Path to Getting a Diagnosis
If your doctor suspects you may have melanoma, you will be referred to a dermatologist, a medical oncologist, or a surgical oncologist. These physicians are experts in identifying suspicious moles and skin lesions and know which diagnostic methods and treatments are most appropriate. To make a definitive diagnosis, they will perform various examinations and tests.
This diagnostic path begins when you or your doctor find a suspicious-looking skin growth or spot.
- A complete medical history will be taken. This should include whether there have been members of your family with melanoma.
The doctor will give you a physical examination with a thorough inspection of your skin. In the case of a diagnosis of melanoma, your doctor will look for any enlarged lymph nodes, particularly near the melanoma. Your doctor will determine if a biopsy is necessary, and whether you need to be referred to a specialist.
The next step is a biopsy. The purpose of a biopsy is to remove enough tissue from the lesion to make an accurate diagnosis. No other testing is recommended at this point. When possible, the whole lesion will be removed, along with 1 mm to 2 mm (about 0.04 to 0.08 inch) of surrounding normal skin. If that is not possible, then the thickest part of the lesion should be removed, including the full depth of the lesion.
A pathologist (a doctor who specializes in examining tissue samples) who is experienced with skin tumors, will examine the specimen to determine if there are features that might indicate a melanoma.
If the doctor gives you a diagnosis of melanoma, do not panic, even though a diagnosis of cancer can be overwhelming.
Usually a physician will want to ask additional questions, perform additional examinations, and, most importantly, explain the recommended next steps for treatment and workup.
Because this is important information, if you feel that you are too emotionally upset, and cannot focus on the information at that time, ask for a few minutes to collect your thoughts, or reschedule your appointment for another time, when a friend or family member can be with you. Your doctor will understand and will try to accommodate your needs.