If melanoma is treated in its early stages, the prognosis is usually very positive. Simple surgical removal may cure early stage melanoma. If the skin cancer has metastasized, treatment becomes much more complicated, involving radiation therapy, chemotherapy, immunotherapy, and/or palliative care.
Small tumors that don’t penetrate deeply into the skin can often be completely removed with surgery, a procedure known as an excisional biopsy. In some cases, this procedure removes the entire skin cancer, and additional treatment may be unnecessary.
If the tumor is large, the physician is more likely to remove a sample for testing and then remove the remainder of the growth if tests confirm that it is malignant. In addition to the tumor, healthy tissue around the growth may also be removed: this is done to ensure that all cancerous tissue is removed.
In some cases, lymph nodes close to the tumor may also be removed as a precaution. Once the cancer spreads to the lymph nodes, it can metastasize to other parts of the body, and surgery is no longer a viable treatment option.
Surgery is often accompanied by adjuvant therapy such as radiation therapy, biological therapy, or chemotherapy, which may be used in addition to surgery to destroy any cancer cells left behind.
Radiation therapy aims focused beams of radiation directly at the tumor. The energy beam kills tumor cells. Treatment is given over the course of several weeks. Radiation therapy is used to slow down the progression of melanoma that has spread to the internal organs, including the lungs and the brain.
Chemotherapy medications are powerful drugs that kill fast-growing cells. Tumor cells fit this category. So do certain types of healthy cells, such as hair follicles. Oral or intravenous chemotherapy is systemic (it affects the entire body). As a result, both fast-growing tumors and healthy cells are affected.
A technique called isolated limb perfusion injects chemotherapy drugs into a limb affected by melanoma, and then temporarily halts the blood flow to that limb. This allows the medication to treat the affected area with a minimum of side effects in the rest of the body.
Biological Therapy (Immunotherapy)
One form of biological therapy, or immunotherapy, uses artificially constructed cytokines to help stimulate the immune system. Cytokines are naturally occurring proteins that help activate the cells of the immune system. Immunotherapy is designed to strengthen the immune system, providing an opportunity for the body to naturally identify and destroy cancer cells.
Gene Therapy and DNA Manipulation
Gene therapy manipulates the DNA in tumor cells. Several types of DNA manipulation exist. In one type, a gene that promotes the expression of a protein recognized as “foreign” by the immune system is inserted in melanoma cells. The hope is that this type of gene therapy will make the cancer more susceptible to the body’s natural defenses.
Skin Cancer Palliative Care
Palliative care is often associated in the public mind with treatment for incurable diseases, but it is actually much more than that. Palliative care is any treatment that reduces the symptoms of a disease. Palliative care for melanoma may include pain relief or treatment to reduce the side effects of chemotherapy. Emotional support is also an important part of palliative care, and may be offered to both patients and their families.