Treatments

Overview of Treatment Options

There are many different treatment options for melanoma, the treatment recommendations made by your cancer care team will depend on the stage of the disease and the thickness of the primary tumor. Your cancer care team may recommend standard treatment (the currently used treatment) or a clinical trial. It is important that you understand your treatment options and the recommendations being made and always ask for an explanation of anything that you don’t understand. Below is a brief overview of standard treatment options, which include: surgery, chemotherapy, radiation therapy, and immunotherapy. There are also numerous clinical trials studying the use of vaccine therapy and chemo immunotherapy (please refer to our page on clinical trials).

Surgery: Generally, surgery is done to remove the tumor as part of the primary treatment for all stages of melanoma. Surgery options include the following: local excision, wide local excision, lymphadenectomy and sentinel lymph node biopsy.

• Local excision takes out the melanoma and some of the normal tissue surrounding it.
• Wide local excision is an excision of a larger area of tissue and may involve removal of lymph nodes.
• Lymphadenectomy involves removing the lymph nodes to see if they contain cancer cells.
• Sentinal lymph node biopsy is when they remove the first lymph node (that the cancer is likely to spread to) during surgery, this is determined by injecting either a radioactive substance and/ or a blue dye near the tumor and following where the dye travels.

Radiation Therapy: Radiation therapy uses high-energy rays or particles to kill cancer cells. Radiation can be external or internal. External radiation uses a machine outside the body to deliver the treatment, whereas, internal radiation uses needles, seeds, wires, or catheters placed directly into or near the cancer (inside the body) to deliver the treatment.

Chemotherapy: Part of the treatment may include chemotherapy with anti-cancer drugs given by injection into the vein or taken orally, this is considered systemic therapy. With systemic therapy the medications travel through the body via the bloodstream to try and attack cancer cells that have already spread beyond the skin. Some chemotherapy drugs used in the treatment of melanoma include but are not limited to: DTIC, BCNU, Cisplatin, Vinblastine, and Temozolide. These drugs can be given alone or in different combinations, depending on what your cancer care team recommends.

Immunotherapy: Immunotherapy encourages a patient’s immune system to recognize and destroy cancer cells. One type of immunotherapy is cytokine therapy. Specifically, cytokines (proteins) are used to activate the immune system and help shrink melanoma cancer cells. The two cytokines used are interferon-alpha and interleukin-2. In addition, interferon-alpha-2b can be used in the adjuvant setting, which means treatment after surgery.

Experimental Therapy: Currently, melanoma vaccines are being given experimentally. The weakened melanoma cells or parts of cells, called antigens, can be injected into a patient in an attempt to stimulate the immune system to destroy melanoma cells.
 

Currently NIH and other institutes are aggressively seeking new therapies to find a cure for melanoma.

References

National Cancer Institute http://www.cancer.gov
National Cancer Comprehensive Network http://www.nccn.org