Melanoma

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Treatment

The standard treatment for primary melanoma is surgical removal. During this procedure, the tumor and an area of surrounding healthy tissue (called margins) is removed. The size of these margins depends on the depth of the tumor. Melanoma that remains confined to the skin is almost 100% curable.

Therapy for melanoma that has spread to lymph nodes or to distant sites exists. Adjuvant, or additional, therapy includes immunotherapy using interferon alpha 2b or interleukin-2. These are immune-stimulating chemicals that helps the body "fight" the cancer. Some studies show that these medications can prolong one's life. But the medication is difficult to tolerate. Virtually all patients experience flu-like symptoms that can be quite severe. Treatment-related deaths have been reported as well. In experiments with lower doses, patients tolerate the medication better and live a little longer.

Various chemotherapy regimens are used to treat metastatic disease, although the results are typically disappointing. Chemotherapy is sometimes combined with immunotherapy. Radiation therapy can relieve some of the pain caused by complications associated with metastatic tumor by reducing the size of a tumor located in the brain, the bones, the skin, or spinal cord.

A major development in treatment is the melanoma vaccine. The vaccine prompts the patient s immune system to recognize and kill the remaining tumor cells before they reproduce and grow. The melanoma vaccine has an overall response rate of 10% to 20%. Attempts to increase the immune-stimulating effects of the vaccine are being undertaken.

Prevention

Regular self-examination is essential to prevent primary melanoma and metastatic disease. It is recommended that all individuals, regardless of risk factors, examine their skin regularly for suspicious growths to provide early detection and improve the outcome. Sun protection, including minimizing overall exposure, regular use of sunscreen, wearing hats and protective clothing, and avoiding tanning beds decreases the risk for developing melanoma. Patients who are at increased risk for developing the disease should be regularly examined by a dermatologist, perhaps using photographs to help assess skin changes.

Once melanoma has been diagnosed, routine follow-ups should be performed every 3 to 12 months to check for recurrence and to check for a second primary melanoma. In some cases, tumor depth indicates that the patient also should have yearly laboratory tests and chest x-rays.

Melanoma, Treatment reprinted with permission from oncologychannel.com
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