Treatments for Melanoma

Treatment list for Melanoma: The list of treatments mentioned in various sources for Melanoma includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Treatments of Melanoma discussion: If melanoma is found, the doctor needs to learn the extent, or stage, of the disease before planning treatment. The treatment plan takes into account the location and thickness of the tumor, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body. Removal of nearby lymph nodes for examination under a microscope is sometimes necessary. (Such surgery may be considered part of the treatment because removing cancerous lymph nodes may help control the disease.)1

The standard treatment for melanoma is surgery; in some cases, doctors may also use chemotherapy, biological therapy, or radiation therapy. The doctors may decide to use one treatment method or a combination of methods.1

Surgery to remove (excise) a melanoma is the standard treatment for this disease. It is necessary to remove not only the tumor but also some normal tissue around it in order to minimize the chance that any cancer will be left in the area.

The width and depth of surrounding skin that needs to be removed depends on the thickness of the melanoma and how deeply it has invaded the skin. In cases in which the melanoma is very thin, enough tissue is often removed during the biopsy, and no further surgery is necessary. If the melanoma was not completely removed during the biopsy, the doctor takes out the remaining tumor. In most cases, additional surgery is performed to remove normal-looking tissue around the tumor (called the margin) to make sure all melanoma cells are removed. This is necessary, even for thin melanomas. For thick melanomas, it may be necessary to do a wider excision to take out a larger margin of tissue.

If a large area of tissue is removed, a skin graft may be done at the same time. For this procedure, the doctor uses skin from another part of the body to replace the skin that was removed.

Lymph nodes near the tumor may be removed during surgery because cancer can spread through the lymphatic system. If the pathologist finds cancer cells in the lymph nodes, it may mean that the disease has spread to other parts of the body.

Surgery is generally not effective in controlling melanoma that is known to have spread to other parts of the body. In such cases, doctors may use other methods of treatment, such as chemotherapy, biological therapy, radiation therapy, or a combination of these methods. When therapy is given after surgery (primary therapy) to remove all cancerous tissue, the treatment is called adjuvant therapy. The goal of adjuvant therapy is to kill any undetected cancer cells that may remain in the body.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It is generally a systemic therapy, meaning that it can affect cancer cells throughout the body. In chemotherapy, one or more anticancer drugs are given by mouth or by injection into a blood vessel (intravenous). Either way, the drugs enter the bloodstream and travel through the body.

Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient (at the hospital, at the doctor's office, or at home). However, depending on which drugs are given and the patient's general health, a short hospital stay may be needed.

One method of giving chemotherapy drugs currently under investigation is called limb perfusion. It is being tested for use when melanoma occurs only on an arm or leg. In limb perfusion the flow of blood to and from the limb is stopped for a while with a tourniquet. Anticancer drugs are then put into the blood of the limb. The patient receives high doses of drugs directly into the area where the melanoma occurred. Since most of the anticancer drugs remain in one limb, limb perfusion is not truly systemic therapy.

Biological therapy

Biological therapy (also called immunotherapy) is a form of treatment that uses the body's immune system, either directly or indirectly, to fight cancer or to lessen side effects caused by some cancer treatments. Biological therapy is also a systemic therapy and involves the use of substances called biological response modifiers (BRMs). The body normally produces these substances in small amounts in response to infection and disease. Using modern laboratory techniques, scientists can produce BRMs in large amounts for use in cancer treatment. In some cases, biological therapy given after surgery can help prevent melanoma from recurring. For patients with metastatic melanoma or a high risk of recurrence, interferon-alfa and interleukin-2 (also called aldesleukin) may be recommended after surgery. Colony-stimulating factors and tumor vaccines are examples of other BRMs under study.

Radiation therapy

In some cases, radiation therapy (also called radiotherapy) is used to relieve some of the symptoms caused by melanoma. Radiation therapy is the use of high-energy rays to kill cancer cells. Radiation therapy is a local therapy; it affects cells only in the treated area. Radiation therapy is most commonly used to help control melanoma that has spread to the brain, bones, and other parts of the body.1

Footnotes:
1. excerpt from What You Need To Know About Melanoma: NCI

Last revision: June 2, 2003


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