The dermatologist will examine any moles in question, and, in many cases, the entire skin surface. Any lesions that are difficult to identify or are suspected to be skin cancer may then be checked. Larger tumors, lesions in high-risk locations, recurrent tumors, and lesions in cosmetically sensitive areas are removed by Mohs micrographic surgery. The surgeon carefully removes tissue, layer by layer, until cancer-free tissue is reached. People who are poor surgical candidates may be treated by external radiation therapy.
Malignant melanoma is treated more aggressively than just surgical removal.
Depending on the thickness of the melanoma, some physicians may take samples of lymph nodes, perform blood work, or order chest x-rays. In advanced cases, trials of immune therapies, vaccines, or chemotherapy may be used. Although the number of skin cancers in the US continues to rise, both the patients and their doctors are catching skin cancer earlier when it is easier to treat. Thus, illness and death rates have decreased. Those that do recur most often do so locally and cause significant tissue destruction.