Understanding Melanoma In Situ (Stage 0)
Learn about the symptoms, treatment, and prognosis for melanoma in situ, the earliest stage of melanoma.
.By Diana Rodriguez
With regular and thorough examinations of your skin, you can increase your changes of catching any abnormalities very early — which is good news in terms of treatment and prognosis if that abnormality turns out to be a malignant melanoma. In fact, experts now recommend that men and women of all ages check their skin frequently to increase their odds of spotting potential malignant mole at the earliest possible point: stage 0, or melanoma in situ.
What Is Melanoma In Situ?
Melanoma in situ comes from the Latin phrase “in situ,” which means “in place.” Melanoma in situ is cancer in the very early stages, when it affects only the top layer of the skin. At this point, the cancer has not spread deeper into the body. Cancer diagnosed at this early stage also means that it is less likely to recur or spread to other parts of the body than melanomas that are diagnosed at a later stage.
The very first symptoms of melanoma are any abnormalities in one or more moles on the skin. Abnormalities include moles with anyAsymmetry, uneven Borders, different Colors, large Diameter, orEvolution (any change). That’s why learning the ABCDEs of melanoma and checking yourself regularly are so important. If you see anything different about any of your moles, it could be a sign of melanoma in situ. The best course is to report any changes that you see to your doctor and schedule an exam to rule out melanoma, or to catch and treat it early.
How Is Melanoma In Situ Treated?
The treatment for melanoma in situ is usually fairly simple. In a doctor’s office, an outpatient procedure can be performed in which the melanoma is cut out of the skin, a process that medical personnel call resecting or excising.
“The treatment option for early stage melanoma is a wide excision procedure,” says Bruce A. Brod, MD, a clinical associate professor of dermatology at the University of Pennsylvania School of Medicine. “The key prognostic feature in melanoma is the thickness [in millimeters] of the melanoma, which is based on the initial biopsy of the lesion.”
How much skin needs to be cut out depends, then, on the biopsy results. “The consensus for treatment of melanoma in situ is to remove a half-centimeter diameter around the lesion or the initial biopsy site,” Dr. Brod says. “The consensus for treating melanomas less than 2 millimeters in thickness is to remove a 1-centimeter diameter, if possible, around the lesion.”
If the melanoma is larger in size, more skin may need to be removed, and a biopsy performed. “In melanomas greater than 2 millimeters [in thickness], the consensus is to excise a 2-centimeter diameter area around the lesion,” he says. “Since melanoma can spread to the lymph nodes in close proximity to the initial melanoma, a biopsy of lymph nodes is sometimes performed for melanoma close to or greater than 1 millimeter in thickness at the time of the wide excision procedure.”
Following Up on Melanoma in Situ
The good news? People who are diagnosed with melanoma in situ and receive early treatment have a great survival rate — 100 percent at 5 and 10 years. And everyone with melanoma in situ, including those diagnosed at an early stage, should check in with their doctors frequently to be certain that the cancer has not returned. Patients should have a complete physical and skin exam every six months for a year or two after their initial diagnosis, and typically once each year for several years after that.
“When melanoma is found early, it is easily cured with simple outpatient surgery,” says Catherine Poole, president and co-founder of the Melanoma International Foundation. “When found in later stages, it may become life-threatening, and there are few effective therapies to treat metastasized melanoma.”
Some good advice for healthy, cancer-free skin: Protect your skin at all times. “The most effective sun protection is to wear protective clothing, a broad-rimmed hat, seek shade, avoid being in the sun during the prime-time solar hours of 10 to 4, and use sunscreen as an adjunct to these behaviors,” says Poole.
A couple of weeks ago an ugly mole was removed from my stomach. After the biopsy results came back Doctor Rowe said that it was confirmed to be ‘Melanoma In Situ.’
Got it early enough that it shouldn’t be serious. I Praise God and thank the Veterans Administration!
Going back for one more minor surgery as a precautionary move. — Bob Diamond