The Melanoma Unit at IOB serves patients diagnosed with melanoma or any other type of skin cancer. Although most patients who come to the Melanoma Unit have been previously diagnosed at another medical centre, IOB also performs, together with the dermatology service of the Quirón hospital, the initial diagnosis of people who have suspected melanoma. It also offers a second opinion service to patients who are treated at other centres.
Patients treated at the Melanoma Unit are treated by a multidisciplinary team consisting of oncologists, dermatologists, anatomic pathologists, radiotherapists, general and plastic surgeons, specialists in radiology and nuclear medicine and nursing staff. This multidisciplinary team makes it easier for patients to undergo all the tests and receive all the treatments they need in a coordinated way in the same place and in as little time as possible, without the need to travel and visit different specialists separately. The team is led by oncologists Javier Cortés, José Pérez and Maria Vidal.
Any spot or lesion that appears on one’s skin deserves a consultation with a dermatologist, paying special attention if it meets the ABCD rule: that it is asymmetric (A), with irregular edges (B), dark coloured (C) and with a diameter greater than five millimetres (D). Although many will not be melanoma, any of these signs should be considered as warning and may allow an early diagnosis that will lead to a successful treatment.
An urgent consultation with a dermatologist is also recommended in cases where a spot on the skin stings, bleeds or grows rapidly.
Melanoma and other skin tumours can affect anyone regardless of their skin type. But it is advisable that people with clear skin and sensitive to the sun, and those with many freckles or spots on their skin extreme caution, since they are most at risk of suffering skin cancer lesions.
The diagnosis begins with a visual examination by a dermatologist of any suspicious lesion on the skin. If the visual examination confirms that it may be a skin cancer, the dermatologist will advise to perform a biopsy – that is, to extract a sample of cells to analyse them. A pathological anatomy specialist will analyse the cells removed in the laboratory to find out if the skin lesion is cancerous or not. If it is not, the dermatologist will advise the patient what steps to take from there. In cases where the diagnosis is melanoma, the patient will be treated by a surgeon and evaluated by an oncologist specialised in handling this disease. In some cases, the oncologist may consider it appropriate to request additional diagnostic imaging tests to check if the cancer has spread to other organs, as well as a comprehensive blood test to determine to what extent the disease has progressed.
The rapid diagnosis circuit implemented at IOB allows to have a final diagnosis within a period of 48 to 72 hours from the time the patient comes to the clinic for a suspected melanoma.
Most skin cancers are removed by surgery and are cured in a very high percentage of cases without the need for chemotherapy or radiotherapy.
In the case of melanoma, the treatment usually begins with a surgical procedure to remove the tumour lesion. Depending on the thickness of the lesion, the nearest lymph nodes are analysed to check whether they contain tumour cells. Depending on the result of the analysis of the lymph nodes, in addition to those of the imaging tests and blood tests that report on the extent to which the disease has spread, the oncologist will decide the most appropriate treatment for each patient. This treatment may include radiation therapy or a pharmacological treatment that can sometimes last for one year.
IOB pioneered introducing genetic analysis to identify patients who may benefit from a new medicine that specifically attacks tumours with an alteration in the B-RAF gene.
Once the treatment is finished, the follow-up tests vary from one patient to another, depending on the extent of the melanoma when it was diagnosed. Generally, the patient’s evolution is monitored with a visit every three month during the first three years. After this period, follow-up visits are reduced to two per year.