Melanoma (cont.)
Methods of treatment
People with melanoma may have surgery, chemotherapy, biological therapy, or
radiation therapy. Patients may have a combination of treatments.
At any stage of disease, people with melanoma may have treatment to control
pain and other symptoms of the cancer, to relieve the side effects of therapy,
and to ease emotional and practical problems. This kind of treatment is called
symptom management, supportive care, or palliative care.
The doctor is the best person to describe the treatment choices and discuss
the expected results.
A patient may want to talk to the doctor about taking part in a clinical
trial, a research study of new treatment methods. The section on "The Promise of
Cancer Research" has more information about clinical trials.
Surgery
Surgery is the usual treatment for melanoma. The surgeon removes the tumor
and some normal tissue around it. This procedure reduces the chance that cancer
cells 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:
- The doctor may be able to completely remove a very thin melanoma during the
biopsy. Further surgery may not be 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 often necessary, even for thin
melanomas. If the melanoma is thick, the doctor may need to remove a larger
margin of tissue.
If a large area of tissue is removed, the surgeon may do a skin graft. 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 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 also spread to other parts of the body. Two
procedures are used to remove the lymph nodes:
- Sentinel lymph node biopsy -- The sentinel lymph node biopsy is done after the
biopsy of the melanoma but before the wider excision of the tumor. A radioactive
substance is injected near the melanoma. The surgeon follows the movement of the
substance on a computer screen. The first lymph node(s) to take up the substance
is called the sentinel lymph node(s). (The imaging study is called
lymphoscintigraphy. The procedure to identify the sentinel node(s) is called
sentinel lymph node mapping.) The surgeon removes the sentinel node(s) to check
for cancer cells.
If a sentinel node contains cancer cells, the surgeon removes the rest of the
lymph nodes in the area. However, if a sentinel node does not contain cancer
cells, no additional lymph nodes are removed.
- Lymph node dissection -- The surgeon removes all the lymph nodes in the area of
the melanoma.
Therapy may be given after surgery to kill cancer cells that remain in the
body. This treatment is called adjuvant therapy. The patient may receive
biological therapy.
Surgery is generally not effective in controlling melanoma that has 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.
Chemotherapy
Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to
treat melanoma. The drugs are 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.
People with melanoma may receive chemotherapy in one of the following ways:
- By mouth or injection -- Either way, the drugs enter the bloodstream and travel
throughout the body.
- Isolated limb perfusion (also called isolated arterial perfusion) -- For
melanoma on an arm or leg, chemotherapy drugs are put directly into the
bloodstream of that limb. The flow of blood to and from the limb is stopped for
a while. This allows most of the drug to reach the tumor directly. Most of the
chemotherapy remains in that limb.
The drugs may be heated before injection. This type of chemotherapy is called
hyperthermic perfusion.
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 reduce side effects caused by some cancer treatments. Biological therapy for
melanoma uses substances called cytokines. The body normally produces cytokines
in small amounts in response to infections and other diseases. Using modern
laboratory techniques, scientists can produce cytokines in large amounts. 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 alpha and interleukin-2 (also called IL-2 or aldesleukin)
may be recommended after surgery.
Radiation therapy
Radiation therapy (also called radiotherapy) uses high-energy rays to kill
cancer cells. A large machine directs radiation at the body. The patient usually
has treatment at a hospital or clinic, five days a week for several weeks.
Radiation therapy may be used to help control melanoma that has spread to the
brain, bones, and other parts of the body. It may shrink the tumor and relieve
symptoms.
Next: Treatment choices by stage »
- interferon - Describes the medication interferon (Roferon-A, Intron-A, Rebetron, Alferon-N, Peg-Intron, Avonex, Betaseron, Infergen, Actimmune, Pegasys), a drug used in managing many diseases that involve the immune system.
- Chemotherapy - Explains chemotherapy, a drug treatment to kill cancer cells. Article includes descriptions, uses, and side effects, and care support.
- Skin Tag - Read about skin tags (acrochordons), benign skin growths thought to be caused by skin friction, treatment, removal and other causes. Plus, see a picture of a skin tag.
Latest Medical News
Cancer RSS