Melanoma Treatment

Melanoma Treatment

Melanoma treatment

     Lymph node swelling or sensitivity may be a sign of the extension of melanoma. Any increased lymph nodes in size should be removed and investigated for melanoma.

     The IV stage (metastatic) of melanoma responds poorly to most forms of treatment. Survival for 5 years in stage IV melanoma is less than 50%. Metastatic melanoma treatment objectives are to control the symptoms, to reduce the complications and to increase the patient comfort at this stage of disease (palliative treatment). It is not intended the treatment of this disease.

The metastatic melanoma can be treated by:

  • Radiotherapy
  • Chemotherapy with dacarbazine. The main adverse effects of chemotherapy with dacarbazine are the nausea and vomiting, which usually can be controlled with antiemetic drugs (against sickness).

     People with metastatic melanoma could be included in clinical trials.

     After removing the primary melanoma, a skin graft may be necessary for cosmetic reasons or to restore the functionality of the area. This is probably necessary if the melanoma was removed from the face, hands, feet, forearms or legs or in the cases of large melanomas.

     Melanomas relapse is common. It is important to review our own skin monthly and communicate to the any changes we notice.

Terminal problems:

     In the cases of advanced melanoma (metastatic) it is indicated to stop the curative treatment and to concentrates on ensuring the patient comfort (palliative treatment). The moment of this decision to stop the medical treatment who's intent is to prolong life, and changing the objective to palliative care is difficult.

     The interferon administered before and after surgery is a treatment of choice for melanoma that has invaded the lymph nodes. The use of interferon may increase the survival rate of people with melanoma in stage III.

     Chemotherapy generally does not increase the survival rate for metastatic melanoma. However, chemotherapy with dacarbazine can be used for palliative treatment of melanoma in stage IV.

Medication options:

     Melanoma treatment with drug therapy may include:

  • Interferon - can be used if melanoma has invaded the lymph nodes
  • Dacarbazine (DTIC) - used to treat melanoma in stage IV (metastatic melanoma).

     The main adverse effects of dacarbazine are the nausea and vomiting, which can usually be controlled with antiemetic drugs. The family doctor will prescribe these drugs to be taken together with the background treatment and outpatient treatment to combat any nausea that might occur.

     These options include medicines like the serotonin antagonists - these drugs may be more effective in preventing nausea and vomiting caused by chemotherapy, when combined with corticosteroids.

     Melanoma treatment is being improved constantly. New forms of chemotherapy are constantly tested. The success of new drugs and new combinations of drugs is determined by clinical trials.

     The complete surgical removal (excision) is the most effective method of melanoma treatment and the most commonly used to treat melanoma. The lymph nodes must be also removed (with lymphadenectomy) in the case of melanoma in stage II and III.

     Metastatic melanoma is also treated by surgical removal of primary melanoma and of the cancer tissue in the vicinity of the tumor or of the lymph nodes.

Melanoma surgical treatment options

     The most common surgical procedures used to treat melanoma include:

  • The surgical excision - The excision removes the entirely melanoma along with a margin of apparently normal tissue (border security)
  • Lymphadenectomy - a surgical procedure in which lymph nodes are removed, the ones which are invaded by melanoma.

     Other melanoma treatment options are used for melanoma that develops in areas with rare localization of melanoma, such as the eye, on a finger of the hand or toe, or underneath the nail.