Malignant Melanoma Treatment Options

Dec 17, 2009 | Comments 0

Thin Melanoma Treatment

The sole treatment alternative in case of thin melanoma is:

Entire removal of the mole.
Employing wide local excision for ensuring that there are no remnant melanoma cells.

Subsequent to the complete removal of the mole and the outcomes of the analysis revealing the presence of a melanoma, then wide local excision would be planned. In case adequate clear tissue was extracted during the time of the mole removal, one would not require undergoing a wide local excision procedure.

Wide Local Excision

During the procedure, the marginal healthy-appearing tissue adjoining the site where the melanoma was present is removed for ascertaining no remnant melanoma cells in the location.

The procedure is conducted under the influence of local or at times under general anaesthesia in analogous way that the mole was taken out.

During the surgery, no less than a centimetre of skin encircling the melanoma is taken out. The operated site would appear reddish and tender initially that would eventually subside. A small-sized remnant scar would remain and would clear out too.

Rarely, a broader part of the skin is taken out and skin grafting would become necessary wherein layers of skin would be removed from another area of the body and transplanted to the operated site. But, in case of the removal of thin melanoma, skin grafting is generally not required.

Pros & Cons of the Treatment

Surgery greatly cures thin melanoma though a scar would remain subsequent to surgery that lightens and become less apparent as time passes. In case surgery is not performed, the melanoma could metastasize and become deep-seated and could reach other body parts.

Stage 2 and Stage 3 Melanoma Treatments

stage3 melanoma Stage 2 melanoma is a condition when melanoma is above two millimetres in thickness or above one millimetre in thickness and ulcerations or broken skin appearing. When the melanoma has spread to one or more lymph nodes, then the condition is known as Stage 3 melanoma.

Subsequent to identification and preliminary treatment, additional tests for checking the metastasis of cancer to the lymph nodes would be required and added treatment for lowering the risk of relapse of melanoma is required.

At times, melanoma could spread to the lymph nodes that are components of the lymphatic system that are part of the body’s innate safeguarding mechanism against infection. In case one has been detected with melanoma, then supplementary tests could be indicated for checking the extent of metastasis which includes:

FNA or Fine needle aspiration
In case there is swelling detected in the lymph node then with the assistance of a thin needle cell samples could be taken from the swollen lymph node which are sent for laboratory evaluation.
Sentinel Node Biopsy
The sentinel node biopsy procedure could be recommended by the doctor at the time of or subsequent to surgery for checking whether the lymph nodes show the presence of melanoma cells as the sentinel node is located nearest to the melanoma. For identifying the sentinel node, injections of a slightly radioactive and blue tinged substance are administered to the site. The node that picks up these substances is taken out during surgery for checking the melanoma cells in it.Some associated risks subsequent to sentinel node biopsy are infection or some form of fluid accumulation in the site that could be effectively cured. In case one has undergone sentinel node biopsy, then there is no requirement to remove any other of the lymph nodes. In case the sentinel node is diagnosed with melanoma cells, then another operative procedure known as lymph node dissection would be requisite for removal of further lymph nodes from the site.
Lymph Node Dissection
Surgery for complete removal of lymph nodes from the spot is known as lymph node or block dissection and is performed under the influence of general anaesthesia. One would sense tenderness in the site for some weeks subsequent to the surgery, though routine activities would not be hampered due to this. Occasionally, lymph nodes when removed could lead to an eventual swell up in the limbs in the site where the glands were taken out – a condition known as lymphoedema.

The below mentioned tests could be conducted either prior to or subsequent to the lymph node dissection procedure.

Blood Analysis
Blood samples are drawn for checking the overall health condition.

Chest X-rays
Chest x-rays are done for evaluating overall health and checking for any visible indications of melanoma in the lungs.

Ultrasound Scan of the Liver and Abdomen
This scanning procedure captures images of the certain parts of the body. During the scan, a tiny piece of equipment similar to a microphone is moved over the gel-slathered part of the abdomen, the echoes that are emitted are transformed into images with the assistance of a computer.

CAT or CT or Computerised Tomography Scan

A sequence of chest and abdominal x-rays are captured that are input into a computer for producing explicit images of the body’s internal organs and could reveal if the melanoma has metastasized. Prior to the ten to thirty minutes long spanning scan, one could be offered a beverage or shot of dye that facilitates better viewing of certain parts of the body. For a span of some minutes, this could lead to feeling hot throughout the body. In case one has allergic reactions to either iodine or are asthmatic then grave side effects of the shot could occur, hence it is imperative to inform the doctor well in advance about it.

Additional Treatment

Adjuvant treatment is occasionally employed subsequent to surgery in an attempt to lower the risk of melanoma relapsing. The drug interferon is at times recommended for this purpose.

Stage 4 Melanoma Treatment

Advanced melanoma treatment is intended to slacken the progression of cancer and allay few of the symptoms.

Surgical Intervention

In case the melanoma is present in the skin, lymph nodes or found in a particular location in the brain, then surgery could be suggested for removing it and for assuaging the signs of advanced melanoma.

Biological Therapy

Biological therapy involves the employment of innately created substances in the body. The chief one employed for treating melanoma is interferon (also known as Intron-A, Rofereon-A). Interferon is manufactured by the body for combating viral infections, a synthetic form is obtainable. Interferon functions by stimulating the body’s own immunity for combating cancer.

Interferon is administered in a jab form by the subcutaneous route generally thrice in a week. It could lead to side effects analogous to flu signs like high temperatures, feeling chilly, headaches and fatigue). Though these could be bothersome, they could eventually subside as the treatment concludes.

Interleukin is another form of biological therapy mostly employed in the United States, though it leads to greater amount of side effects as compared to interferon. There is dearth of proof which confirms one having greater efficacy than the other.

Chemotherapy

Chemotherapy employs cancer-fighting drugs for killing cancer cells. A chemo drug known as dacarbazine or DTIC could be utilised for the treatment of advanced melanoma. At times it is given alongside other chemo drugs. Mostly chemo drugs are administered intravenously via drip form and generally in a time interval of 3 or 4 weeks. Temozolomide or Temodal is another kind of chemotherapy drug that is also been under use in melanoma research trials.

Isolated Limb Perfusion

In case the secondary melanoma is restricted to merely an arm or the leg, then a focused procedure known as the isolated limb perfusion is given wherein chemotherapy could be administered to merely a single limb. The side effects experienced are lowered as the chemotherapy is just localized to a particular part of the body.

Radiotherapy

Radiotherapy employs high-power energy beams for annihilating cancerous cells while sparing normal tissues. It could be employed in case the cancer has metastasized to the bones and could aid in lowering pain. It could additionally be utilised for treating melanoma affecting the skin and the brain.