Melanoma units are mostly located in the major capital cities. Each has a team of experts coming from an array of disciplines such as dermatology, palliative care, nursing, medical oncology, radiation oncology, surgical oncology, psychology, head and neck surgery, neurosurgery, plastic surgery and general surgery.
Most patients with uncomplicated melanoma do not need to be assessed or managed by a melanoma unit. Management at a melanoma unit will not improve one’s chances of long term survival from melanoma. When a melanoma is found fairly early, the essentials of treatment are:
Excision with an appropriate wide margin of apparently normal skin
Regular follow up appointments involving checking for enlarged lymph nodes and checking around the site of the surgery
Frequent full skin checks including usage of digital photography and dermoscopy (surface skin microscopy)
Other interventions such as chemotherapy, radiotherapy, scans, lymph node biopsies and blood tests are not a routine component of managing melanoma. You will notice that these three essentials of management can be undertaken even in small country centres in Australia and New Zealand.
But there are certain patients who may well benefit from being assessed by a melanoma unit. These circumstances include patients with:
In these situations sometimes complex surgery or other treatments can be offered to patients. For example, patients with melanoma that has spread to the glands or liver or brain can sometimes benefit from specialized surgery to these organs.
Research
Many melanoma units undertake important clinical research into future possible melanoma treatments. While we currently do not have further treatments such as chemotherapy that have been shown to improve patient survival, we need this ongoing research to find future breakthroughs. This is the most important role of a melanoma unit.
Support
Melanoma units have dedicated melanoma nurses and often psychologists. These experts deal with melanoma patients and their families on a daily basis. They are very good at understanding the needs and concerns of patients with melanoma or for whom a loved one is suffering melanoma. Many find the counseling and individual advice that can be offered to be of immense value when coming to terms with a life threatening or potentially life threatening cancer.
Palliative care
In the late stages of the disease, specialized treatments and pain managements can be organized for patients dying of melanoma. This is also a time when support for the patient and their family is essential.
Not all melanoma units are the same. They run different research programs and have different interests. Talk to your doctor about your needs and whether you could be assisted by the services of a melanoma unit. Your doctor can also advise which units are appropriate and in which cities.