Skin Cancer - Melanoma: Treatment Options

How is it treated?

Treatment for Melanoma depends on the stage that the cancer is in and the age and general health of the patient. Treating a Melanoma can be as simple as removing a mole from the surface of the skin. However, it can also involve more serious surgery as well as chemotherapy and radiation therapy. Early detection of a Melanoma is crucial to a quick and successful treatment.

Surgery for Melanoma

Some form of surgery is almost always used to remove a melanoma. It is important to remove not only the tumor, but also some surrounding normal tissue in order to make sure all the cancer is removed. Some commonly used surgical treatments are listed below:

• Simple Excision: The mole or lesion is removed from the top layer of skin along with a small amount of nearby tissue. The wound is small and can normally be closed with 1 or 2 stitches, which may leave a small scar. This procedure is performed in a doctor's office.
  
  
• Wide Excision (Re-excision): This is used when the tumor is more than 1mm thick. The procedure is the same as a simple excision except that a larger area of tissue is removed. In some cases a skin graft may be needed to close the wound.
  
  
• Lymph Node Dissection: If the doctor thinks that the cancer has spread, then the surrounding lymph nodes may be removed. This procedure may require a hospital stay.
  

Other Treatments

Chemotherapy

Chemotherapy is not the primary treatment for Melanomas. However, it can be used when the cancer is believed to have spread to other areas of the body besides the skin. In these cases it is very commonly used.

Chemotherapy is a systemic, or whole body, treatment, the goal of which is to kill any cancer cells in the body and to keep the cancer from spreading to other organs. The drugs are typically given in cycles of a few days of treatment and then 3-4 weeks of rest. These cycles go on for a period of weeks or months.

There are two ways chemotheraphy can be given, depending on patient health and the drugs being used. Chemotherapy pills can sometimes be used and allow the patient to remain at home during treatment. More commonly, chemotherapy drugs are administered through an IV at a doctor's office or clinic.

Radiation Therapy

Radiation therapy for Melanoma can be used for tumors that are found to be inoperable, or to relieve symptoms that are caused by spreading cancer. Radiation alone is not used to cure Melanoma. In some cases these X-rays can be used to destroy or shrink cancer cells at the site of the tumor.

Radiation therapy is a type of localized treatment, which means that it affects only a specific area of the body. External Beam Radiation is when the radiation is produced from a machine outside of the body and aimed at a specific site. Brachytherapy is when small amounts of radioactive material are inserted into the body near the site of the tumor.

Biological Therapy

Biological therapy is a relatively new and still experimental method of cancer treatment. It involves using substances to boost the body's own immune system responses, prompting it to kill the cancer cells. This treatment appears to be promising for Melanoma.

Treatment by Stage

Treatment plans differ for patients based on the extent of their disease, their age, and their general health. There are some commonly used treatment plans that may be used for each stage of Melanoma. Treatment may include all or some of the therapies listed for each stage. Only you and your doctor can determine which treatment is right for you.

• Stage 0:
  
  • Simple Excision.
    
• Stage I:
  
  • Wide Excision.
    
• Stage II:
  
  • Wide Excision.
    
  • Lymph node dissection.
    
  • Chemotherapy or biological therapy.
    
• Stage III:
  
  • Wide Excision (Up to 3 cm surrounding tumor may be removed).
    
  • Lymph node dissection.
    
  • Chemotherapy and/or Biological therapy.
    
• Stage IV Melanoma:
  
  • Lymph node dissection.
    
  • Surgery to remove tumors that have spread to other areas of the body.
    
  • Radiation therapy to relieve symptoms caused by the cancer.
    
  • A clinical trial of systemic chemotherapy and/or biological therapy.
    
  • A clinical trial of biological therapy injected directly into the tumor.
    
  • A clinical trial of heated chemotherapy.
    

What are the possible side effects from treatment?

*Most side effects are temporary and can often be relieved with medication.

Surgery

The side effects of surgical removal of Melanoma usually include:

• Temporary pain in the affected area.
  
• Fatigue or weakness.
  
• Scarring.
  
• Increased risk of infection if the lymph nodes are removed.
  

Chemotherapy

Since chemotherapy is a total body treatment, healthy tissues as well as cancerous tissue feel its effects. There are a variety of possible side effects, and those experienced are different for individual persons and individual drugs being used. Some more common side effects of chemotherapy include:

• Nausea/Vomiting.
  
• Hair loss.
  
• Mouth sores.
  
• Diarrhea.
  
• Fatigue.
  
• Infection or bleeding (rare).
  

Biological Therapy

The side effects of biological therapy usually include fatigue and flu-like symptoms, such as fever, chills, nausea, etc. All of these symptoms are temporary, and should disappear once treatment has ended.

Clinical Trials

There are always new experimental treatments being tested that often have promising results. The effectiveness and side effects of clinical trials are not always known, but they can sometimes offer hope of survival. Consult your physician or the Rhode Island Cancer Council to find out what clinical trials are going on near you and if you are eligible.

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