Treatment of malignant melanoma
The main line of treatment for malignant melanoma is surgery. Other treatment modalities may or may not be added according to the stage of the disease.
To make sure that all the malignant cells are removed from the skin, the surgeon has to remove the tumor plus a rim of surrounding skin as a “Safety margin”. This is called a wide local excision.
If the patient’s lymph nodes are confirmed to contain tumor cells, they must be removed as well to prevent the tumor from recurring. This is called lymph node dissection.
A patient with an advanced Melanoma may need additional lines of treatment in conjunction with surgical removal of the tumor. These may include the use of chemotherapy. Chemotherapeutic drugs are powerful agents which break down the tumor architecture. Choosing the appropriate chemotherapeutic agent is a pretty complex process but it should be noted that these drugs are so strong that they cause damage to the body’s normal cells, resulting in some undesirable side effects. The physician weighs the pros and cons of selecting a particular drug for each patient according to the case.
Another type of adjuvant therapy is what we call immunotherapy. This method aims to stimulate the body’s immune system and to make it more aggressive towards cancer cells.
A third add-on treatment line is targeted therapy, which actually attacks the mutated genetic material present in the tumor cells, crippling their ability to replicate and survive.
Yet another line of therapy is radiotherapy. This modality depends on using high doses of ionizing radiation such as X-rays to damage and destroy the DNA present in the cancer cells, leading to tumor destruction. However, not all tumours are sensitive to this treatment.
When it comes to stage 4 metastatic Melanoma, treatment is more difficult, and the goal becomes palliative therapy. Surgery may be performed to relieve some symptoms but is not expected to cure the patient completely. Immunotherapy, targeted therapy, and chemotherapy play a more important role in metastatic disease. Regarding metastatic melanoma that affects the brain, external beam irradiation is quite effective.
