Question 1. I am a fair-skinned woman. I have a black mole on my neck. It was surgically removed. It was a skin cancer called melanoma. According to what I learned from the Internet, the depth of this me is important. The depth of the tumor removed from my neck is 1.3 millimeters. Is there any need for any additional procedure or treatment after this? What would you recommend doing in the follow-up?
Answer 1. Skin cancers known as malignant melanoma are treated surgically. The point to be considered in surgery is to remove the tumor together with the surrounding clean tissue. For tumors with a depth of up to 1 mm, it is desirable that the surrounding clean tissue be 1 cm. The desired tissue width is increased in tumors above 1 mm depth. Since your tumor is 1.3 mm, it is requested that it be removed with at least 1.5 cm of clean tissue around it.
Malignant melanomas tend to travel to neighboring lymph nodes. For this reason, the nearest lymph node to the area where the mole was taken should be examined. For this, a dyed substance is given to the place where the tumor was taken. The first place this substance goes is the neighboring lymph node, which is the first place where the tumor cell can go. This lymph node should be removed and investigated for tumor. If there is a tumor here, all regional lymph nodes should be surgically removed. It is known that when lymph nodes are involved, it is useful to use the immunoregulatory drug called interferon for 1 year. If there is no tumor in the lymph node, no additional treatment is needed.
Malignant melanomas are more common in fair-skinned people who have a genetic predisposition, who are exposed to the sun. For this reason, I do not particularly recommend sunbathing. It is better to enter the sea in the morning and evening, when the sun’s rays are more oblique. If you are going to be in the sun, sunscreen creams should be used.
Oncological controls should be done every 3 months in the first year, every 4 months in the second year, and then every 6 months. After 5 years, an annual check is sufficient. Tomography is not a rule. It is better for the oncologist to decide on this. In addition, a skin examination should be done by a dermatologist at certain intervals.
Prof. Dr. Coşkun Tecimer
