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Further tests for melanoma

Men and women discussing melanoma skin cancer

This page tells you about further tests for melanoma skin cancer. There is information about

 

A quick guide to what's on this page

Further tests for melanoma

If you are found to have melanoma, your doctor will check how deep the melanoma is. If you have early stage melanoma that is only in the surface layers of the skin, the melanoma is very unlikely to have spread and you are likely not to need any further tests.

If your melanoma is more than 1mm deep into the skin or if you have swollen lymph nodes in the area, your surgeon may recommend that you have an ultrasound scan and a biopsy of the lymph nodes. This can show whether there are melanoma cells in the lymph nodes. Or your surgeon may suggest a sentinel lymph node biopsy. 

Sentinel node biopsy

Your doctor injects a dye close to the area of the melanoma and watches to find the first lymph nodes that the dye reaches. These are the sentinel nodes. Your doctor will remove the nodes and send them off to the lab. If they contain cancer cells, you will need another operation to remove the other lymph nodes in the area.

Other tests

If your melanoma has spread into nearby areas of skin or into nearby lymph nodes, you will have a CT scan to see if the melanoma has spread any further. If the melanoma is found to have spread you may have other scans or blood tests. 

After the tests

Your test results are bound to take a little time. You will probably feel very anxious while you wait. It may help to talk to a close friend or relative about how you feel. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Diagnosing melanoma section.

 

 

Why you may need further tests

If you are found to have melanoma, your doctor will check how deep the melanoma is. The depth of the melanoma in the skin affects how likely it is to come back and whether it may spread.

If you have early stage melanoma that is only in the surface layers of the skin, the melanoma is very unlikely to have spread anywhere else. You will not need to have further tests.

 

Checking the lymph glands

If the melanoma is more than 1mm deep into the skin or you have swollen lymph glands in the area, your doctor may recommend that you have an ultrasound scan and a sample of cells taken from the lymph nodes. This can show whether there are any melanoma cells in the nodes. The ultrasound scan uses sound waves to look for changes in lymph glands. This involves putting some jelly on the skin over the lymph glands and passing a small device over the skin. The device sends out sound waves and receives them back. The sound waves bounce off the lymph glands and build up a picture of them on a screen. We have information about having an ultrasound scan.

The doctor takes a sample of cells by putting a thin needle into the lymph node and drawing out some of the cells. This is called fine needle aspiration (FNA). A pathologist then examines the cells in the laboratory. 

Instead of an ultrasound scan and needle biopsy your doctor may suggest a sentinel lymph node biopsy to find out if there are any melanoma cells in the lymph glands. If any melanoma cells have broken away from the tumour, they are most likely to get trapped in the sentinel lymph node.

 

Sentinel node biopsy

You have sentinel lymph node biopsy (SLNB) under general anaesthetic. Usually you have it at the same time as the operation to remove the melanoma (wide local excision). A surgeon injects a small amount of dye or a mildly radioactive liquid into the area where the melanoma was removed. The dye or liquid drains away into the lymph glands. The surgeon can see when the dye reaches the first group of lymph nodes or they can measure the radioactivity with a scanner. These nodes are known as the sentinel nodes. The surgeon removes 1 or more of these nodes and sends them to the lab to see if they contain melanoma cells. 

If the lab finds that none of the lymph nodes contain melanoma cells, you won't need to have any more nodes removed. And you usually won't need any further tests. 

If the sentinel lymph nodes contain melanoma cells, there is a risk that other lymph nodes may also contain melanoma cells. You will usually need to have a further operation to remove the other lymph nodes in the area. This operation is called a lymphadenectomy.

We know that sentinel node biopsy is a useful way to find the stage of melanoma. It can tell you whether your melanoma has spread into the lymph nodes. But it is not a treatment for the melanoma itself. At the moment, it is still unclear how useful it is to do a sentinel node biopsy. Even if the test shows that your lymph nodes contain cancer, there is no evidence that removing the lymph nodes will help you live longer. So not all hospitals offer these tests. You can talk to your doctor about sentinel node biopsy. They can help you decide whether or not to have this test.

 

CT scan

If melanoma cells are found in the lymph glands, or if your melanoma is more than 4mm deep into the skin, you may have a CT scan. This scan uses a series of X-rays to create a picture of the inside of the body. It can check whether the cancer has spread anywhere else. We have information about having a CT scan.

 

After your tests

Your doctor will ask you to go back to the hospital when your test results have come through. This is bound to take a little time. You will probably feel very anxious while you wait.

During this time it may help to talk to a close friend or relative about how you feel. Or you may want to contact a cancer support group to talk to someone who has been through a similar experience. There are organisations all round the UK that have trained counsellors who can give you support. Look at our melanoma organisations page for details of people you can contact if you have issues you want to talk over with someone trained to help you.

If you want to find people to share experiences with on line, you could use CancerChat, our online forum. 

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Updated: 13 February 2014