Diagnosis & staging
These are tests that may be used to diagnose this type of cancer.
- Complete medical history with a focus on skin problems, exposure to high-risk situations and family history of skin cancer or other types of cancer.
- Complete physical examination, including a careful examination of the skin all over the body, hard-to-see areas on the back, back of the neck, buttocks, genital area and scalp.
- Excision biopsy (complete removal and examination of a small bit of tissue). This can be done in the doctor's office or outpatient clinic under a local anesthetic. If the skin lesion is quite large an incision biopsy (partial removal) may be done.
- Serum biochemistry (blood test).
- Chest X-ray.
- CT scan.
- Lymphoscintiscan (scan of nearby lymph nodes).
For more information on tests used to diagnose cancer, see our Recommended Links, Diagnostic Tests
Types and Stages
- Melanomas may be classified into several types, all of which can grow and spread quickly.
- Superficial spreading melanoma (SSM)
- Accounts for two-thirds of all melanomas
- May start from a pre-existing mole (dysplastic nevus)
- Nodular melanoma (NM)
- A nodule appears, usually unrelated to a pre-existing mole
- Lentigo maligna melanoma (LMM)
- Less common
- Occurs most commonly on the sun-exposed faces of the elderly
- Acral lentiginous melanoma
- Occurs in the palms or the soles or under the nail beds
- Accounts for the majority of malignant melanomas for dark-skinned people but for only a small percentage of all melanomas for light-skinned people
Staging describes the extent of a cancer. The TNM classification system is used as the standard around the world. In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.
T describes the site and size of the main tumour (primary)
N describes involvement of lymph nodes
M relates to whether the cancer has spread (presence or absence of distant metastases)
For a chart of the current TMN classification for melanoma, see Staging
- Early detection of melanoma is of vital importance as survival is directly related to the depth of tumour invasion at diagnosis and whether the local or regional nodes are positive.