Melanoma is the most aggressive form of skin cancer. Early diagnosis and intervention may improve the likelihood of survival.There are different options available for the treatment of melanoma. Treatment recommendation depends on many factors, including the diameter of the primary melanoma, stage of the melanoma, the presence of specific genetic changes in melanoma cells, the rate of melanoma growth, and the patient’s other medical conditions.  Other factors considered in treatment determination includes the patient’s overall health and preferences and possible side effects

 

What is the most common treatment of melanoma skin cancer

The current used and standard treatment of melanoma skin cancer includes; Surgery, chemotherapy, radiation therapy, immunotherapy and targeted therapy. Newer types being tested in clinical trials are the vaccine therapy.

Surgery is the mainstay treatment for people with localized melanoma and most people with regional melanoma. For a patient with metastatic melanoma, surgery could be considered as an option. If surgery is not an alternative, the melanoma may be termed ‘Unresectable.’ In recommending a specific treatment modality, doctors will first take into consideration the stage of the disease, as well as the patient’s individual risk for recurrence.

Types of surgery used to treat local and regional melanoma are:

  • Wide excision. The primary treatment for melanoma is excision. The extent of excision depends on the thickness of the melanoma. Most melanomas are discovered when they are less than 1.0mm thick and outpatient surgery is often the only recommended option. The tumor is removed, along with tissue found under the skin and also some surrounding healthy skin tissues called a margin so that no cancer cells remain. Depending on the site and extent of the surgery, a skin flap or a skin graft may be required. A skin graft uses skin from another part of the body to cover the wound.

Chemotherapy used drugs that kill cancer cells. They can be used to treat advanced melanoma but are not used as the first line of treatment since newer forms of immunotherapy, and targeted drugs have become available. Chemotherapy is usually not effective for melanoma as it is for some other types of cancer, but it may alleviate symptoms or extend survival for some patients. Several drugs include Dacarbazine, Paclitaxel, Temozolomide, Vinblastine, Cisplatin, Carboplatin, and Nab-paclitaxel. Some of these drugs are given alone, while others are often combined with other medications.

Radiation therapy involves the use of high-energy x-rays or other particles to destroy cancer cells. This is done by a radiation oncologist, who will recommend a specific radiation therapy regimen, or schedule, with a total number of treatments and dose of radiation

The most common type of radiation treatment is called external beam radiation therapy. The beam is directed towards the cancer cell and blocked using special techniques to limit side effects caused by exposure to healthy cells.

General side effects of radiation therapy include skin irritation and fatigue. These symptoms usually improve few weeks after adjuvant radiation therapy is finished. Adjuvant therapy refers to treatment after initial treatment. Topical steroids or antibiotics may be applied to help prevent and treat radiation-induced skin irritations

Adjuvant radiation therapy

This is considered after surgery to prevent recurrences. Though research has shown that this may reduce the risk of the melanoma reoccurring in the area that received radiation, it does not improve the survival rate of the patient.

Adjuvant immunotherapy     

Immunotherapy also referred to biologic therapy, is designed to boost the body’s natural defenses to combat cancer. Biology therapy uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Different types of immunotherapy can cause different side effects.

In recent years, there have been significant advances in treating advanced or stage IV melanoma with immunotherapy. Most of them are still in clinical trials. These options include Anti-CTLA4 antibody, Anti-PD-1 antibodies, and interleukin-2.

Targeted therapy

Targeted therapy uses drugs to ‘target’ the abnormal aspects of tumor cells without harming healthy cells. Several of these therapies have been approved for use in treating various cancers, and this approach is now being evaluated in melanoma.

Can you get rid of melanoma skin cancer?

Advanced or stage        IV melanomas are often hard to cure due to their distant spread to lymph nodes or other areas of the body. Skin tumors or symptomatic enlarged lymph nodes can often be removed by surgery or radiation therapy.

Is melanoma skin cancer curable?

Most melanomas can be cured if they are diagnosed early. Advanced or Stage iv melanomas are often difficult to cure and usually fatal because they have already spread to distant organs and lymph nodes in the body. Enlarged lymph nodes causing symptoms can often be removed by surgery or treated with radiation therapy.

What is the survival rate for melanoma?

The overall survival rate for melanoma depends on the thickness or diameter of the primary melanoma and whether it has spread to lymph nodes and distant sites. For very early-stage melanoma localized to where it started, the 5-year survival rate is 99%. The survival rate for melanoma that has spread to the nearby lymph node is 63%. For distant metastasis, survival is at 20%.

Other factors that could also determine the prognosis includes the individual state, stage of cancer, available treatment, weakened immune system such as organ transplants.

Take note, these survival rates are only estimates, they can’t predict precisely what happens to any individual.

Dermatologists near me

Finding a good dermatologist doesn’t have to be an uncomfortable or stressful experience. If you discover a mole that has an irregular shape and border with different shades of color, or a mole that is larger in size, shape, and texture, do not hesitate to contact a doctor or dermatologist near you to rule out any malignancy or tumor. Other symptoms to look for include sores that do not heal, redness or swelling that spreads outside the border of a spot to the surrounding skin. Depending on your options, you may be referred to different types of doctor for your treatment. A surgical oncologist, a medical oncologist or a radiation oncologist.

References

Gary W. Cole, F. (2018). Melanoma Causes, Types, Symptoms & Treatment. Retrieved from https://www.medicinenet.com/melanoma/article.htm

Melanoma – SkinCancer.org. (2018). Retrieved from https://www.skincancer.org/skin-cancer-information/melanoma

Skin cancer (melanoma). (2018). Retrieved from https://www.nhs.uk/conditions/melanoma-skin-cancer/