Malignant melanoma is actually a very small percentage of all skin cancers. Malignant melanoma starts in the melanocytes—cells that produce pigment in the skin. It can also begin as an abnormal mole that then turns cancerous.
This cancer may spread quickly. Malignant melanoma most often appears on fair-skinned men and women, but persons with all skin types may be affected.
Types of Skin Cancer
Our dermatologists are a part of Huntsman Cancer Institute’s Melanoma Cutaneous Oncology Program and treat and research all areas of cutaneous cancer conditions, including the following:
Skin Cancer Treatment
A specific treatment plan for your skin cancer will be determined with you by our highly skilled physicians. It could include the following:
- Laser therapy
- Radiation therapy
Because our dermatologists and oncologists are experts in their field, you will receive the best treatment available, along with information about the latest research studies and newest technologies for the treatment of skin cancer.
Diagnosing melanoma starts with checking out a mole or other mark on your skin. Your health care provider will examine your skin with the ABCDE rules in mind. This means looking at:
Asymmetry. One half of the mole does not match the other half.
Border irregularity. The edges of the mole are ragged or irregular.
Color. The mole has different colors in it. It may be tan, brown, black, red, or other colors. Or it may have areas that appear to have lost color.
Diameter. The mole is bigger than 6 millimeters across, about the size of a pencil eraser. But some melanomas can be smaller.
Evolving. A mole changes in size, shape, or color.
Your health care provider will ask you about the mole. Tell him or her:
When you first noticed it
If it hurts or itches
If it oozes fluid or bleeds, or gets crusty
If it’s changed in size, color, or shape
Make sure to tell your health care provider if you’ve had skin cancer in the past. Also note whether anyone in your family has had skin cancer.
Getting a biopsy
A biopsy is a sample of tissue that’s taken to be checked in a lab. Your health care provider will likely take a biopsy of any mole or other skin mark that may look like cancer.
Types of biopsies
The different types of biopsies include the following:
Excisional biopsy. This type of biopsy is often used when a wider or deeper piece of the skin is needed. It’s done when a melanoma is suspected. The entire mole and part of the surrounding skin is removed. First, a local anesthetic is used to numb the area. Using a surgical knife (scalpel), a full thickness wedge of skin is removed. The wound is closed with surgical thread (sutures), staples, steri-strips, or surgical glue. This depends on the size and location of the incision.
Incisional biopsy. This procedure is the same as an excisional biopsy. But only part of the mole or mark is removed.
Punch biopsy. This type uses a special tool to take a deep sample of skin. The tool removes a short cylinder of tissue, like an apple core. First, a local anesthetic is used to numb the area. The punch tool is turned on the surface of the skin until it cuts through all the layers of skin. This includes the dermis, epidermis, and the most superficial parts of the subcutis (fat). The biopsy sample is removed and the edges of the wound are then stitched together.
Shave biopsy. This type of biopsy removes the top layers of skin. They are shaved off with a scalpel. Shave biopsies are done with a local anesthetic. This method may be used on a mole if the chance if melanoma is very low. This method is not usually used if melanoma is suspected.
Lab tests of your biopsy sample
A biopsy sample is sent to a lab, where a doctor called a pathologist looks at them under a microscope. He or she may do other tests on them to see if they contain melanoma cells.
If melanoma is found, the pathologist will look at certain features of the melanoma. These include the thickness of the melanoma and the portion of cells that are actively dividing (mitotic rate). These can help determine the extent (stage) of the melanoma. The stage of melanoma helps determine treatment options.
The pathologist might also do other tests to look for certain gene changes within the melanoma cells that could affect treatment options. For example, about half of all melanomas have changes in the BRAF gene that help the cells grow. Certain medicines can help treat melanomas that have this change. But these medicines are not likely to help treat melanomas without this gene change. Testing the cells before treatment is important.
Getting your biopsy results
Your biopsy results will likely be ready in a few days to a week or so. Your health care provider will notify you of the results. He or she will talk with you about other tests that may be needed if melanoma is found.
Glen M. Bowen, MD specializes in the diagnosis and treatment of skin cancer. At the Huntsman Cancer Institute, Dr. Bowen is the clinical director of the Multidisciplinary Cutaneous Oncology Program and collaborates with physicians in plastic surgery, otolaryngology (ear, nose, and throat), surgical oncology, radiation oncology, and medical oncolog... Read More
Keith Duffy, MD, is an assistant professor in the Department of Dermatology at the University of Utah School of Medicine and a Huntsman Cancer Institute investigator. Dr. Duffy's clinical interests include Mohs surgery (a microscopic technique that allows skin cancers to be removed with very narrow surgical margins), diagnostic dermatopathology (th... Read More
Mark Eliason, MD has specialized interest in skin cancer and inflammatory diseases of the skin. He is board certified in dermatology. He has completed a two-year fellowship in familial melanoma genetics and published research in this area. In addition, he has interest in inflammatory diseases such as urticaria and eczema. He sees patients for any g... Read More
Douglas Grossman, MD, PhD, is an expert in the early diagnosis and treatment of skin cancers. He received his medical degree from Baylor College of Medicine in 1994, and completed his dermatology training at Yale University School of Medicine in 1998. Following a research fellowship in cancer biology at Yale, he was recruited to the University of... Read More
Mark Hyde, PA-C has specialized expertise in the treatment of patients with melanoma, non-melanoma skin cancer, and cutaneous T-cell lymphoma. As a Physician Assistant, he is board certified in primary care. Mr. Hyde assists in performing Mohs micrographic surgery, having performed more than 9000 procedures at the Huntsman Cancer Institute.... Read More
Garrett C. Lowe, MD, is an assistant professor in the Department of Dermatology at the University of Utah School of Medicine. Dr. Lowe's clinical interests include Mohs surgery (a microscopic technique that allows skin cancers to be removed with very narrow surgical margins), lower extremity venous insufficiency (varicose veins, VNUS procedure, amb... Read More
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Eric Millican, MD, is an Assistant Professor in the Department of Dermatology at the University of Utah School of Medicine. He specializes in the prevention, diagnosis and treatment of skin cancer. He is fellowship-trained in Mohs Micrographic Surgery - a tissue-sparing technique for treating skin cancers with the highest cure rate. His clinical... Read More
Payam Tristani-Firouzi, MD has specialized expertise in Mohs Micrographic Surgery. This is a tissue-sparing technique for removal of skin cancers such as basal cell carcinomas and squamous cell carcinomas with the highest cure rate. She is board certified in Dermatology and is a Fellow of the College of Mohs Surgery. Dr. Tristani-Firouzi’s main ... Read More
David Wada, MD is a dermatologist who specializes in cutaneous oncology. His clinical focus is centered on the diagnosis and treatment of cutaneous lymphoma, lymphomatoid disorders (skin conditions that resemble lymphoma), and melanoma and non-melanoma skin cancers. He is involved in clinical trials associated with the treatment of cutaneous lymp... Read More
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