Understanding Your Diagnosis

Knowledge Leads to Empowered Decision Making

After you are diagnosed with melanoma, your medical team will introduce you to a lot of new information and unfamiliar words. Learning everything you can about your diagnosis will help you feel more empowered. The more you know about melanoma, the better prepared you will be to make treatment decisions with your doctors. Actively participating in the direction of your care will offer you a much-needed level of control as you plan to move forward. Consulting with your patient/ nurse navigator, oncology nurse and other members of your health care team may also offer valuable insights. Understanding the medical terms, the types of tests and how to read your pathology report are the first steps to understanding your diagnosis.

Although several tests are used to diagnose melanoma, a biopsy is required for confirmation of the diagnosis. The biopsy will provide your doctor with the information needed to confirm your diagnosis and plan treatment.

Depending on the size and location of the melanoma, one of the following types of biopsy may be used.

  • An excisional biopsy removes an entire lump or suspicious area.
  • An incisional biopsy removes a portion of a lump or suspicious area.
  • A punch biopsy removes a small round piece of tissue about the size of a pencil eraser using a sharp, hollow, circular instrument.
  • A shave biopsy removes a skin abnormality and a thin layer of surrounding skin with a small blade for examination under a microscope.

After the biopsy sample is removed, your doctor will send it to a laboratory where a pathologist will examine it for specific characteristics, including the following.

  • The type and subtype of melanoma
  • The depth of the melanoma
  • Whether the top skin layer is intact or broken (ulcerated)
  • How fast the melanoma cells are growing (mitotic rate)
  • Whether the melanoma has spread to lymph vessels, blood vessels, lymph nodes or other organs

Other factors may also be tested for and, in some cases, another biopsy may be needed. The information obtained from your biopsy tests will be in a pathology report, which is the description of cells and tissues made by a pathologist based on microscopic evidence. A pathologist is a doctor who has special training in identifying diseases by studying cells and tissues under a microscope.

The results of the pathology report will be used to diagnose and stage your melanoma, and it will help your doctor plan the best treatment options for you. You may request a copy of the pathology report for your records.

Who’s On Your Medical Team?

Once you are diagnosed with cancer, you will work closely with a multidisciplinary health care team. This team will be composed of a variety of specialists and other health care professionals, including the following.

  • Dermatologist, who specializes in skin diseases
  • Medical oncologist, who treats cancer with medication
  • Pathologist, who specializes in laboratory testing
  • Radiation oncologist, who treats cancer with radiation
  • Radiologist, who specializes in diagnosing disease from imaging tests
  • Surgical oncologist, who treats cancer with surgery

You may also work with oncology nurses, physician assistants, nurse practitioners, pharmacists, social workers, counselors, dietitians and others.