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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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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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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 Trial

Find 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.

Tom Baker Centre
29 St NW
Calgary, AB, T2N 4N2
Cross Cancer Institute
8440 112 St NW
Edmonton, AB, T6G 2B7
Cross Cancer Institute
11560 University Ave
Edmonton, AB, T6G 1Z2
Alberta Ocular Brachytherapy
10240 Kingsway NW
Edmonton, AB, T5H 3V9
British Columbia Cancer Agency (Surrey)
13750 96 Ave
Surrey, BC, V3V 1Z2
British Columbia Cancer Agency (Victoria)
2410 Lee Ave
Victoria, BC, V8R 4X1
CancerCare Manitoba
409 Tache Ave
Winnipeg, MB, R2H 2A6
Saint John Regional Hospital
400 University Ave
Saint John, NB, E2L 4L2
H. Bliss Murphy Cancer Centre
300 PPD
St. John's, NL, A1B 3V6
Nova Scotia Health Authority
1276 South Park St
Halifax, NS, B3H 2Y9
Cape Breton Cancer Centre
1482 George St
Sydney, NS, B1P 1P3
Royal Victoria Hospital of Barrie
201 Georgian Dr
Barrie, ON, L4M 7B7
Brampton/Etobicoke William Osler Health System
2100 Bovaird Dr E
Brampton, ON, L6R 3J7
Juravinski Cancer Centre
699 Concession St
Hamilton, ON, L8V 5C2
Grand River Hospital
835 King St W
Kitchener, ON, N2G 4K9
Cancer Centre of Southeastern Ontario, Kingston General Hospital
25 King St W
Kingston, ON, K7L 2V7
London Health Sciences Centre
790 Commissioners Rd E
London, ON, N6A 4L6
Credit Valley Hospital – Carlo Fidani Peel Regional Cancer Centre
2200 Eglinton Ave W
Mississauga, ON, L5M 2N1
Stronach Regional Cancer Centre at Southlake
581 Davis Dr
Newmarket, ON, L3Y 2P6
Walker Family Cancer Centre
1200 Fourth Ave
St. Catharines, ON, L2S 0A9
R.S. McLaughlin Durham Regional Cancer Centre
1 Hospital Ct
Oshawa, ON, L1G 8A2
The Ottawa Hospital Cancer Centre
501 Smyth Rd
Ottawa, ON, K1H 8L6
Sudbury Regional Hospital – Regional Cancer Program
41 Ramsey Lake Rd
Greater Sudbury, ON, P3E 5J1
Thunder Bay Regional Health Sciences Centre
980 Oliver Rd
Thunder Bay, ON, P7B 6V4
Odette Cancer Centre at Sunnybrook
2075 Bayview Ave
Toronto, ON, M4N 3M5
Princess Margaret Hospital
610 University Ave
Toronto, ON, M5G 2C4
Windsor Regional Cancer Centre at Windsor Regional Hospital
2220 Kildare Rd
Windsor, ON, N8W 1L9
PEI Cancer Treatment Centre
60 Riverside Dr
Charlottetown, PE, C1A 0A9
Lady Davis Institute at the Jewish General Hospital
3755 Chem. de la Côte-Sainte-Catherine
Montréal, QC, H3T 1E2
Royal Victoria Hospital
687 Av. des Pins
Montréal, QC, H3A 1A1
Hotel Dieu de Quebec
11 Côte du Palais
Québec, QC, G1R 2J6
Allan Blair Cancer Centre, Saskatchewan Cancer Foundation
4101 Dewdney Ave
Regina, SK, S4T 1A5
Saskatoon Cancer Center
103 Hospital Dr
Saskatoon, SK, S7N 0W8