Most of the time, the only reason to get labs at the time of initial melanoma diagnosis relate to requirements (if any) to have surgery and anesthesia.

There are currently no specific blood tests to detect melanoma.

If your melanoma has just been diagnosed, most physicians will obtain standard tests to make sure that definitive surgery can be peformed safely. These tests typically include complete blood count, blood chemistries, and liver function blood tests. Melanoma is unlikely to change any of these blood values unless it is incredibly advanced.

If the melanoma has spread to other organs, the situation changes:

One blood test, LDH, is an older type of test that recently has been shown to be relevant, but only in patients with metastatic melanoma. Patients with abnormally elevated LDH levels and metastatic disease survive less time than those with normal LDH levels. It is not entirely clear why the LDH level is important. However, if you have metastatic melanoma, you absolutely should have your LDH level tested periodically, as it is a vague (but helpful) assessment of how you are doing.

There are multiple newer tests that will shortly be widely available and paid for by medical insurance. These are NOT blood tests; they require a portion of your removed melanoma to be sent to a lab. These tests will investigate the genetic mutations that make your melanoma unique. Some are already available; others will be coming “on-line” soon, and others are just around the corner. I fully expect that within a year, ALL patients with Stage III or Stage IV melanoma (in lymph nodes or beyond) will have some level of genetic testing done, and this testing will directly influence their treatment recommendations, decisions, and outcome.

The most important test that will almost certainly be widely available (and reimbursed by insurance) by the end of 2011 will be the BRAF (pronounced BEE-raff) mutation test. This gene controls tumor cell growth patterns, and specific mutations have been identified. More importantly, some mutations, especially the v600e mutation, can potentially be treated by new drugs under investigation. Once these drugs are approved, this test will be widely used.

Another genetic test is for the c-KIT mutation (pronouced see-Kit), also found in some types of leukemia. Only some less common forms of melanoma have been found to have any c-KIT mutations, and only a percentage of them have the specific mutation that can potentially be treated with approved drugs like Gleevec.

At this point, the important thing for you to do is to ask your physician if there are any genetic tests that should be run on your melanoma tissue. Most specialty melanoma physicians are rapidly adopting the practice of genetic testing for ALL cases of metastatic melanoma.


Eric D. Whitman, MD

Senior Editor,

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