Understanding Melanoma In Situ (Stage 0)

Symptoms, treatment, and prognosis for melanoma in situ, the earliest stage of melanoma.

.By Diana Rodriguez

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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.

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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

Indoor tanning is associated with an increased risk for skin cancer

Indoor tanning is associated with an increased risk for skin cancer, the most common form of cancer in the United States (1,2).

The World Health Organization considers ultraviolet (UV) tanning devices to be a cause of cancer in humans (3).

Exposure to UV radiation, either from sunlight or indoor tanning devices, is the most important, avoidable known risk factor for skin cancer (4,5).

Annually, skin cancer costs an estimated $1.7 billion to treat and results in $3.8 billion in lost productivity (6).

Reducing the proportions of adolescents and adults who report using artificial sources of UV light for tanning are Healthy People 2020 objectives (7).

Current state-level policies to restrict indoor tanning are directed at youths aged <18 years. To examine the proportion of the adult U.S. population reporting indoor tanning in the past 12 months, CDC and the National Cancer Institute analyzed data from the 2010 National Health Interview Survey (NHIS). Overall, the age-adjusted proportion of adults reporting indoor tanning in the past 12 months was 5.6%, with higher rates among whites, women, and adults aged 18–25 years. Nationwide, the highest rates of indoor tanning were among white women aged 18–21 years (31.8%) and 22–25 years (29.6%). Among white adults who reported indoor tanning, 57.7% of women and 40.0% of men reported indoor tanning ≥10 times in the past 12 months. Continued public health efforts are needed to identify and implement effective strategies for reducing indoor tanning among adults in the United States, particularly among whites, women, and adults aged 18–25 years.

Click here to read the entire article with research citations >>> http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6118a2.htm?s_cid=mm6118a2_e

Did I have a mole a wart or skin cancer?

Moles and basal cell lesions can be hard to differentiate
Moles and basal cell lesions can be hard to differentiate

A little over a year ago I noticed what looked like a small pimple or possibly an infected hair follicle on my upper lip. I squeezed a little exudate out of it and cleaned it with alcohol and applied an antibiotic ointment, thinking that it would be gone in three or four days. It didn’t go away as quickly as things like that usually do. It grew fairly rapidly. It started to look like a pale-colored mole about 5 mm — less than a quarter of an inch — across. I tried to remove it a couple of times; once by using an over the counter wart-freezing spray and later a salicylic acid liquid-bandage type of product. Both times it got small enough that I thought it was about gone, but then it came right back to its original size in a few days.

While I was at the VA Outpatient Clinic in Charlotte for an annual physical, I asked Dr. Patel to take a look at the sore on my lip. She did and said she wasn’t sure what it was but that she would schedule an appointment with a dermatologist.  A few days later the dermatologist said that it would need to be removed just to be safe and made an appointment with the minor surgery department for me to have it taken care of the following Monday.

The surgeon looked at the sore on my lip in rapt attention, as if he were studying something for a final exam — like he was trying to memorize every detail. He was so focused on it that it made me feel uncomfortable. He finally looked up and said, “Yep, we need to take that out.”

I was glad that it was going to be taken care of. Still thinking that it might be a mole or some sort of persistent wart, I asked him if he had a diagnosis. Without skipping a beat of any kind he said, “You have a basal cell carcinoma. I’ll send a specimen to the lab to make sure — after we cut it out.”

I’ve had a mustache for over 40 years, so my image in the mirror this morning doesn’t look quite right without it. The bandage feels like it covers my whole face. The stitches are the type that will dissolve and it hurts a little, but I am more than glad to have this thing over and done with.

In retrospect, I was more concerned about my slightly elevated cholesterol, than I was about that thing on my lip. Now that I have proven that I can make cancer, I’ll be a little more careful about pooh-poohing any little lumps or bumps that might pop up in the future.

Thank God for annual checkups and the Veterans Administration.