Treatment for Melanoma

Treatment will vary amongst individuals depending on the progression and severity of the original melanoma tumour, as well as the individual needs of the patient. Melanoma is more likely to be cured if treatment can be administered in its early stages. The main treatments for malignant melanoma, however, are surgery, radiotherapy and chemotherapy, surgery being the primary and often the only necessary treatment.

Surgery –

Melanomas are always removed by surgery. Depending on how deep the melanoma has progressed into the skin, the patient may be admitted into hospital so that the tumour can be cut out, along with a safety margin of normal skin around the tumour, varying between 5 millimetres to 2 centimetres. This is a safety precaution to remove any cancerous cells in the surrounding skin and to prevent the melanoma from relapsing at that site.

A patient may or may not require a skin graft, which involves the removal of a layer of skin from another part of the patient’s body and positioning it over the wound (original site of melanoma). Another option involves the surgeon closing the wound using a flap of skin nearby. However, most patients complete the surgery without requiring a skin graft or ‘flap’.

After the operation, the patient’s wounds would be dressed and then checked for healing after several days. There is always a risk of infection, haematoma and scarring after surgery for melanoma. Areas of skin graft will eventually heal and the redness will fade; occasionally if a skin graft fails further treatment will be required to correct it.

Lymph node biopsy and dissection –

If it is believed that the cancer has spread to the patient’s lymph nodes, the patient may do one of the following biopsies:

A fine needle aspiration biopsy – involves a doctor inserting a needle into the suspected lymph node and drawing tissue into a syringe, which will then be sent to a lab to be examined. If the node is found to contain cancer cells under microscope, the node/s may be surgically removed.

A sentinel node biopsy – a dye and a weak radioactive substance is injected into the melanoma site. After an hour, a hand-held machine called a ‘counter’ will be able to detect the sentinel lymph nodes that drain fluid from the melanoma site by locating the radioactivity, and the detected nodes (now stained) can then be checked for cancer and be removed accordingly.

Radiotherapy –

This involves using radiation to destroy or injure the melanoma (cancerous) cells. Depending and the size and type of the melanoma and the general health of the patient, treatment may be administered about once a week for several weeks. The treatment itself takes only a few minutes. Side effects may include reddening of the treated skin.

Chemotherapy –

Chemotherapy is usually used as a palliative treatment, and is taken up when the melanoma has spread and surgery is no longer an effective option. Chemotherapy would involve the intravenous injection of anti-cancer drugs, usually a combination of several. This hopefully will kill the cancer cells while leaving the patient’s healthy cells unharmed. Taking tablets is another option in chemotherapy. Side effects vary and can include nausea, vomiting, lethargy, feeling unwell and thinning or loss of hair from body or head. These effects, however, are temporary and with modern treatment can be prevented or diminished.

Maria Nguyen