Dr Todd Schlesinger: Treatment for Early-Stage Melanomas Can Be Safely Delayed During the Pandemic

We can safely delay excising in situ and early-stage melanomas while managing our patients’ care, noted Todd Schlesinger, MD, FAAD, director, Dermatology and Laser Center of Charleston and Clinical Research Center of the Carolinas.

We can safely delay excising in situ and early-stage melanomas while managing our patients’ care, noted Todd Schlesinger, MD, FAAD, director, Dermatology and Laser Center of Charleston and Clinical Research Center of the Carolinas.

Transcript

How has the management of patients with advanced skin cancers changed from before the pandemic?

The pandemic has changed how we look at skin cancer. And I think one of the main things that's happened, especially in the realm of melanoma, is that we'd normally be very concerned with early-stage melanoma, about getting the cancer out very quickly. But the pandemic has taught us that, and this is also reflected in the more recent [National Comprehensive Cancer Network] guidelines for care, with early-stage melanomas, the re-excision of a known melanoma that's either in situ or considered to be early stage—less than 0.8 mm in Breslow thickness—can be delayed up to 90 days without detriment or [with] minimal effect on the patient's overall outcome. So that's something that's changed how we feel.

We've also had to do a lot of telemedicine discussion and sort of diagnosis over telemedicine, which has been more difficult, I think, for skin cancer patients to have something shown to us over Zoom or something like that. It's not as easy as seeing, of course, that lesion in the office.

Those things, I think, are the main consideration.

But I think the main change will be more with a melanoma, that we now sort of have that understanding that excision in 90 days or less of an early-stage melanoma will not affect the outcome of the patient very much at all.