Melanoma care

At Allina Health, you will receive comprehensive care from your cancer care team, which includes your primary care provider and many highly trained specialists. A nurse navigator will coordinate your cancer care to ensure you understand each step and receive the best care possible. See your test results, review appointment notes, securely message your care team and more in your Allina Health account.

At Allina Health Cancer Institute – Saint Paul, we have a multidisciplinary team that cares for stage three (III) melanoma patients. The team includes specialists in surgical and medical oncology, dermatology and imaging. This care model enables you to get imaging and see multiple specialists during a single visit. 

For more information about the multidisciplinary melanoma clinic, call 651-241-7174.

At Allina Health, you will be seen by a team of health care providers to diagnose and manage your melanoma. Your health care team may include your primary care provider, dermatologist, surgeon, oncologist, nurses and others.

To get started, you will have a physical exam, where you will talk about your health history and family history. During this exam, your doctor will look at your skin for signs of melanoma. If you have an abnormal-looking mole, your health care provider will perform a biopsy, which removes the mole or a small sample of tissue for testing under a microscope. If your biopsy shows that you have melanoma, your health care provider will refer you to a surgeon for treatment that is based on the stage of the melanoma.

The stage of your cancer is based on TNM Staging System:

• T (Tumor): The T stage is based on how far the tumor has invaded into the deeper tissues, ranging from 1 to 4. The depth of the tumor is determined by examining it under a microscope and using a special tool to measure it. The thicker the growth, the more serious the cancer.
• N (Lymph Nodes): The N stage determines if there are lymph nodes involved with melanoma. This can be determined by physical exam, imaging, or by removing one to three lymph nodes at the time of surgery and looking at them under the microscope to determine if the melanoma has spread to the lymph nodes.
• M (Metastasis): The M stage determines if melanoma has spread to distant parts of your body. Imaging tests, such as ultrasound, MRI, CT scan, or PET scans can look for additional sites of disease and a biopsy may be done to confirm metastatic cancer (cancer that has spread).  Your health care team will work with you to determine which testing is right for you.

• Stage 0: The melanoma is only found in the epidermis and has not spread. This stage is also called melanoma in situ.
• Stage I: The melanoma has grown into the skin (dermis) but has not spread to the lymph nodes or other parts of your body.
• Stage II: The melanoma has grown deeper into the skin but still has not spread to the lymph nodes or other parts of your body.
• Stage III: The melanoma has spread to nearby lymph nodes but has not spread to other parts of your body.
• Stage IV: The melanoma has spread to distant lymph nodes or other parts of your body such as the liver, lungs or brain.

You and your health care providers will work together to develop a treatment plan that is right for you. This plan will be unique to your needs, concerns and preferences. Treatment for melanoma depends on your general health, the stage of your cancer as well as:

• the depth the melanoma goes into the deeper tissues
• if you have lymph nodes with melanoma in them
• if the melanoma has spread to other parts of your body

Treatment for melanoma may include one or more of the following:

• Surgery: where the melanoma and some normal tissue around it are removed (wide local excision) or where the lymph node may also be removed to check for the spread of melanoma (sentinel lymph node biopsy).
• Targeted therapy: treatment that uses medicines designed to target specific features of cancer cells and stop them from growing and spreading. Immunotherapy is the most the most common type in treating melanoma.
• Imlygic injections (T-VEC): this treatment destroys melanoma cells that are in the skin, under the skin or in the lymph nodes. T-VEC is injected directly into the melanoma tumors.
• Radiation therapy: this treatment uses high-energy radiation (X-rays) to shrink or destroy the cancer cells.
• Clinical trials (cancer treatment studies): are done to try to improve the prevention, detection, and treatment of melanoma. If you are interested in being part of a clinical trial, talk with your medical oncologist to see if there is one that would be right for you.

You will probably first see your primary care provider or dermatologist if you have a concerning skin lesion. If they suspect melanoma, they will do a biopsy and may refer you to a surgeon. Questions to ask your health care team:

• How treatable is melanoma?
• What stage of melanoma do I have?
• What is the most common/recommended treatment for my melanoma?
• How will treatment affect my daily life?
• Will treatment impact my fertility?
• Does melanoma spread?
• Can my melanoma be cured?
• What support resources are available to help me?
• Whom should I call if I have questions after I leave the office?

What causes melanoma?

The main risk factor for getting melanoma is exposure to ultraviolet (UV) radiation from the sun, sunlamps and tanning beds. There are other risk factors for melanoma that you can control and some that you can not control.

What are the symptoms of melanoma?

Melanoma can occur anywhere on your skin. The most common sign of melanoma is a change in an existing mole, including changes to the same, color, size or feel. Read about the ABCDEs will help you remember the signs of melanoma in moles.

What can I do to prevent melanoma?

The best way to prevent melanoma is to protect yourself from UV exposure and to do skin self-exams on a regular basis. Learn more about the things you can do in preventing melanoma with these skin exam and protection tips.