Diagnosis & Treatment
RARE MELANOMAS & SKIN CANCERS DIAGNOSIS & TREATMENT INFORMATION
A cancer diagnosis can be a life altering experience, one that pushes most to a place of unwanted change in their lives. Melanoma Canada offers many free resources to help you make it through. We’re here for you at every step of your cancer journey.
Uveal Melanoma
How is Uveal Melanoma diagnosed?
There is NO formal screening program for uveal melanoma. Routine eye exams are the best option for identifying potential issues.
Staging Uveal Melanoma
There has been several categorization systems of uveal melanoma according to their dimensions, cellular type or genetic defects, and their link to the potential for spread outside the eye. The current most practical categorization is the TNM staging.
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How is Uveal Treated?
The treatment options for uveal melanoma may include radiation therapy or surgery. Some patients will receive both radiation therapy and surgery.
Treatment Of Advanced Uveal Melanoma
Kimmtrak (tebentafusp) is a breakthrough new therapy indicated for the treatment of HLA-A*02:01–positive adult patients with uveal melanoma that has spread to other parts of the body or can’t be removed with surgery.
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Questions to ask your doctor
It is often difficult to think of the right questions while you are in an appointment. We have a list of questions to ask your doctor at each stage of your cancer journey.
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SUBUNGAL MELANOMA (SM)
How is SM diagnosed?
A definitive diagnosis of SM requires a full-thickness biopsy of the nail matrix and nail bed. Any lesion suspicious of SM warrants a biopsy, as an earlier diagnosis leads to better health outcomes.
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Staging SM
SM stages are based on several factors. The staging system used for melanoma is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information T (thickness of the tumour) N (lymph node involvement) M (metastasis)
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How is SM Treated?
The main treatment for SM is surgical excision and any decisions regarding the depth of excision should be based on the stage of SM. You may be referred to a surgical oncologist for lesions confirmed to be SM or a referral to dermatology may be appropriate when a second opinion is needed.
Questions to ask your doctor
It is often difficult to think of the right questions while you are in an appointment. We have a list of questions to ask your doctor at each stage of your cancer journey.
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ACRAL LENTIGINOUS MELANOMA (ALM)
How is ALM diagnosed?
Dermoscopy can be used to help clinicians correctly identify lesions that have a high likelihood of being malignant. It does so by facilitating the visualization of subsurface skin structures which are otherwise not visible to the naked eye.
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Staging ALM
Stages are based on several factors. The staging system used for acral melanoma is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information
T (thickness of the tumour)
N (lymph node involvement)
M (metastasis)
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T (thickness of the tumour)
N (lymph node involvement)
M (metastasis)
How is ALM Treated?
Following biopsy-confirmed ALM by a pathologist, the treatment of ALM is typically handled by a dermatologist or oncologist.
Generally, ALM in-situ is best treated with a wide local excision. The surgical margin recommendations are based on the tumor thickness at the time of biopsy.
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Generally, ALM in-situ is best treated with a wide local excision. The surgical margin recommendations are based on the tumor thickness at the time of biopsy.
Treating Advanced ALM
If metastases are detected, systemic treatment with chemotherapeutic agents, targeted mutational therapy, and immune checkpoint inhibitors may be indicated.3 Nonsurgical treatment decisions should be made through referral to an oncologist.3
MUCOSAL MELANOMA
Diagnosing Mucosal Melanoma
When confronted with a suspected mucosal melanoma, it is crucial to differentiate a case of primary melanoma from metastasis.
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Staging Mucosal Melanoma
The staging of mucosal melanoma follows the TNM Classification of Malignant Tumours.
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Treating Mucosal Melanoma
The treatment of mucosal melanoma is not always clear and treatment plans will depend heavily on the size, type, and location of the tumour. The best treatment of mucosal melanoma is the complete surgical removal (resection) of the tumour.
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MERKEL CELL CARCINOMA
How is Merkel Cell Carcinoma Diagnosed?
The first step to a diagnosis includes a physical exam, examination of health history, a skin exam, or a referral to a dermatologist or other skin specialist. If merkel cell carcinoma (MCC) is suspected, a skin biopsy will be completed
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Staging Merkel Cell Carcinoma
Merkel Cell Carcinoma (MCC) has five stages: 0, I, II, III, IV and uses the AJCC UICC 8 Staging System:
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Treating Merkel Cell Carcinoma
Once merkel cell carcinoma (MCC) is diagnosed, a CT scan, PET scan, or MRI can be used to see if metastasis has occurred. In order to guide treatment plans, a sentinel lymph node biopsy or lymph node dissection can be used to understand how fast the MCC is growing and spreading.
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HEALTH AND NUTRITION
Dealing with a Diagnosis
Being diagnosed with cancer can feel overwhelming. Managing cancer involves much more than effective treatment. Adjusting to and finding ways to cope with a melanoma diagnosis is an important part of healing, along with treatment.
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Managing Melanoma & Skin Cancer
Whatever the stage of your cancer, it is important that you look after your physical health. That means eating a healthy diet, getting enough rest, and being as physically active as you can be. It is also important to care for your emotional health by spending time with family and friends and planning activities you enjoy.
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Managing Advanced Melanoma
Receiving a cancer diagnosis, especially in the later stages, can dredge up a variety of emotions such as feelings of anxiety, fear and hopelessness. It’s important to note that even when you feel out of control, there are always ways to take charge, and this starts by learning more about your diagnosis.
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Managing Cancer Fatigue
Cancer-related fatigue is the most common and often the most distressing side effect experienced by people with cancer.
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How to stay well nourished and hydrated?
Getting all of the nutrients your body needs can help you maintain your weight and strength, stay active and support your recovery – all important factors in managing cancer-related fatigue.
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Vitamin D
We need vitamin D to absorb calcium, to build and maintain bones and teeth, and to support our immune system, but most of us won’t get enough of this important vitamin without using a supplement.
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How to Manage Diarhea During Cancer Treatment?
When you are experiencing diarrhea, eating well can be a challenge. Diarrhea caused by cancer treatment is best managed with prescription medications.
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How to be Active with Cancer?
If you haven’t been exercising, start slowly and build up the time and intensity of your physical activity.
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OTHER INFORMATION
Recurrence
Fear of recurrence is a universal concern of individuals with a cancer diagnosis and is one of the most frequent concerns for those who have completed treatment..
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Fertility & Family Planning
As survival rates rise among young cancer patients, so does the importance of discussing fertility preservation and family planning with healthcare providers.
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Flushot & Covid Vaccine Information
It is important to speak to your healthcare team to discuss further medical advice receiving this vaccine.
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Skin Cancer Resources
Melanoma & Skin Cancer Clinical Trials
Clinical trials provide individuals with cancer access to the newest types of treatment. These trials are studies of new therapies to determine whether a medication is safe and effective.
Find a Clinical TrialFind a Treatment Centre Near You
A list of melanoma and skin cancer specialist at treatment centres across Canada. Type in your postal code in the search tool below to find a centre near you.