Your GP has referred you to the dermatologist of the Jan van Goyen Medical Center because you may have melanoma. On this page you can read what awaits you per visit in our clinic. This trajectory is fixed and is also called care path melanoma. This way you know what to expect before, during and after the treatment.
For general information about melanomas, please visit our brochure to download.
Your GP has referred you for a suspicious mole (suspected melanoma). The dermatologist is now your primary care provider for this mole.
During the first consultation, the dermatologist will look at your mole. Because dermatologists have extensive experience in assessing moles, they can usually tell with the naked eye whether it is a benign mole or possibly a melanoma. The dermatologist sometimes also uses a dermatoscope to check for abnormal shapes, colors, or irregular edges.
Removal of the birthmark: first operation
If there is a suspicion that it could be a melanoma, it is necessary to remove the entire spot. This is called a diagnostic excision and is done under local anaesthetic. The wound is sutured and the piece of skin is sent to the pathologist. The pathologist looks through the microscope at the cells and the structure of the whole and ultimately makes the decision whether it is a mole (benign) or a melanoma (malignant). After 7-14 days, you will return to our clinic for the sutures to be removed. You will also receive the results of the pathological examination. If the mole is benign, the treatment is concluded. If there is a melanoma, additional surgery and treatment will follow.
If the pathologist decides that it is a melanoma, the characteristics of the melanoma are mapped out. The further follow-up process depends on these characteristics.
In the case of low-risk melanoma, we schedule the appointment for a definitive operation (medical term: re-excision). Around the scar where the melanoma was initially removed, another piece of skin is removed with a safety margin of 1 or 2 cm, just to be sure.
Sometimes, especially if the melanoma is somewhat thicker, it is advised to do a sentinel lymph node examination in addition to the re-excision. In that case, the re-excision is performed by the surgeon in OLVG or AVL, under anesthesia. The procedure is described on the website of the Melanoma Foundation.
The result after the possible second operation
After 7-14 days you will return to the person who performed the procedure for a wound check and the results. If there are no indications of metastases, an appointment will be made with a dermatologist for a check-up three months after the diagnosis of melanoma.
If metastases have been found, further treatment will take place in OLVG or AVL.
Checks after removal of the melanoma
After treatment of a melanoma, it is important to keep a close eye on the skin. If new pigmentation abnormalities arise or if existing moles change, it is wise to consult a doctor or dermatologist. Also pay attention to skin changes in the vicinity of the surgical scar. It is also wise to pay attention to any enlargement of lymph nodes. Excessive exposure to sunlight and especially sunburn should be avoided.
After the melanoma has been removed, check-up appointments are also made with the dermatologist. The check consists of inspecting the scar and feeling for the lymph nodes. The skin is also checked for restless moles.
For thin melanomas (less than 1 mm thick), a single check-up visit one to three months after the treatment of the melanoma is sufficient. Melanomas with a thickness of more than 1 mm are monitored for 5 years. The first year once every three months, the second year once every four months, and in the third to fifth years once every six months. Melanomas with a thickness of more than 2 mm are monitored for 5 years, and then once a year for up to 10 years after surgery.
Contact with fellow sufferers
If you want to get in touch with people who have also been treated for a melanoma (fellow patients) or if you want to get further information, you can visit the website www.stichtingmelanoom.nl
Do you have questions?
Please contact us on 020 – 305 58 45