Melanoma Diagnosis
This overview explains our diagnostic process to help you understand what to expect as you go through the early steps of your care.
Because melanoma is a diverse group of diseases, an accurate diagnosis is critical for your treatment plan. It helps us to recommend the most effective treatment options for you, in the right sequence.
WHAT TO KNOW ABOUT MELANOMA DIAGNOSIS
1Getting Started In Your Care
2Getting Your Diagnosis
Consultation & Testing: What to Expect »
3Planning Your Treatment
4Undergoing Treatment & Follow-Up
Select your type of treatment below.
For everyone who comes to Stanford, we start your care by establishing or confirming a diagnosis.
First Visit
Consultation
Test Results
Complex Cases
We collect your previous test reports and other medical records. We may need your help to do so, in case you need to sign a release form with your doctor.
a. Our goal is to review this information before we meet with you so that we understand your unique case. Knowing the details of any previous diagnoses and treatments helps us provide the best possible care for you.
b. When you schedule your first appointment, our patient coordinators will contact your primary care physician and any other doctors to gather your medical records. We may need your help to do so, in case you need to sign a release form with your doctor. If we cannot obtain them in time, we may need to reschedule your appointment. You can speak with your patient coordinator or your doctor for more details.
c. Some types of medical records that you should keep include:
- Pathology reports from any biopsies or surgeries. For most skin melanomas, this is the most common outside record that is needed, along with the outside biopsy slides, which are reviewed by our dermatopathologists to confirm your diagnosis.
- Imaging test results, either on paper or stored on a DVD (although imaging and laboratory tests are not needed for most newly-diagnosed skin melanomas)
- Operative reports from any surgeries related to your melanoma
- List of medications, doses, and how long you took them
- Discharge summary if you had a hospital stay
- Contact information for health care providers who treated you for cancer
a. Our team meets with you for a thorough diagnostic evaluation. We gather more information during your first appointment but may still need additional tests to confirm or rule out a diagnosis.
b. If needed, you may undergo further imaging tests, blood work, or an additional skin or lymph node biopsy biopsy.
a. After this testing, it typically takes a few days to review the results and confirm your diagnosis. While our new patient coordinators request your outside skin biopsy slides as soon as your doctor refers you to Stanford, getting your test results can take more than a week as your team is working hard to determine an accurate diagnosis for you.
b. Many health care professionals collaborate in the process and provide expert analysis, including your cutaneous, surgical and/or medical oncologist (cancer doctors), pathologist/dermatopathologist, and radiologist. Years of experience diagnosis melanoma every day means your dermatopathologist can accurately identify critical details, such as whether the cancer:
i. Invades into the skin or just involves the top layer of the skin (epidermis), including a measurement of the tumor thickness (called Breslow depth),
ii. Shows ulceration, where tumor cells push through the epidermis,
iii. Is aggressive or slow growing, which can be determined by looking at the type and number of growing and dividing cells, called mitotic figures,
iv. Shows features of certain melanoma subtypes that may affect treatment
c. Your care team will also determine the stage of your cancer. Staging describes the size of the cancer and whether (and how far) it has spread. Staging is the most important step in planning your treatment.
Stanford melanoma experts from several specialties meet as a tumor board team that occurs as part of the structured parallel visits among your cutaneous, surgical, and medical oncologists. Based on the diagnosis, we recommend the best sequence of treatment for each patient.
Your doctor or a team of doctors (including cutaneous, surgical, and medical oncologists) will meet with you to discuss the recommended treatment plan. Together, you and your doctors decide on the options that are right for you.
