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  • Patients
  • Exploring cancer care
  • Conditions we treat
  • Melanoma cancer

Introduction

Melanoma cancer

While skin cancer is the most common type of cancer in the US, melanoma only accounts for 1% of them. Despite low prevalence, melanoma is the most severe type of skin cancer as it can more rapidly metastasize, or spread, to other parts of the body.

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Overview

Chapter 1

What is melanoma?

Melanoma is a type of skin cancer that develops from melanocytes, which are cells that produce melanin and gives your skin color (or pigment). Melanin also plays an important role in protecting you from ultraviolet radiation and sunburn.

Melanoma is linked to sun exposure, but it can also affect areas of the body that aren’t often exposed to sun. In rare cases, it affects the skin that lines the nose, mouth and genitals. Those at highest risk have unprotected and excessive exposure to sun and ultraviolet radiation (UVR), a suppressed immune system, are fair skinned, have many moles or a skin cancer history. Additionally, melanoma can be caused by a genetic predisposition.

When melanoma cancer cells grow, a mark typically resembling a mole appears on the skin, usually brown or black in color. Melanoma can metastasize, or spread, to other parts of the body, including the lymph nodes, bone, lung, liver, and brain.

The most common type of melanoma is superficial spreading melanoma, which starts by spreading across the top layer of the skin. Over time, it begins to grow deeper into the skin. Other types include, nodular, lentigo maligna, acral lentiginous, and amelanotic melanoma.

When caught early, melanoma can be easier to treat, and patients may have better outcomes

The first sign of melanoma cancer is often a new spot on the skin, or change in size, shape or color of an existing mole. You may find that the spot is also bleeding, painful, inflamed or itchy.

A good way to remember the warning signs for melanoma is the A-B-C-D-E method:

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  • A is for asymmetrical – is the mole or spot irregularly shaped?
  • B is for border – is the border jagged?
  • C is for color – is the color uneven?
  • D is for diameter – is it larger than the size of a pea?
  • E is for evolving – has it changed during the past few weeks?

Having one or more of these skin cancer symptoms doesn’t mean you have cancer, as they may be caused by other, benign (non-cancerous) conditions. It’s best to speak to your primary care physician for advice if you have any concerns.

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Diagnostics

Chapter 2

Diagnostics

Diagnosis

The first sign of melanoma cancer is often a new spot on the skin, or change in size, shape or color of an existing mole. You may find that the spot is also bleeding, painful, inflamed or itchy. Your physician may want to run diagnostics if there is a concern for malignancy.

Melanoma is usually diagnosed by performing a biopsy. Occasionally a biopsy can remove all the cancer tissue and no treatment is required. If necessary, imaging scans such as ultrasound, PET, CT, and MRI may be used to confirm the extent of a diagnosis. You may also have advanced diagnostic tests throughout treatment to assess effectiveness and how your cancer is responding.

Treatment focused on you

Chapter 3

Treatment focused on you

Treatment

We understand that being diagnosed with cancer can be overwhelming – we are here to help you navigate this journey. At GenesisCare, we specialize in the latest technologies and continually evaluate the latest skin cancer treatments so we can offer the most up-to-date options to every patient without delay. We offer treatments that can improve your skin cancer prognosis, manage the disease and help minimize any discomfort and pain. You and your doctor will work together to decide on the most appropriate treatment plan for you, tailored to your needs.

Surgery

Chapter 4

Surgery

Surgery

Our experienced team of surgeons are specially trained in the removal of tumors containing cancerous and benign (non-cancerous) cells. There are different procedures used for skin cancer surgery and your surgeon will recommend the most appropriate one for you depending on how advanced your melanoma is.

Wide excision

Excisional surgery involves cutting out the cancerous tissue and a surrounding margin, or area of skin with a goal to remove all the cancer. This procedure is performed under local anesthetic. Once complete, the sample is looked at under a microscope to ensure no cancer cells were left behind at the edges of the skin that was removed. Larger margins may be cut for thicker tumors, and margins may be smaller if the melanoma is on the face to minimize visible scarring.

Mohs surgery

Mohs surgery, or Mohs micrographic surgery, is a technique that causes minimal damage to the surrounding healthy tissue and only removes the skin containing the melanoma. With Mohs surgery, the visible tumor is removed, and your surgeon will then remove a layer of the skin and analyze it under a microscope to see if it contains cancer cells. If cancer is found, your surgeon will remove another layer of skin and again analyze it under the microscope. This process is continued layer-by-layer until no more cancer cells are found.

