She notes that melanoma can spread before patients figure out a skin change doesn’t look normal.
“Once it spreads, it’s difficult to treat,” Davis says, and adds that melanoma “does not respond to most traditional chemotherapies. It doesn’t respond to a lot of treatment.
“It is very scary, frequently (because it’s) found at a later stage. But if a melanoma tumor is small, not thick, the prognosis is excellent.”
Although melanoma is the most infamous, it isn’t the only skin cancer; there are two other types: basal cell carcinoma and squamous cell carcinoma.
“You can basically pool squamous and basal,” says plastic surgeon Michael Janitch, who oversees the Plastic Surgery & Rejuvenation Center. “The warning signs for those are non-healing lesions and sores associated with a sun-exposed (skin) area. They (can also) show up as reddened or white patches of skin.”
Janitch explains that while melanoma is also frequently found on the body in areas that are commonly exposed to the sun, it doesn’t have to be; in fact, while it’s more rare, melanoma can occur wherever there are melanin cells in the body, such as in the iris of the eyes.
While melanoma can spread to other organs and squamous cells are found in places other than the skin, and can therefore become cancerous in a place such as the lungs, skin cancer is not a harbinger of other types of cancer, says Davis. But people who have already had another type of cancer and received chemotherapy or radiation treatments, or had an organ or bone marrow transplant, are more susceptible to skin cancer.
Judi Krawczyk of Green Bay knew that she was at an increased risk for skin cancer because of the medication she takes due to her heart transplant 17 years ago. Although she has had yearly check-ups with a dermatologist since the transplant, the sudden appearance in 2006 of the spot on her lower calf was reason enough to schedule a new appointment.
“[It] just appeared,” says Krawczyk, 62. “It reminded me of a pencil eraser; it was not asymmetrical, but the [blackish red] color was kind of scary. I nicked it when shaving; [it bled a lot] and that was kind of a warning sign.”
While Klubertanz says recovery from the surgery following her diagnosis was easier than she expected, for Krawczyk, it was the worst part.
“The physician that removed it said it looked like a shark took a bite out of my leg,” Krawczyk says. “It [was a big area because] they were going in to make sure all the tissue was clean; they keep removing tissue until there isn’t any cancer. It was a good six weeks in a wheelchair and a walker.”
Davis says that while no two patients are the same, it’s common for most patients to see a dermatologist when they notice a skin change. If necessary, an excision and biopsy will be performed; if the biopsy comes back positive for melanoma, another surgery will be scheduled for another excision to get good margins, or to the point where there are no more cancerous cells. A patient’s lymph nodes will also be tested.
If the lymph nodes are clear of cancer, further treatment typically isn’t warranted. But if cancer is found in the lymph nodes, various treatments, such as radiation, may be recommended.
“The important thing is that there are not many effective treatments out there [for melanoma],” says Davis. “Participation in [clinical] trials is important; the only way to get more treatments available is to find out what works.”