Early stages of melanoma—melanoma that has
not spread—can typically be treated with surgery to remove the cancerous cells
and some surrounding tissue. Cancer that has spread to nearby lymph nodes may
require the removal of the lymph nodes as well.
For cancer that has spread to other organs,
treatment is more challenging. Melanoma is usually not curable at this point, and
treatment becomes directed at shrinking the tumor and improving symptoms. However,
there are always new discoveries and advances in treatment aimed at curing more
serious cases of melanoma.
Treatment options include:
- radiation therapy
- sentinel lymph node biopsy (SLNB)
often the first step toward treating melanoma. It can involve removal of the
tumor, or may require additional removal of some of the surrounding area. Once
the cancerous cells have been removed, no further treatment may be necessary.
In many cases, the procedure for thinner melanoma can be performed in a
doctor’s office, or as an outpatient procedure. Excision, which can be done in
a doctor’s office, involves a numbing of the affected area followed by a
surgical excision to remove the melanoma.
Chemotherapy is often used as an additional
method of treatment following surgery in more advanced cases of melanoma. Administered
either orally, topically, or through a vein, chemotherapy drugs kill cancer
Chemotherapy is applied in cycles, staggered
between periods of rest. The American Cancer Society points out that
chemotherapy is less effective for melanoma than for other types of cancer. However,
the treatment may help relieve some symptoms in advanced cases of the disease.
Due to the fact that chemotherapy kills
cancer cells as well as normal cells, there may be side effects, including:
bruising (from low blood platelets)
chance of infection
Ongoing studies continue as to the benefits
of anti-angiogenic drugs, a class of
drugs designed to prevent new blood vessels from forming, therefore cutting the
supply from be able to nourish cancer cells. Still considered experimental,
these drugs could show promising efforts at combating melanoma.
Immunotherapy (Biologic Therapy)
Immunotherapy involves the use of protein-based
medications, such as interferon, to boost the immune system, and may be used in
combination with other treatments. For example, in patients with thicker
melanomas, the cancer cells may appear to have been completely removed by
surgery but still remain in small traces. To ensure that cancer cells don’t
spread, an injection of proteins that boost the immune system is used to
prevent any remaining cells from growing.
Radiation therapy is rarely used on the
original tumor, but is instead directed more often on the nearby lymph nodes,
following surgery, to prevent the return of the cancer. This form of treatment
is also used to relieve painful symptoms due to the spread of cancer in the
body. Side effects may include fatigue, nausea, and vomiting, and typically end
once treatment is completed.
Sentinel Lymph Node Biopsy (SLNB)
detection of melanoma is crucial in curing the disease. Once melanoma has
spread to the lymph nodes or other organs, it is much harder to treat. Before
the 1990s—and the introduction of the sentinel
lymph node biopsy (SLNB)—patients had two options: complete lymph node
removal, or observing an anxious “wait and see” period. The first option posed
some serious health problems. Complications like tissue swelling and numbness
were a potential side effect of entirely removing the lymph nodes—an
unnecessary procedure for many patients. The number of patients actually requiring complete lymph node
removal remained relatively low, accounting for “only 20 percent of melanoma
patients,” according to the National Cancer Institute (NCI). The second option,
it goes without saying, was not very popular either.
led to the SLNB, introduced by Dr. Donald Morton of the John Wayne Cancer
Institute (JWCI). This new procedure allowed doctors to examine the sentinel
nodes to determine the next course of action. As NCI reports, based on findings
from Dr. Morton’s 1992 study, “only if the sentinel nodes are found to be
cancerous are all the nearby lymph nodes removed.” While much remains to be
learned, this new technology took strides in diagnosing stages of melanoma and
designing a treatment plan. By identifying and removing the sentinel nodes in
patients, doctors could then establish if all the lymph nodes needed to be
removed. Results from a follow-up study by JWCI appeared in The New England Journal of Medicine in September
2006. Researchers stated that SLNB offered a valuable method in determining if melanoma
had spread to the lymph nodes, leading to significantly improved survival rates