Imaging and Testing

Most people who are diagnosed with melanoma are found to have it in its early stages, when it’s only skin deep and may not have spread. It’s important after a diagnosis is made, though, to have a thorough check-up to look for any signs that the melanoma could have spread to other parts of the body.

A medical oncologist will usually see you after diagnosis and ask you questions about your general health and specific symptoms. You will also have a physical exam, looking not just at your skin, but at checking for any lymph node enlargement, and listening to the lungs and feeling the abdomen and other tissues to make sure there are no abnormalities.

Depending on features of your melanoma, you may also have some tests ordered. Often a medical oncologist will order some blood tests to make sure you are not anemic, and to look for evidence of melanoma spread to the bones or liver (which is fortunately rare). You may have a chest x-ray performed to look for any signs of spread to the lungs.

Most of the time, melanoma stays confined to the skin, and it will be cured if it is surgically removed. Sometimes, however, melanoma will spread microscopically to nearby lymph nodes, and then sometimes to other organs. Often it will travel to lymph nodes before it will spread to vital organs, and one goal of testing is to catch it at the lymph node stage before it travels further.

A relatively new technique for detecting cancer spread to lymph nodes is by use of very high resolution MRI (Magnetic Resonance Imaging) scans of lymph nodes near in the body to where the cancer was removed. It is possible to detect a spot of cancer measuring only 2 mm in size with this technique – bigger than microscopic, but still very small. Two physicians at Redwood Regional Medical Group – Dr. Peter Brett and Dr. David Feinberg – have a clinical trial that they developed comparing the results with very high resolution MRI scan to what is later found on lymph node biopsies or by clinical exams. Feel free to ask for more information on this clinical trial when you come for an appointment.