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A diagnosis of melanoma will usually begin with an examination of your skin.
Some GPs take digital photographs of suspected tumours so they can email them to a specialist for assessment.
As melanoma is a relatively rare condition, many GPs will only see a case every few years. It's important to monitor your moles and return to your GP if you notice any changes. Taking photos to document any changes will help with diagnosis.
You'll be referred to a dermatology clinic for further testing if melanoma is suspected. You should see a specialist within two weeks of seeing your GP.
A dermatologist (skin specialist) or plastic surgeon will examine the mole and the rest of your skin. They may remove the mole and send it for testing (biopsy) to check whether it's cancerous. A biopsy is usually carried out under local anaesthetic, which means the area around the mole will be numbed and you won't feel any pain.
If cancer is confirmed, you'll usually need another operation, most often carried out by a plastic surgeon, to remove a wider area of skin. This is to make absolutely sure that no cancerous cells are left behind in the skin.
You'll have further tests if there's a concern the cancer has spread into other organs, bones or your bloodstream.
If melanoma spreads, it will usually begin spreading through channels in the skin (lymphatics) to the nearest group of glands (lymph nodes). Lymph nodes are part of the body's immune system. They help remove unwanted bacteria and particles from the body and play a role in activating the immune system.
Sentinel lymph node biopsy is a test to determine whether microscopic amounts of melanoma (less than would show up on any X-ray or scan) might have spread to the lymph nodes. It's usually carried out by a specialist plastic surgeon, while you're under general anaesthetic.
A combination of blue dye and a weak radioactive chemical is injected around your scar. This is usually done just before the wider area of skin is removed. The solution follows the same channels in the skin as any melanoma.
The first lymph node the dye and chemical reaches is known as the "sentinel" lymph node. The surgeon can locate and remove the sentinel node, leaving the others intact. The node is then examined for microscopic specks of melanoma (this process can take several weeks).
If the sentinel lymph node is clear of melanoma, it's extremely unlikely that any other lymph nodes are affected. This can be reassuring because if melanoma reaches the lymph nodes, it's more likely to spread elsewhere.
If the sentinel lymph node contains melanoma, there's a risk that other lymph nodes in the same group will also contain melanoma.
Your surgeon should discuss the pros and cons of having a sentinel lymph node biopsy before you agree to having it. The National Institute for Health and Care Excellence (NICE) has developed an interactive decision aid called Melanoma: sentinel biopsy – yes or no? to help make the decision easier.
An operation to remove the remaining lymph nodes in the group is known as a completion lymph node dissection or completion lymphadenectomy. NICE have also developed an interactive decision aid called Melanoma: completion lymphadenectomy – yes or no? which outlines the pros and cons of the procedure.
Other tests you may have include:
Healthcare professionals use a staging system called the AJCC system to describe how far melanoma has grown into the skin (the thickness) and whether it has spread. The type of treatment you receive will depend on what stage the melanoma has reached.
The melanoma stages can be described as:
Cancer Research UK has more information about the stages of melanoma.