New Standards of Melanoma Care Introduced 

Detecting the early spread of cancer to the lymph nodes is critical for successful outcomes. In the past two years, the National Comprehensive Cancer Network (NCCN) has advanced accurate diagnosis by issuing new standards of care for melanoma removal, recommending sentinel lymph node biopsies (SLB) more often for smaller melanomas to detect possible spread.

For twenty years, Dr. Wright has performed hundreds of SLB at Meridian Surgery Center.  With the new standard of care published by the NCCN for smaller melanomas, he is doing a lot more of them.

Concern you may have melanoma can be scary.  But understanding your options can improve outcomes.

What is sentinel lymph node biopsy (SLB)?

This technique to detect early spread of cancer to the lymph nodes was pioneered specifically for melanoma and rapidly adapted to breast cancer.  It involves injecting a tracer material to help the surgeon localize the nodes during surgery, which are then removed and analyzed.

If melanoma is removed and there is no spread, that is the best outcome. But melanoma skin cancer can spread quickly to your lymph nodes, thus it’s critical to determine if there is a cancer spread.   Spread can only be determined only at the time of the mole removal with a diagnostic sentinel lymph node biopsy (SLB). When performed with your melanoma removal, then and only then, can spread be determined.

Benefits of surgical removal with SLB

Often, smaller melanomas are removed in a dermatology office without the need for sentinel node biopsy. When sentinel node biopsy is indicated, Dr. Wright is not only able to perform the SLB at the time of removal, but with training in plastic surgery, is also able to perform soft-tissue reconstruction with a special technique called flap closure. Some surgeons will perform the melanoma removal with SLB but then require the patient to have a second day of surgery with a plastic surgeon.  This requires leaving an open wound while you wait, causing a tremendous amount of discomfort, increased risk for infection, inflated costs and wait times.

By offering melanoma patients the sentinel node lymph biopsy AND flap closure reconstruction Meridian Surgery Center ensures the most efficient treatment and diagnostic acuity at a tremendous cost savings.

Early treatment is key to improved survival rates

Although melanoma is an aggressive form of skin cancer, survival has increased substantially in recent decades – in the United States, the overall five-year survival is 93%.  This marks a significant improvement of 22% overall in the last forty years, thanks to better screening, earlier detection, better staging, and better tools for treatment.

Earlier detection

As the awareness of abnormal moles has increased, the detection of melanoma at an earlier stage significantly improves cancer survival.  When cancer is localized to the mole itself, the overall survival of patients five years after discovery is 99%.  If cancer has already spread to the lymph nodes, the five-year survival drops to 66%.  And for those unfortunate enough to be found with melanoma that has already spread to the bones, brain, or liver, the five-year survival is unfortunately only 27%.

Dr. Wright wants you to remember more than five significant sunburns significantly increases your likelihood of getting melanoma!  If you have a mole that is changing or suspicious in any way, please see your doctor soon and get it biopsied.

  • ASYMMETRY – a mole that is not uniform in its appearance from side to side
  • BORDERS – irregular borders rather than smooth borders can indicate an invasive change in a mole
  • COLOR – any color change in a mole is suspicious, even it is not particularly dark
  • DIAMETER – moles that are larger than 1 cm in diameter that used to be smaller are definitely suspicious
  • EVOLUTION – moles that are changing in any way are suspicious and should be considered for biopsy

Better Staging

Dr. Wright has been performing sentinel lymph node biopsies since 1989 and has been doing sentinel lymph node biopsies for the detection of melanoma for over twenty years now!  Using radioactive tracers, Dr. Wright uses a sterile Geiger counter to detect and direct surgery with small incisions to specially remove cancer-containing lymph nodes.  This technique is very accurate and significantly improves the detection of metastatic melanoma required.

Remember – you must be proactive!

If you are healthy, the melanoma and SLB can be done in the outpatient setting. This is an especially attractive option for patients, as many hospital-based surgeons are currently experiencing Covid-related delays. Dr. Wright and the staff at Meridian Surgery Center have been a part of the advance of melanoma staging more than twenty years and are here to continue treating melanoma patients in their own community as outpatients, with minimally-invasive techniques and low infection rates at Meridian Surgery Center.

Make an appointment for a consultation today. Call (253) 840-1999. Often, you can get an appointment on the next weekday.

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