments, work by shrinking tumors and halting or slowing disease progression. Dr. Ratner refers patients with more advanced melanomas to Medical Oncology for evaluation and treatment.
Whatever treatment you need, Désirée Ratner, M.D., P.C., can help. Please reach out to us today at (212) 814-5884 to discuss your skin cancer situation and treatment options. We look forward to speaking with you.
Désirée Ratner, M.D., P.C.
115 East 61st Street, 9th Floor
New York, NY 10065
Phone:
(212) 814-5884
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