Expert Shares Key Insights During Melanoma Awareness Month

In recognition of Melanoma Awareness Month, CURE spoke with Dr. Douglas Johnson about what people need to know after a melanoma diagnosis, including how the disease is staged and treated. Understanding the depth and features of the melanoma — such as whether it’s ulcerated — is key to determining whether surgery alone is enough or if additional treatment is needed.

Johnson is a physician-scientist and professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee, where he leads the melanoma clinical research program. He explained that for patients with very early-stage melanoma — often defined as tumors less than 0.75 or 1 millimeter deep — treatment may involve only a wide local excision, typically performed by a surgeon or dermatologist.

If the melanoma is deeper or presents with more concerning features, patients may require further evaluation to assess lymph node involvement. This could lead to additional surgery, and in some cases, further therapy based on the surgical findings.

Transcript:

CURE: For patients newly diagnosed with melanoma, what are the most important things to know about the disease and its treatment options today?

Douglas: It certainly depends on a number of factors, and certainly the staging of the melanoma is important to think about. [This is] because it affects where patients need to go, as far as their next step. Usually a biopsy is done, and that's how a patient would know that they might have melanoma. It really depends how deep them the melanoma is. That's probably the first consideration that we think about when figuring out what the next steps are and whether the melanoma has what's called an ulceration on the top of it, and those factors would potentially determine what the next steps are.

If a patient has a very early-stage melanoma — defined as is less than 0.75 or less than one millimeter — then they would just have surgery alone. Usually something like a wide local excision and then that would be it. Patients may have that with surgery [and have checks with their dermatologist].

If [the cancer is] a little bit deeper than they would need to see a surgeon and then understand whether they have any lymph node involvement as well and have a bit bigger of an operation. Depending on what's found at those operations, then we need to think about any sort of additional treatment after that.

Transcript has been edited for clarity and conciseness.

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