We collect your previous test reports and other medical records. We may need your help to do so, in case you need to sign a release form with your doctor.
a. Our goal is to review this information before we meet with you so that we understand your unique case. Knowing the details of any previous diagnoses and treatments helps us provide the best possible care for you.
b. When you schedule your first appointment, our patient coordinators will contact your primary care physician and any other doctors to gather your medical records. We may need your help to do so, in case you need to sign a release form with your doctor. If we cannot obtain them in time, we may need to reschedule your appointment. You can speak with your patient coordinator or your doctor for more details.
c. Some types of medical records that you should keep include:
- Pathology reports from any biopsies or surgeries. For most skin melanomas, this is the most common outside record that is needed, along with the outside biopsy slides, which are reviewed by our dermatopathologists to confirm your diagnosis.
- Imaging test results, either on paper or stored on a DVD (although imaging and laboratory tests are not needed for most newly-diagnosed skin melanomas)
- Operative reports from any surgeries related to your melanoma
- List of medications, doses, and how long you took them
- Discharge summary if you had a hospital stay
- Contact information for health care providers who treated you for cancer
close First Visit
a. Our team meets with you for a thorough diagnostic evaluation. We gather more information during your first appointment but may still need additional tests to confirm or rule out a diagnosis.
b. If needed, you may undergo further imaging tests, blood work, or an additional skin or lymph node biopsy biopsy.
close Consultation
a. After this testing, it typically takes a few days to review the results and confirm your diagnosis. While our new patient coordinators request your outside skin biopsy slides as soon as your doctor refers you to Stanford, getting your test results can take more than a week as your team is working hard to determine an accurate diagnosis for you.
b. Many health care professionals collaborate in the process and provide expert analysis, including your cutaneous, surgical and/or medical oncologist (cancer doctors), pathologist/dermatopathologist, and radiologist. Years of experience diagnosis melanoma every day means your dermatopathologist can accurately identify critical details, such as whether the cancer:
i. Invades into the skin or just involves the top layer of the skin (epidermis), including a measurement of the tumor thickness (called Breslow depth),
ii. Shows ulceration, where tumor cells push through the epidermis,
iii. Is aggressive or slow growing, which can be determined by looking at the type and number of growing and dividing cells, called mitotic figures,
iv. Shows features of certain melanoma subtypes that may affect treatment
c. Your care team will also determine the stage of your cancer. Staging describes the size of the cancer and whether (and how far) it has spread. Staging is the most important step in planning your treatment.
close Test Results
Stanford melanoma experts from several specialties meet as a tumor board team that occurs as part of the structured parallel visits among your cutaneous, surgical, and medical oncologists. Based on the diagnosis, we recommend the best sequence of treatment for each patient.
Your doctor or a team of doctors (including cutaneous, surgical, and medical oncologists) will meet with you to discuss the recommended treatment plan. Together, you and your doctors decide on the options that are right for you.
close Complex Cases
At Stanford, we tailor the diagnostic phase of Melanoma care to each patient. If you need further testing to complete your diagnosis, your doctor and care team will work with you to determine which tests you need. Tests may include:
- Biopsy (Pathology)
In a biopsy, doctors try to remove most or all of the melanoma on the skin so a dermatopathologist can fully examine it under a microscope. - Genetics Assessment for Melanoma
Genetic testing is a medical test that identifies changes in genes, chromosomes, or proteins. For melanoma, genetic testing can show whether you have gene mutations that may be targeted by drug therapy (test done on the melanoma tumor) or whether you are at risk for hereditary melanoma (test is done on a sample of your blood or saliva). Not every patient requires genetic testing. - Lab Tests (Blood Draws)
Blood tests are not usually done for skin or lymph node melanoma, unless you are on adjuvant therapy for regional lymph node involvement. More advanced melanoma (involving others sites of the body) generally requires specific lab testing, especially if you are on systemic immunotherapy or targeted drugs. In this setting, blood tests can provide a variety of information, and help to plan your course of melanoma treatment. - Imaging Tests (Radiology)
To obtain the most precise understanding of your melanoma, your doctor may schedule you for different types of imaging tests that show if the melanoma has spread. If you have been screened elsewhere and received abnormal results, we may perform additional imaging, if needed.