Melanoma Health Article

Treatment

The cancerous skin cells and a portion of the normal surrounding skin usually have to be surgically removed. A procedure called surgical lymph node biopsy may be necessary, to check if the cancer has spread to nearby lymph nodes. If it has, these lymph nodes may also need to be removed. A skin graft may be necessary after the surgery if a large area of skin is affected.

Only the smallest and most shallow melanomas can be cured by surgery alone, so early diagnosis is very important. Radiation therapy, chemotherapy, or immunotherapy (use of medications that stimulate the immune system, such as interferon) may be recommended in addition to surgery.

If the skin cancer is deeper than 4 mm or the lymph nodes have cancer, there is a high risk of the cancer spreading to other tissues and organs. Treatment with interferon after surgery may be useful for these patients. Studies have suggested that interferon improves the overall chance of cure by approximately 10%.

However, interferon has many side effects and is sometimes difficult to tolerate. Patients with high-risk melanomas should consider enrolling in clinical trials. These are research studies of new medications or other treatments.

For patients with melanoma that has spread beyond the skin and lymph nodes to other organs, treatment is more difficult. At this point, melanoma is usually not curable. Treatment is usually directed at shrinking the tumor and improving symptoms. Both chemotherapy and use of interferon or interleukin may be tried. These patients also should consider participating in clinical trials.

Support Groups

For additional resources, see cancer support group.

Expectations (prognosis)

Treatment success depends on many factors, including the patient's general health and whether the cancer has spread to the lymph nodes or other organs.

If caught early, melanoma can be cured. The risk of the cancer coming back increases with the depth of the tumor -- deeper tumors are more likely to come back. If the cancer has spread to lymph nodes, there is a greater chance that the melanoma will come back.

For melanoma that has spread to other tissues and organs, the cure rate is low. Melanoma that has spread may lead to death.

Complications

Complications of melanoma include the following:

• Spread to other organs
• Damage to deep tissue
• Side effects of treatment
  • Nausea
  • Hair loss
  • Fatigue
  • Pain

Calling your health care provider

Call your health care provider if you notice any symptoms of melanoma, particularly the following:

• If any existing skin growth changes in color, size, or texture
• If an existing lesion develops pain, swelling, bleeding, or itching

Prevention

Protect yourself from the sunlight's damaging ultraviolet rays. This includes the following:

• Applying a sunscreen with SPF 15 or higher, every day (during winter months as well)
• Wearing protective clothing, including hats and sunglasses
• Refraining from intentionally lying in the sun or using tanning devices
• Minimizing sun exposure
  • Especially during the summer
  • Particularly between the hours of 10:00 a.m. and 2:00 p.m.

References

Geller AC. Screening, early detection, and trends for melanoma: current status (2000-2006) and future directions. J Am Acad Dermatol. Oct. 1, 2007; 57(4): 555-72; 573-6