Some cancers are difficult to diagnose until they are advanced. The good news about melanoma is that it is not one of those cancers. The better news is that if caught early, it is easy to treat and there is a high survival rate. Unfortunately, if melanoma is not diagnosed early, it can become much more serious and, indeed, life-threatening. Here’s what you should know about melanoma, and your options if your doctor failed to diagnose it when he or she first should have.
The cause of melanoma is not always known, but we do know that too much exposure to the sun or tanning beds increases risk. Perhaps that is why melanoma is so common, being the fifth-most common type of cancer in men, and seventh in women. In 2019, 192,000 people in the United States will be diagnosed with melanoma; in this same year, 7,230 Americans will die of melanoma. Though melanoma only accounts for about 1-2% of skin cancer cases, it causes the vast majority of deaths from skin cancer.
The ten-year survival rate for all types of melanoma is 89%; obviously, that rate is higher for earlier stages, and much lower for later stages. Like many types of cancer, melanoma is grouped into four stages:
Cancer cells can be observed, but are limited to the outer layer of the epidermis. There is minimal chance of cancer spreading (metastasis) at Stage I; for patients diagnosed at this stage, the five-year survival rate is 98%.
The mass formed by the cancer cells has become more thick and dense and has penetrated into the dermis (the layer of tissue just beneath the epidermis, or outer layer of skin). Chance of metastasis is slightly increased from Stage I, but patients diagnosed at Stage II still have a five-year survival rate of 98%.
In Stage III, cancer cells from the melanoma have reached the lymphatic system. Because cells can travel to other parts of the body through the lymphatic system, metastasis is much more likely at Stage III, and the five-year survival rate drops to 63%.
In Stage IV, cancer cells have moved into the bloodstream, and have the potential to enter the brain, bones, lungs, liver, or gastrointestinal tract. Because melanoma at Stage IV can infiltrate multiple organ systems in a brief time period, it is very difficult to treat, and the five-year survival rate plummets to 16%.
The best way to diagnose melanoma is to have a thorough, whole-body examination by an experienced dermatologist (be sure to see a licensed medical doctor board-certified in dermatology, not a technician). The doctor will closely examine the skin all over your body, including in places you can’t readily see, like your back and the top of your head. If the dermatologist sees a mole, bump, or an area that looks suspicious, he or she may order a biopsy of that tissue.
Removing the suspect tissue and performing a biopsy is the only way to confirm a diagnosis of melanoma, though there are some other tests which can detect cancerous cells. The removal of the suspect tissue can usually be done in the dermatologist’s office using local anesthetic, and is usually only mildly uncomfortable. If your doctor suspects that you may have a Stage II, III, or IV melanoma, he or she might order a test such as an ultrasound or MRI to see whether and how far the cancer has advanced.
It’s important to confirm that the person who is examining you is, in fact a dermatologist. It is not always obvious, even if you are in a dermatology office. Technicians are more likely to order biopsies of areas that a well-trained doctor would know are not suspicious; they are also more likely to overlook a lesion that should be biopsied. Of course, even doctors who should know better can make a mistake and fail to order further testing of a mole or lesion that has characteristics of melanoma. But if a reasonable doctor in the same situation would have performed more advanced tests, that oversight could be medical malpractice.
Failure to promptly diagnose any cancer is a shame, but it is especially heartbreaking with melanoma, because it is often curable if caught early, and often lethal if not. If you did as you should, going to the doctor for an examination of a suspicious mole, or getting regular skin checks as part of your health care, you have a right to expect your doctor to hold up his or her end of the bargain.
If your melanoma was diagnosed later than it should have been, especially if that late diagnosis caused you further health issues and a greater risk of early death, you may be entitled to compensation. Nothing can buy back lost health or time, unfortunately, But holding your doctor or dermatology practice accountable for their errors can mean that your medical bills are covered and your family’s financial worries eased. We invite you to contact The Fraser Law Firm P.C. to discuss your rights regarding your doctor’s failure to diagnose your melanoma.
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