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Most skin cancer is treatable, especially when detected and treated early. And while many types of skin cancer spread slowly and are more easily removed and treated, melanoma is different. Melanoma is a deadlier form of skin cancer as it spreads more quickly than other skin cancer types. Therefore, it’s important to detect and treat it as early as possible.

Common Questions and Answers About Melanoma

If you think you have melanoma, or if you have found a suspicious spot, lesion, or mole on your skin, it’s important to see a board-certified dermatologic surgeon as soon as possible. If you don’t have any suspicious moles, spots, or lesions, it’s still recommended that you see a dermatologist every year while performing monthly, at home skin checks.

With that said, here are some answers to frequently asked questions about Melanoma detection, diagnosis, and treatment.


What is melanoma and what does it look like?

Melanoma Detection

Melanoma is a malignant (deadly) form of skin cancer that can spread rapidly on the skin and into other parts of the body. It is named for melanocytes, the cells that make melanin (skin pigmentation), as the growth most often begins in those cells.

Melanoma appearance varies greatly. However, you can usually spot melanomas by using the ABCDE checklist. If your spot has one or more of these features, it could be melanoma:

  • Asymmetry: Irregular shape, where one half doesn’t match the other.
  • Border: Hard to spot borders that are blurry or not smooth.
  • Color: A spot with more than one color, including black, brown, tan, white, gray, red, and even blue.
  • Diameter: A mole that is larger than a pea, especially if it recently grew rapidly.
  • Evolving: Sudden changes in size, shape, or color.

It’s important to note that any new spot on the skin should be examined. A new spot can be a melanoma.

Where can I find photos of melanomas?

Melanomas vary a great deal in their appearance. However, photos can be found with the American Society for Dermatologic Surgery and the Melanoma Research Foundation.

We recommend, however, following the ABCDE’s of skin cancer detection for your monthly skin cancer self-checks. If you notice one or more of these characteristics in a skin growth, or a new lesion has appeared,schedule an appointment with us right away. Do not rely on comparisons with photographs you find on the internet.

What causes melanoma?

Overexposure to UV-rays is the primary cause for all skin cancers. However, certain populations are more susceptible to developing skin cancers. People who are more likely to develop melanomas include those who:

  • are fair skinned
  • are prone to freckling
  • have a history of sunburns, especially second degree sunburns that caused blisters*
  • have had skin cancer or melanomas in the past
  • have a family history of skin cancers or melanomas
  • were born with large, brown moles
  • have lightly colored hair, especially red hair
  • have lightly colored eyes, especially blue eyes
  • intentionally tanned their skin, even in tanning beds and booths or using UV lamps
  • spend a lot of time outside without adequate sun protection

*Note that just one blistering sunburn during childhood can double your skin cancer risk in adulthood. If you had a blistering sunburn any time in your life, be sure to share this history with your dermatologic surgeon during your first skin check. They may want to see you more frequently to ensure early detection and treatment.

How do you know you have melanoma?

To properly diagnose melanoma, a biopsy of the growth must be done, which may include full or partial removal of the skin lesion. Biopsies can be performed right in the doctor’s office. The skin sample will then be tested and analyzed in a lab by a pathologist, who can diagnose the skin growth as cancerous or benign.

Biopsies are performed by dermatologic surgeons in one of three ways:

  • Excisional Biopsy: where the entire mole is cut away from healthy skin and removed
  • Incisional Biopsy: where a small portion of the mole is removed, specifically the most irregular part of the growth
  • Punch Biopsy: where a specific punch biopsy tool is used with a circular blade, allowing the dermatologic surgeon to cut deeper and cleaner

Once the biopsy is complete, the sample is analyzed, and our office will contact you with the results. If the results are positive for a melanoma, we will bring you in for further treatment. It is important to keep your appointment and not postpone further meetings with your dermatologic surgeon, as melanoma can become aggressive and spread quickly.

Where does melanoma usually start?

Of course, skin cancers start on the skin, but melanomas can develop in the eyes as well. There are also areas of the skin that tend to develop these malignant lesions more often. You may be surprised to learn that this varies between men and women as well. For men, melanomas usually grow on the back or chest. For women, we often find them on the back of the leg. Melanoma can grow anywhere where prolonged exposure to the sun occurs, including the arms, face, back of the neck, and even the back of the hands.

Where does melanoma spread to first?

The goal is always to catch melanomas before they spread. When melanoma spreads, it starts in the lymph nodes and travels through the body from there. In Stage IV Metastatic Melanoma, the cancer has spread through the lymph nodes to the liver, lungs, bones, or brain.

Early detection is key in preventing the spread of melanoma. By scheduling and keeping your annual appointments, and by checking your skin monthly, you and your dermatologic surgeon can protect you from later stage melanomas that spread.

How deadly is melanoma? What is the survival rate for melanoma?

With early detection, melanoma is very treatable. Annual exams with your dermatologic surgeon and monthly exams of your skin will go a long way to ensure quick and early detection of any skin cancer. When detected early, when the lesion is still in the upper layer of the skin (epidermis) and hasn’t spread, survival rate is 99%. If the growth has spread into the lymph nodes, the survival rate drops to 63%. In Stage IV, survival drops to 20%.

Again, early detection saves lives. Check your skin regularly and schedule annual checkups with a board-certified dermatologic surgeon.

I’ve never had a sunburn. Can I still get melanomas?

