Don’t Ignore This Mole Melanoma
Melanoma is a serious condition and getting accurate information matters. I can walk you through how melanoma is diagnosed and how it’s treated, but I want to emphasize upfront: if you or someone you know has a suspicious mole or skin change, it’s important to see a qualified healthcare professional. Early evaluation makes a huge difference.
How Melanoma Is Diagnosed
Short answer: Diagnosis requires a skin exam and a biopsy. Staging tests may follow if melanoma is confirmed.
1. Skin Examination
A clinician—often a dermatologist—looks for features suspicious for melanoma. They may use:
Dermoscopy (a magnifying tool to see structures under the skin surface)
Reflectance confocal microscopy (RCM) in some cases to avoid unnecessary biopsies
2. Skin Biopsy (the definitive diagnostic step)
A biopsy removes part or all of the suspicious lesion so a pathologist can examine it under a microscope. Types include:
Excisional biopsy – removes the entire lesion (preferred when possible)
Punch biopsy – removes a cylindrical core of tissue
Shave biopsy – removes top layers; used cautiously because depth measurement is critical in melanoma
3. Determining the Stage (if melanoma is confirmed)
Staging depends on:
Tumor thickness (Breslow depth)
Ulceration
Mitotic rate
Spread to lymph nodes or organs
Tests may include:
Sentinel lymph node biopsy (SLNB) for tumors with risk of spread
CT, MRI, or PET scans if deeper or advanced melanoma is suspected
How Melanoma Is Treated
Short answer: Treatment depends heavily on the stage. Early melanoma is treated with surgery; advanced melanoma may require immunotherapy, targeted therapy, radiation, or combinations.
Stage 0 (Melanoma in situ)
Wide local excision (removal of the lesion with a margin of normal skin) is usually curative.
Stage I
Wide excision remains the main treatment.
Sentinel lymph node biopsy may be recommended for higher‑risk features.
Stage II
Wide excision plus consideration of SLNB.
Some patients may receive adjuvant immunotherapy (e.g., pembrolizumab) to reduce recurrence risk.
Stage III
Melanoma has spread to nearby lymph nodes or skin.
Surgery to remove the primary tumor and affected lymph nodes.
Adjuvant immunotherapy (e.g., checkpoint inhibitors) or targeted therapy if the tumor has a BRAF mutation.
Radiation therapy may be used in certain cases.
Stage IV (Metastatic Melanoma)
Treatment focuses on controlling disease and prolonging life:
Immunotherapy (often first‑line):
Pembrolizumab, nivolumab, ipilimumab, or combinations
Targeted therapy for BRAF‑mutated melanoma:
BRAF + MEK inhibitor combinations (e.g., dabrafenib + trametinib)
Radiation therapy for symptom control or specific metastases
Surgery for isolated metastases when feasible
Clinical trials are strongly considered
What You Should Do Next
If you’re asking because of a specific mole or concern, the most important next step is to get evaluated by a dermatologist. They can determine whether a biopsy is needed.
If you want, I can also help you with:
Understanding melanoma risk factors
How to monitor your skin using the ABCDE rule
What to expect during a biopsy
Treatment options for a specific stage.
This video is for educational purposes only.