If you or your physician notice an unusual spot on your body that might be a sign of melanoma, there are a number of tests and questions that you will need to go through. These will help confirm or disprove a skin cancer diagnosis. The usual procedure is as follows:
- Questions about symptoms. The doctor will ask you whether you remember when the possible melanoma appeared and whether you have noticed any change. You will also be asked about any cancer risk factors. These can include high exposure to sunlight, a family history of cancer, or previous cancerous growths on the skin.
- Physical examination. The doctor will note the appearance of the potential melanoma and examine it with a magnifying lens called a dermatoscope. He or she may examine the rest of your body for other possible melanomas. The doctor may ask to feel your lymph nodes, which are clusters of small cells in your neck, armpits, and groin. When cancer spreads, it often does so through the lymph nodes, so swollen lymph nodes are a potential trouble sign.
- Biopsies. If the doctor suspects melanoma, the next step is to remove some of the suspicious area and have it laboratory tested. This is referred to as a skin biopsy. When performed by a board-certified dermatologist, biopsies are simple and painless. Local anesthesia will be used to numb the area. There are several ways to perform a biopsy. The doctor may remove part of the affected skin with a scalpel or shaver. A punch can also be used to take a deeper sample of the affected skin. In some cases, the biopsy can even be performed directly on the body, without having to remove any skin.
If the melanoma has already spread inside the body, more complex biopsy procedures may be needed. A fine needle can be used to remove cells from lymph nodes or tumors inside the body for examination. A more complex method, sentinel lymph node biopsy, tracks the
spread of cancerous cells in the lymphatic system using radioactive dye. In especially serious cases, the doctor may order surgery to remove tumors or lymph nodes for direct examination
The material collected from a biopsy will be sent to a laboratory for examination by a pathologist. If melanoma cells are detected, the pathologist will determine the stage of the cancer. This will enable the treating doctor to decide on a course of action.