Ways be possible. This procedure is done under local anesthesia in your doctor’s office or other outpatient clinic. viagra without a doctor prescription The sample then goes to a lab where a pathologist will examine it under a microscope. pfizer viagra vgr 100 If the physician suspects metastatic melanoma, other tools of diagnosis and staging may include a blood test for ldh (lactate dehydrogenase) levels or imaging studies such as chest x-ray, ct (computed tomography), mri (magnetic resonance imaging), and pet (positron emission tomography) scans. The doctor may also need to take a sample of your lymph nodes using procedures such as sentinel lymph node mapping or fine needle aspiration. Staging if the biopsy shows that you have melanoma, your doctor needs to know the extent (stage) of the disease to effectively plan your treatment. According to the national institutes of health, the stage is based on these three factors: the size of the growth how deeply it has grown beneath the top layer of skin whether it has spread to nearby lymph nodes or to other parts of the body briefly, the stages of melanoma are as follows: stage 0: the cancer involves only the top layer of skin. It is called melanoma in situ. viagra no prescription Stage i: the growth is less than two millimeters deep. buy viagra online safely Stage ii: the growth is more than two millimeters deep. Stage iii: the cancer has spread below the skin to cartilage, muscle, bone, or to nearby lymph nodes. is viagra or viagra or viagra best It has not spread to other places in the body. Stage iv: the cancer has spread to other places in the body. buy viagra This is known as the tnm system of staging. can you get viagra over the counter Your doctor may also assign a clark and breslow number -- measurements of tumor penetration and thickness, respectively -- to further stage your melanoma and determine your prognosis. viagra how long to work Staging is a critical step, since it determines your treatment options. To ensure an accurate diagnosis, consider getting a second opinion from a specialist such as a dermatologist. Sources: "what you need to know about skin cancer. " national cancer institute. cheap viagra July 2002. 21 july 2008. viagra samples "all about skin cancer – melanoma. " american can. viagra for sale