Yes. While sunburns increase your risk of developing skin cancer and melanoma, they aren’t the only cause. You have an increased risk of developing melanoma if you:

  • spend a lot of time in the sun without adequate sun protection, even if you didn’t burn
  • outdoor tanning, especially if you used tanning oils
  • spent time in tanning beds or beneath UV lamps
  • have a family history of melanoma
  • are in a high-risk group (see above)

What other melanoma symptoms should I look for?

If your melanoma has spread, you may experience other symptoms, including:

  • hard lumps beneath the skin
  • breathing difficulty or a persistent cough
  • painful and/or swollen lymph nodes
  • loss of appetite and weight loss
  • fatigue

The goal is to make sure you are being seen by a board-certified dermatologic surgeon long before you experience symptoms related to later stage cancer. To make sure you receive treatment before the cancer has spread, schedule a consultation with a dermatologist to receive diagnosis and treatment as soon as possible. Do not wait.

What melanoma treatment options are available?

Recommended treatment is determined by how much the cancer has spread, if at all. In Stage 0, where the melanoma hasn’t grown beyond the epidermis and into the deeper layers of the skin, excision to remove the growth will likely be performed, with testing to ensure total removal. Mohs surgery may be recommended, especially for facial growths.

In other stages, your dermatologic surgeon will likely also perform lymph node biopsies and removal near the growth site, immunotherapy, radiation therapy, and/or chemotherapy, among other treatment options.

Will I have to see an oncologist?

In addition to your dermatologic surgeon, you may also benefit from the care of an oncologist (a physician who specializes in cancer diagnosis and treatment). This is most often the case when the cancer spreads into other parts of the body.

If we detect and remove your cancer early enough, such as in Stage 0 or Stage 1, your treatment can be handled exclusively by our board-certified dermatologic surgeon, Dr. C. William Hanke.

What will I look like after the cancerous growth is removed?

Removing the cancer may result in a visible wound on the skin. However, we will provide you with instructions on how to care for the surgery site following your cancer removal.

How can I make sure I spot melanoma early?

Annual skin checks are one way to make sure you spot skin cancer early. However, it’s important that you check your skin monthly and/or enlist the help of a trusted friend or family member. If you see new spots, even if they are small, or witness the sudden change in a mole, call your dermatologist right away and schedule a check-up. Do not wait until your annual exam!

Protection and Prevention Tips


While you may already have significant sun damage from your younger years (before you knew better), protecting your skin from sun damage and cancer-causing UV-rays now is still important.

  1. Do Not Tan. Tanning is not good for the skin. Tanning is sun damage and can cause premature aging and increase your risk of skin cancer. Tanning beds are not safer than sun exposure. Tanning beds are dangerous and there is simply no such thing as a safe tan.
  2. Wear Proven Sunscreen. You’ve likely heard that most sunscreens do not protect as promised on the label. Make sure your sunscreen is proven to work as described. A good way to make sure your sunscreen is effective is to discuss the proper sunscreen brands with your dermatologist or purchase directly from the dermatology clinic. We offer high-quality sunscreen brands in our practice. Ask us about which products are best for your needs.
  3. Apply Sunscreen Properly. A little spritz of sunscreen isn’t effective. Make sure you’re using a lotion or cream sunscreen. Massage it into the skin for superior protection. Spray lotions are also effective, but you must massage them into the skin. Be sure you use enough sunscreen, too. A shot glass full of sunscreen can provide full protection from head to toe. Don’t forget to reapply every 60-80 minutes, and make sure your sunscreen is designed for your activity. Water-resistant sunscreen is best and not just when you’re swimming or sweating a lot.
  4. Shade Isn’t Always Protection. Don’t think that standing in the shade will shield you from sun damage. UV rays can penetrate through fabric, so if you’re in a tent during a camping trip or lounging under an umbrella by the pool, you should still wear sunscreen. Note that some companies do make umbrellas and tents out of UV protective material. Consider upgrading to enhance your sun protection.
  5. UV Protective Clothing. Fabric can protect your skin to a point, but UV protective clothing can provide even better protection. Many people wear shirts and hats made from these specialized fabrics to enhance sun protection, in addition to liberal use of sunscreen. We carry wide-brimmed hats that provide UV protection. Ask us about Wallaroo Hats during your next appointment.
  6. Wear Sunscreen Every Day. Even if you aren’t going to spend hours outside, make sunscreen a part of your daily habit. The exposure during your daily commute is enough to cause sun damage and increase your risk for developing skin cancer. It helps to find a sunscreen you like to wear. Scented sunscreen that doubles as moisturizing lotion may be worn and increases your chances of using it regularly.

Melanoma and Skin Cancer Detection and Treatment at the Laser and Skin Surgery Center of Indiana

At the Laser and Skin Surgery Center of Indiana, Dr. C. William Hanke and our expert staff provide patients with routine skin exams, diagnosis, and treatment of skin cancers and other medical skin conditions. If you suspect that you have a skin cancer, have already been diagnosed with cancer in the past, or if you just want to start your annual skin exams as recommended by dermatologists, contact us for a consultation. Dr. Hanke and our team will evaluate your medical history, examine your skin, and, if necessary, provide treatment.

Why Choose the LASSI to Treat Melanoma in Indianapolis

In addition to being a board-certified dermatologic surgeon with decades of experience, Dr. Hanke is the past president of the American College of Mohs Surgery and currently the Senior VP for the renowned Skin Cancer Foundation. Dr. Hanke has contributed to numerous peer reviewed publications related to skin cancer and has led clinical trials on skin cancer and precancerous skin conditions and treatments.

Schedule a consultation with Dr. Hanke for trusted examination, diagnosis, and treatment for melanoma in Indianapolis.