Melanoma Treatment

Three keys of treatment

Melanoma that is found early can usually be treated with surgery alone.

The treatment for melanoma depends on three factors:

the age of the person
the general health of the person
the stage of the disease

Surgery is the first treatment for all stages of melanoma (stages IA through IV). The tumor is removed entirely, along with some surrounding tissue (usually about ¾ of an inch all around). The surgery may be done by a dermatologist or a surgeon, and it sometimes happens as part of the diagnosis process. In some cases, a skin graft may be needed to replace skin that has been removed.

If the melanoma has spread to the nearby lymph nodes, the affected lymph nodes may also be removed surgically.

Surgery is usually the only treatment needed for people with early-stage melanomas (thinner melanomas that have not spread to the lymph nodes). However, these people still need regular follow-up visits to the doctor, to make sure the melanoma has not come back and that other moles do not need biopsies.

Who Treats Melanoma?

Often, a team of doctors and other health care professionals with special skills will work together to treat melanoma. This team may include:

Dermatologist: has special training to diagnose and treat skin problems
Surgeon: performs operations to repair or remove parts of the body
Medical oncologist: specializes in diagnosing and treating cancer; he or she may be your main doctor and the one who heads up your health care team
Radiation oncologist: specially trained to use radiation to treat cancer
Plastic surgeon: specializes in reducing scarring or other visible results of treatment

Other members of your treatment team include:
Oncology nurse
Pharmacist
Social worker
Patient educator
Dietitian
Mental health professional
Discharge planner
Patient advocate

Later-stage melanoma may require additional or "adjuvant" treatments after surgery.

For later-stage melanomas (thick melanomas or those that have spread to the nearby lymph nodes), other treatments besides surgery may be needed. These are called "adjuvant" treatments, and they may include radiation therapy, systemic therapy, chemotherapy, vaccines, chemotherapy of an isolated arm or leg, or a combination of chemotherapy and biotherapy. Only your physician can decide which treatment or combination of treatments is right for you.

Immunotherapy

Immunotherapy (also called biological therapy) uses cancer-fighting substances similar to the ones produced by the body's immune system. When you have an infection or other disease, your immune system releases proteins called cytokines. They help fight the illness. Some of these cytokines can also help fight cancer cells. Normally, the body produces very small amounts of these cytokines. But it is now possible to make large quantities of cancer-fighting cytokines in a laboratory, to use as cancer treatment.

The two types of immunotherapy used to treat melanoma are:

Glossary

Biological therapy: The use of the body's immune system, either directly or indirectly, to fight cancer or to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier therapy.
Biopsy: The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue.
Cancer: A general term for more than 100 different diseases that involve the uncontrolled increase of abnormal new cells. These cells form tumors that can destroy surrounding tissue and spread throughout the body.
Chemotherapy: The treatment of cancer (or other disease) with drugs.
Cytokine: A substance that is produced by cells of the immune system and can affect the immune response. Cytokines can also be produced in the laboratory by recombinant DNA technology and given to people to affect immune responses.
Immune system: The complex group of organs and cells that defends the body against infections and other diseases.
Interferons: Proteins produced naturally by white blood cells that stimulate the growth of certain disease-fighting blood cells in the immune system. Manufactured forms of interferons are used in cancer immunotherapy to improve the body's natural response to disease.
Interleukin: A biological response modifier (substance that can improve the body's natural response to infection and disease) that helps the immune system fight infection and cancer. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases.
Lymph nodes: Glands that produce lymph and that filter out harmful agents (such as bacteria, viruses, and cancer cells).
Melanoma: A highly malignant type of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole.
Mole: A cluster of melanocytes and surrounding supportive tissue that usually appears as a tan, brown, or flesh-colored spot on the skin.
Radiation therapy: The treatment of cancer with high-energy X-rays. Also called radiotherapy.
Skin graft: A surgical procedure in which a piece of skin is transplanted from one area to another.
Stage: The extent of a cancer, especially whether the disease has spread from the original site to other parts of the body.
Tumor: An abnormal mass of tissue that results from excessive cell division. Tumors perform no useful body function. They may either be benign (not cancerous) or malignant (cancerous).
Systemic treatment: Treatment using substances that travel through the bloodstream, reaching and affecting cancer cells all over the body.