Treating cancerous moles
The treatment for malignant melanoma initially involves the surgical removal of the mole and what is called a ‘healthy margin’ of the surrounding tissue. If this is done early enough, then chances are the cancer will be completely cured and is unlikely to recur.
Surgical mole removal
The most common skin cancer surgery for malignant melanoma is the complete removal of the mole. This is usually done under a local anaesthetic.
Traditionally, dermatological surgery for a cancerous mole involves removal of the mole using a scalpel. The dermatologist uses his or her skill and experience to identify potentially cancerous cells. A small amount of the surrounding tissue is also taken to be certain that no cancer cells are left behind. The resulting wound is then stitched. Rarely it may be left to be closed at a later date (delayed primary closure) once the histology diagnosis is available.
For skin cancer that is not melanoma (non-melanoma skin cancer) a specific form of surgery called Mohs’ micrographic surgery may be helpful. As skin cancers may not always grow on top of the skin, sometimes they can grow beneath the skin making it difficult to plan an accurate surgical margin for excision. For these tumours Mohs’ micrographic surgery can be helpful, particularly if the skin cancer affects skin sites of cosmetic importance.
Mohs’ microsurgery has typically been limited to non-melanoma skin cancers but the latest techniques mean that it is now being used more widely for a specific type of melanoma affecting facial skin, called lentigo maligna.
Sentinel lymph node biopsy
This is a diagnostic test to see whether any cancerous cells have spread from the site of the original melanoma to the local lymph nodes. The process involves sampling the first (sentinel) lymph node in the collection of lymph nodes draining the site of the original melanoma. If positive the remaining lymph nodes will need to be removed for examination.
Lymph node removal
If a malignant melanoma has spread to the regional lymph nodes, then they will also need to be removed. This is called a block dissection. This is a much more complex operation and will be done under general anaesthetic.
Other treatments for malignant melanoma
Most cases of malignant melanoma are treated by surgically removing the cancerous mole. However if the melanoma has spread to internal organs then more complex treatment options are available. These treatments are usually prescribed by medical and clinical oncologists and include:
- Radiotherapy: beams of radiation are focussed on the cancer cells to kill them.
- Chemotherapy: chemicals are used to kill the cancer cells.
- Immunotherapy: the body’s own immune system is altered in a way that attacks cancer cells.
Some of these treatments are also used in combination if the skin cancer has spread to other organs.
Treating advanced malignant melanoma
If skin cancer is not identified early, then it can spread throughout the body to other major organs. This is known as advanced malignant melanoma cancer. The focus of treatment will be the reduction of your symptoms, to make the cancer more manageable and, if possible, to slow its spread.
Monitoring patients after successful treatment
If malignant melanoma is caught early and treated promptly, it can be cured.
Having had malignant melanoma once does, however, put you at risk of developing it again, in another mole. You need to avoid being sunburnt or being exposed to UV radiation – so avoid sunbeds, for example.
Dr Bowling can arrange for you to come to his mole clinic regularly for assessment of all your moles by digital mole mapping so that future occurrences can be treated equally successfully.
“It is still essential for people to enjoy a healthy outdoor lifestyle post diagnosis of melanoma. Remember sunscreen and surveillance – two words to give you the confidence to enjoy the great British Summer.”