Melanoma skin cancer treatment

  Melanoma skin cancer treatment
Melanoma skin cancer treatment

Melanoma skin cancer treatment ...

The type of treatment (s) the doctor advises will depend on the stage and position of the melanoma and on your overall health. This section lists the options usually considered for each phase of melanoma.
Treat stage melanoma 0

Some doctors may consider using imiquimod cream (Zyclara) or radiation therapy instead of surgery, although not all doctors agree with this.

For melanomas in sensitive areas on the face, some doctors may use Mohs surgery or even imiquimod cream if surgery could be disfiguring, although not all doctors agree with these uses.
Treat stage I melanoma

Some doctors may recommend a sentinel lymph node biopsy. especially if the melanoma is stage IB or has other features that make it more likely to have spread to the lymph nodes. You and your doctor should discuss this option.

If the tumor cells are on the sentinel biopsy of the lymph node, a lymph node dissection (removal of all lymph nodes near the tumor) is often advised, but it is unclear whether this improves survival. Some doctors may recommend adjuvant treatment (additional) with interferon after lymph node surgery. Other medications or perhaps vaccines could be options as part of a clinical trial to try and lower the chances melanoma will return.
Treat phase II of melanoma

Extensive excision (a surgical procedure to remove melanoma and a margin of normal skin around it) is the standard treatment for stage II of melanoma. The amount of normal skin removed depends on the thickness and location of the melanoma.

Because melanoma may have spread to lymph nodes near melanoma, many doctors recommend a sentinel biopsy of the lymph node as well. This is an option that you and your doctor should discuss. If it is done and the sentinel lymph node contains tumor cells, then a lymph node dissection (where all the lymph nodes in that area are surgically removed) will probably be done at a later time.

For some patients (such as those with cancer-containing lymph nodes), doctors may recommend interferon treatment after surgery (adjuvant therapy). Other medications or perhaps vaccines may also be recommended as part of a clinical trial to try to lower the possibility melanoma will return.
Treat stage III melanoma

These tumors have already reached the lymph nodes when melanoma is first diagnosed. Surgical treatment for stage III of melanoma usually requires wide excision of the primary tumor as in previous phases, together with lymph node dissection. Interferon adjuvant therapy can help keep some melanomas back longer. Other medications or perhaps vaccines may also be recommended as part of a clinical trial to try and reduce the possibility melanoma will return. Another option is to give radiation therapy to areas where the lymph nodes have been removed, especially if many of the nodes contain cancer.

If melanomas are found in lymphatic vessels close to, or just under the skin (known as transiting tumors), they should be removed, if possible. Other options include injections of T-VEC vaccine (Imlygic), Bacillus Calmette-Guerin (BCG) vaccine, interferon or interleukin-2 (IL-2) directly into melanoma; radiotherapy; or the application of imiquimod cream. For melanomas on an arm or leg, another option could be locoregional perfusion (infusing the limb with a heated chemotherapy solution). Other possible treatments could include targeted therapy. immunotherapy. chemotherapy, or a combination of immunotherapy and chemotherapy (biochemotherapy).

Some patients could benefit from more recent treatments being tested in. Many patients with stage III melanoma may not be treated with current therapies, so they may want to consider taking part in a clinical trial.
Treat stage IV melanoma

Metastasis in internal organs are sometimes removed, depending on how many there are, where they are, and how likely it is to cause symptoms. Metastases that cause symptoms but can not be removed can be treated with radiation, immunotherapy, targeted therapy, or chemotherapy.







 The treatment of diffuse melanomas has changed in recent years as new forms of immunotherapy and targeted drugs have proven to be more effective than chemotherapy.

drugs called immunotherapy checkpoint inhibitors such as pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy) have been shown to help some people with advanced melanoma live longer. These drugs can sometimes have serious side effects, so patients who need them to be watched closely. Other types of immunotherapy could also help, but these are only available through clinical trials.

In about half of the melanomas, the tumor cells have variations of the BRAF gene. If you think that this genetic mutation, treatment with new targeted drug therapy, such as vemurafenib (Zelboraf), Dabrafenib (Tafinlar), trametinib (Mekinist), and cobimetinib (Cotellic) might be helpful. They could be tried before or after the recent immunotherapy drug, but they are not used at the same time. Like checkpoint inhibitors, these medications can help some people live longer, even if they have not been shown to treat these melanomas.

Immunotherapy with interferon or interleukin-2 can help a small number of people with stage IV melanoma live longer. Higher doses of these drugs appear to be more effective, but may also have more serious side effects, so it may need to be given to the hospital.

Some doctors may recommend biochemotherapy, which is a combination of chemotherapy and interleukin-2, interferon, or both. This can often reduce tumors, which could make patients feel better, even if it has not been shown to help patients live longer.

It is important to carefully consider the possible benefits and side effects of any recommended treatment before starting it.

Because stage IV melanoma is difficult to cure with current treatments, patients may want to think about taking part in a clinical trialErrore! invalid hyperlink reference. . Many studies are now looking for new targeted drugs, immunotherapies, chemotherapy drugs, and combinations of different types of treatments.

Although stage IV melanoma is often difficult to treat, a small portion of people respond very well to treatment and survive for many years after diagnosis.
Treat the recurrent melanoma

Treatment of melanoma that returns after initial treatment depends on the stage of the original melanoma, which treatments a person has already had, where melanoma returns, and other factors.

Melanoma could return to the skin near the site of the original tumor, sometimes even in scar from surgery. In general, these (skin) local recurrences are treated with surgery similar to what would be recommended for a primary melanoma. This could include a sentinel biopsy of the lymph node. Depending on the thickness and location of the tumor, other treatments may be considered, such as isolated perfusion chemotherapy; radiotherapy ; or local immunotherapy treatments, such as tumor injection with the T-VEC vaccine (Imlygic), BCG vaccine, interferon or interleukin-2. systemic treatments, such as immunotherapy. targeted therapy. or chemotherapy could also be options.

Melanoma can also return to distant parts of the body. Almost any organ can be affected. Most often, melanoma will return to the lungs, bones, liver or the brain. The treatment for these recurrences is generally the same as for stage IV melanoma (see above). Melanomas that occur on an arm or leg can be treated with isolated perfusion chemotherapy.

As with the other stages of melanoma, people with recurrent melanoma may want to think about taking part in a clinical trial.

The information given here is not the official policy of the American Cancer Society and is not intended as medical advice to replace the experience and judgment of the cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons to suggest a treatment plan other than these general treatment options. Do not hesitate to ask him or her questions about treatment options.