Early-Stage Melanoma: Diagnosis, Treatment and Next Steps

Stage 1 melanoma is treatable with surgery, and when combined with early detection, proper care and regular follow-ups, it offers a favorable outlook.

What Is Early-Stage Melanoma?

Melanoma is a type of skin cancer that begins in the cells that produce pigment, called melanocytes. These cells are found in the outermost layer of your skin. When these melanocytes become cancerous and multiply uncontrollably, they form a tumor known as melanoma.

When the melanoma is still considered early-stage or stage 1, it means the cancerous cells are contained within the top layers of the skin and have not spread deeper or to other parts of the body. Think of it like a small weed with very shallow roots — it's much easier to remove completely when it hasn't had a chance to grow deeper. This early detection is why stage 1 melanoma is considered highly treatable and has an excellent prognosis.

How Do Doctors Diagnose Stage 1 Melanoma?

The journey to a diagnosis usually starts when you or your doctor notice a mole or a spot on your skin that looks suspicious. The diagnostic process then involves a key step: a skin biopsy.

• Skin Biopsy: A small sample of the suspicious mole is removed, either with a shave biopsy (taking a thin slice of the surface) or a punch biopsy (removing a small circle of tissue). This sample is then sent to a pathologist who examines it under a microscope to confirm if it is melanoma.
• Staging: If melanoma is found, the pathologist will provide specific information that helps determine the stage. For stage 1 melanoma, the most important factors are the Breslow thickness, which measures how deep the tumor has grown into the skin, and whether or not there is ulceration (a break in the skin's surface). These details are crucial for your oncologist to determine the best course of action.

What are the Treatment Options for Stage 1 Melanoma?

For early-stage melanoma, the treatment is typically straightforward and highly effective.

• Wide Local Excision: The primary and often only treatment for stage 1 melanoma is a minor surgical procedure called a wide local excision. This involves removing the melanoma along with a small margin of healthy-looking skin around it. The purpose of the margin is to ensure that all cancerous cells, including any that may not be visible to the naked eye, are completely removed. This procedure is usually done in an outpatient setting, often in your doctor's office, using a local anesthetic.

Unlike more advanced cancers, stage 1 melanoma generally does not require more extensive treatments like chemotherapy, radiation or immunotherapy. This is because the surgery itself is usually curative.

What Side Effects Can Happen After Melanoma Surgery?

Since the main treatment for stage 1 melanoma is surgery, the side effects are usually minimal and localized to the treatment area.

• Scarring: You will have a scar where the melanoma was removed. The size and appearance of the scar depend on the size of the initial tumor and its location.
• Pain and Discomfort: You may experience some mild pain, swelling, or bruising at the surgical site for a few days after the procedure. This is typically managed with over-the-counter pain medication.
• Infection: As with any surgical procedure, there is a small risk of infection. Your doctor will provide you with instructions on how to care for your wound to prevent this.

Living With Stage 1 Melanoma: What to Expect Next

A diagnosis of melanoma can feel overwhelming, but it's important to remember that because yours was caught early, it is a very treatable cancer. Your treatment plan is simple and focused on a curative procedure.

This guide is meant to serve as a starting point for your conversations. It's crucial to partner with your healthcare team. Use this information to ask questions, voice any concerns you have about your diagnosis or the upcoming procedure, and talk about what your follow-up care will look like. Your doctors will want to see you for regular skin checks to monitor for any new spots, and being an active participant in your care will help you feel more in control throughout this journey.

Editor’s note: This guide is designed to be a starting point. Your personal experience will be unique. By using this information as a foundation for your discussions, you can partner with your oncologist to make the best decisions for your health.

This article is for informational purposes only and is not a substitute for professional medical advice. Please contact your healthcare team with any questions or concerns.

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