Lymph node dissection

Lymph nodes are vessels that push lymph fluid through the body. For more advanced melanomas where there is a risk of the cancer spreading to the lymph nodes, your surgeon may recommend removing the lymph nodes that are in close proximity to the cancer. A lymph node dissection is often done after the nearby lymph nodes have been examined and are abnormal (example: they are large in size or hard), or a biopsy has been performed and cancerous cells have been found in one or more nodes.

Radiation therapy

Chapter 5

Radiation therapy

Radiation therapy

Radiation therapy is often most appropriate for melanoma where surgery is contraindicated in earlier stages, or as an additional treatment for advanced disease to help minimize spread of cancer after surgery is performed. At GenesisCare, we specialize in advanced radiation therapy techniques, with treatment plans focused on minimizing side effects and putting your needs at the forefront.

Our latest-generation machines are built to deliver highly targeted radiation beams. The accuracy of these treatments, together with the expertise of our teams, means that we can often complete a course of radiation therapy in a shorter amount of time - so you can spend more time doing the things you love.

Radiation therapy for skin cancer

External Beam Radiation Therapy (EBRT)

At GenesisCare our melanoma treatments consist of External Beam Radiation Therapy (EBRT) techniques, where radiation is delivered from outside the body. 

Stereotactic Radiation Therapy (SBRT)

SBRT, also known as Stereotactic Ablative Radiation Therapy (SABR), delivers a precise beam of radiation to a tumor, while providing minimal damage to the surrounding healthy tissue. Treatment is typically shorter than the average radiation plan, often offered over three to five sessions. It is most frequently used in more advanced cases of melanoma that has metastasized. 

Intensity-Modulated Radiation Therapy (IMRT)

IMRT is an advanced external beam radiation therapy technique where the beams of radiation are precisely shaped to exactly match your tumor, which limits radiation exposure to healthy tissues.

Volumetric Modulated Arc Therapy (VMAT)

VMAT is an advanced form of IMRT that directs beams of radiation in an arc across the treatment area. VMAT very accurately target areas of cancer and can be used to give a consistent dose to large treatment areas, while limiting radiation exposure to surrounding areas of the body.

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Medical oncology

Chapter 6

Medical oncology

Medical oncology

At GenesisCare, we offer a wide range of drug therapies and the latest anti-cancer drugs for skin cancer treatment, including chemotherapy, targeted therapy and immunotherapy.

Chemotherapy for melanoma

Chemotherapy refers to drugs that destroy cancer cells. Our expert teams may recommend chemotherapy after other treatments or on its own. Chemotherapy is not usually used as the first treatment for melanoma, but it may shrink the size of the tumors in some cases.

The type of chemotherapy you’ll receive will depend on how advanced your skin cancer is. If your melanoma has spread to other parts of your body, chemotherapy may help control its growth, relieve symptoms and improve your skin cancer prognosis.

Immunotherapy for melanoma

Cancer cells rapidly divide out of control unlike normal, healthy cells, and often are able to hide from the immune system. Immunotherapy helps your body’s own immune system recognize and fight the cancer. Checkpoint inhibitors may be an effective immunotherapy against melanoma, working by blocking the signals that stop the immune system from attacking the cancerous cells. 

Targeted therapy for melanoma

Targeted therapy, also known as precision medicine, is a newer type of treatment that ‘targets’ cancer cells without affecting normal healthy cells. Targeted therapy seeks, attacks and blocks cellular activity that cancer depends on to survive and grow. Targeted therapies help determine what DNA mutation is driving a cancer, based off your individual genomic and genetic makeup. Types of targeted therapy for melanoma include: 

  • Cancer growth inhibitors – some melanomas can have an altered proteins called BRAF, MEK, and C-KIT,  which helps them grow. These drugs target the faulty  proteins to stop the cancer from growing.

Why choose GenesisCare?

Chapter 7

Why choose GenesisCare?

Why choose GenesisCare?
Our locations

People choose GenesisCare so they can access the latest technologies, effective treatments and personalized care that’s tailored to them without delay.

Cancer treatment and care is constantly evolving and we offer the world’s latest evidence-based treatments that have been shown to benefit patients. By working together closely, our multidisciplinary teams of oncologists, surgeons, radiation therapists and other healthcare specialists provide care that’s focused on you, not just your cancer.

We know that for many people, cancer is a life-changing experience and our goal is to help you through it in the most positive way possible. That’s why as well as offering exceptional cancer treatments, we also provide you with support and resources for your cancer journey—including advice about nutrition and exercise, expert help for managing side effects and information on local support groups.

Designing better care

Our centers are conveniently located throughout the United States, and each location has a dedicated Office Financial Counselor on hand to help you with your paperwork and answer your questions. We accept most insurance plans as well as Medicare Part B, which covers physician services, including radiation therapy.

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