Once the stage is determined, an appropriate melanoma treatment plan can be developed for you. You should discuss all treatment options with your physician. For some people, a combination of treatments may be the best option.
Most of the removal, or excision, of the melanoma is the first thing done to begin treating the cancer. Often this can be done in your physician's office with local anesthesia with little scarring. If the melanoma is larger and requires more extensive surgery, a better cosmetic appearance can be obtained with flaps made from skin that is near the tumor, or with grafts of skin taken from another part of your body. For grafting, the skin is removed from areas that are normally or easily covered with clothing.
Today, surgeons are removing less of the healthy skin around the tumor. Based on new guidelines from the National Institutes of Health, the margins, which are the borders of the entire area to be removed, are much narrower.
Melanomas greater than 10mm in depth have potential to metastasize to lymph nodes. Surgeons can detect occult (non-evident) metastasis using a surgery called "sentinel lymph node biopsy. In this procedure, the first lymph node that the melanoma would spread to is identified using nuclear medicine and is surgically excised. If this first, or "sentinel" node, is negative, spread to other lymph nodes is unlikely. If the sentinel node is positive, further dissection of lymph nodes in the affected area is usually recommended.
Radiation therapy uses highly advanced technology and innovative treatment techniques to destroy cancer cells or to prevent diseased cells from growing.
External Beam Radiation
External beam radiation allows high doses of radiation to be directed specifically to the tumor itself, sparing healthy tissue in areas around it. Using three-dimensional treatment planning, the radiation oncologist can avoid critical structures, such as organs, while delivering the high dose of radiation to the cancer cells. This is usually used to treat melanoma that has spread to other organs. Most patients experience fatigue as a side effect of this treatment. Aurora St. Luke's has three different linear accelerators that allow our radiation oncologists to choose the optimal type of radiation for you.
With cancer, cells of the immune system are inactive (asleep), allowing the tumor to grow. Immunotherapy activates these cells to destroy cancer. One type uses cells of the immune system, which are taken out of the patient's blood and manipulated in the laboratory. Once the cells have obtained cancer-killing ability, they are given back to the patient to destroy their cancer.
Immunotherapy has been effective against two types of cancer that were previously unresponsive to other treatments─melanoma (skin cancer) and renal cell (kidney) cancer.
The Immunotherapy Program at St. Luke's was founded in 1987 and has treated over 500 patients in that time. It is one of only a few centers in the country to offer immunotherapy, and the only center in the state of Wisconsin. Lead by an expert team of physicians and researchers, the Immunotherapy Program is on the cutting edge of research and treatment for melanoma.
If you have Stage 3 or 4 melanoma, may want to consider clinical trials as a treatment option. They can give you access to new treatments that are not otherwise available. Because they are in clinical trial stage, there are risks.
Aurora Health Care gives patients access to ongoing, national clinic trials, including those sponsored by the National Institutes of Health.