Treatment is determined by the stage of melanoma. Early stages of melanoma—in which the disease has not spread—can typically be treated with surgery to remove the cancerous cells and some surrounding tissue. A sentinel lymph node biopsy (SLNB) may be used to determine if the cancer has spread to the nearby lymph nodes. Cancer that has spread to lymph nodes may require the complete removal of the lymph nodes as well.
In addition to surgery, other forms of treatment, depending on the stage of melanoma, include:
- radiation therapy
- clinical trials (vaccines)
FDA-approved drugs for the treatment of melanoma include:
- aldesleukin (Proleukin)
- dacarbazine (DTIC-Dome)
- ipilimumab (Yervoy)
Breakthrough Drug: Yervoy
In March 2011, the Food and Drug Administration (FDA) approved the use of Yervoy (ipilimumab) for the treatment of melanoma. Clinical trials, in which vaccines were administered to Stage III and IV melanoma patients, revealed some progress in destroying the cancer and prolonging survival. A 2010 article in The New England Journal of Medicine reported promising findings from ipilimumab to treat advanced melanoma patients. Researchers concluded that the “trial showed significant improvement in overall survival among patients with metastatic melanoma,” with an average survival rate of 10 months.
Yervoy works by over-stimulating the immune system. It does this by blocking CTLA-4, a molecule that prevents the immune system from over-functioning. By blocking CTLA-4, Yervoy allows the immune system to identify and attack melanoma cells. Yervoy does have side effects, which include itching, skin rash, and diarrhea (all results of an overactive immune system). There is the risk of more serious side effects, which includes inflammation of the intestines, liver, and nerves.
A breakthrough in melanoma treatment, ipilimumab still requires more research to determine how best to administer the drug and which patients are best-suited to receive it. Doctors are examining whether to use ipilimumab alone, or in combination with other therapies.
Clinical trials allow doctors to determine if a new treatment is safe and effective. Due to their experimental nature, clinical trials may pose risks to patient health. Clinical trials are not standard treatments; they are studies aimed at improving the survival rate for patients, and require further research and testing. Patients should always discuss the risks and benefits before committing to a medical study.
There are various types of clinical trials, including gene therapy, targeted therapy, and other forms of immunotherapy, directed at treating advanced cases of melanoma.
Immunotherapy, a rapidly advancing field of medicine, includes several experimental vaccines. The vaccines are not considered a form of regular treatment; however they offer promising steps toward fighting off or slowing the progression of melanoma.