Melanoma Center of Hope
David C. Ritter, M.D., F.A.C.S.
Melanoma and Cutaneous Oncology
9776 Bonita Beach Rd. S.E. Suite 102
Bonita Springs, FL    34135
Ph: 239-949-1777   Fx: 239-498-3777

Patient Education

How is Skin Cancer Diagnosed?

  • How does My Doctor Know Which Spots to Biopsy?                                                                 ABCDEs of Melanoma:                                             Asymmetry: one half unlike the other half.                 Border: irregular, scalloped or poorly defined border.         Color: Varied color from one area to another.        Diameter: larger than 6mm or 1/4 inch in diameter.    Evolving: a change in size, color, shape, elevation, or any new symptom such as bleeding, itching, or crusting. (SKF)

  • What happens to the Biopsy and How do They Know it Contains Cancer? Most biopsies will be sent to Naples Pathology and Associates and sometimes sent to other pathologists who then analyze the sample  and determine if it is benign or malignant. 

  • What is "Clark's Level"?  The Clark level of a melanoma uses a scale of I to V (with higher numbers indicating a deeper melanoma) to describe whether:

    • the cancer stays in the epidermis (Clark level I)
    • the cancer has begun to invade the upper dermis (Clark level II)
    • the cancer involves most of the upper dermis (Clark level III)
    • the cancer has reached the lower dermis (Clark level IV)
    • the cancer has invaded to the subcutis (Clark level V) (ACS)

  • What are Melanoma Stages?                                Stage 0: In stage 0, abnormal cells are found in the squamous cell or basal cell layer of the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.                                    Stage I: In stage I, cancer has formed and the tumor is 2 centimeters or smaller.                                            Stage II: In stage II, the tumor is larger than 2 centimeters.                                                             Stage III: In stage III, cancer has spread below the skin to cartilage, muscle, or bone and/or to nearby lymph nodes, but not to other parts of the body.                            Stage IV: In stage IV, cancer has spread to other parts of the body. (ACS)

SKF, The Skin Cancer Foundation                                         ACS, American Cancer Society