Melanoma is a type of skin cancer that originates from the pigmented cells in the skin. It is more aggressive than other types of skin cancer, and typically starts from a pigmented mole located somewhere on the skin. Once melanoma is diagnosed, a physician determines the stage of the cancer according to how far the cancer has spread. There are several types of treatments available for patients with advanced melanoma, or melanoma in which the cancer has spread beyond the skin.
Surgery
Surgery may not be an option for all patients with advanced melanoma. However, if there is one metastasis--or cancer that has spread to another part of the body--in an easily accessible location, or if removing some of the metastases might improve the quality of life of a patient, a surgeon may undertake that procedure, according to the American Cancer Society. In advanced melanoma, surgery is not likely to cure the patient.
Chemotherapy
Chemotherapy drugs are used to kill fast-growing cells like cancer cells. Chemotherapy is useful for treating cancer that has spread, because the medication travels throughout the entire body; it is usually administered by mouth or by vein. According to the American Cancer Society, chemotherapy is not as effective for advanced melanoma as it may be for other cancers. Dacarbazine is a chemotherapy drug that has been approved for the treatment of advanced melanoma. If the melanoma only involves an arm or leg, sometimes doctors will infuse the chemotherapy strictly to that limb to avoid systemic--or entire body--side effects. Chemotherapy side effects include hair loss, sores in the mouth, loss of appetite and/or fatigue.
Immunotherapy
Immunotherapy uses the immune system to attack the cancer cells. There are several types of immunotherapy that can be used for melanoma, such as interferon-alpha, which is a substance that kills tumor cells; vaccines that try to boost the immune system to kill the cancer cells; and an antibody called ipilimumab which destroys a chemical in the body that allows cancer cells to spread. A study published in the June 2010 issue of the "New England Journal of Medicine" showed that ipilimumab improved survival for patients with advanced melanoma. Side effects depend on the type of immunotherapy, and include nausea, diarrhea and liver problems.
Radiation Therapy
High-energy light is used to kill cancer cells in radiation therapy. Radiation therapy is not used to treat the initial tumor, but it may be used to treat metastases or recurrent melanoma tumors. Each radiation treatment itself does not take very long, and the preparation and setup for the procedure can take a while longer, according to the American Cancer Society.
Targeted Therapy
Targeted therapy uses knowledge about the mechanisms of cancer cell growth to specifically attack the cancerous cells. Various types of targeted therapies are being studied in clinical trials as of 2010, usually in combination with other types of treatments. According to a 2009 article published in "Biologics: Targets & Therapy," some targeted agents include sorafenib, which stops cells growth by affecting blood vessels, and bevacizumab, which disrupts blood vessel formation. Side effects depend on the specific targeted therapy.
References
- American Cancer Society: How Is Melanoma Treated?
- The Skin Cancer Foundation: Melanoma Treatment
- "Biologics: Targets & Therapy"; Targeted therapy in melanoma; Tawbi H, Nimmagadda N; October 2009
- "The New England Journal of Medicine"; Improved Survival with Ipilimumab in Patients with Metastatic Melanoma; Hodi FS, et al.; June 2010
