More than 68,000 Americans are diagnosed each year with melanoma, according to the American Cancer Society, which notes it is the deadliest type of skin cancer. It begins in melanocytes, the cells responsible for producing melanin which gives the skin pigmentation and protects its deeper layers from the UV rays of the sun. While serious and sometimes life-threatening, if diagnosed in the early stages, chances of recovery are good. Course of treatment typically depends on the stage of the cancer however. The higher the stage, the more complex your treatment will be.
Stage Zero
Stage zero is the earliest stage to diagnose melanoma. According to the American Cancer Society, the cancer has not spread beyond the epidermis, or outer layer of skin. Treatment may consist of surgical removal of the melanoma along with 1/5 inch of healthy skin, or application of imiquimod (Aldara), a medicated cream known as an immune response modifier. Your doctor may prescribe imiquimod if surgery would cause cosmetic problems. Imiquimod may be applied once a day or up to twice a week for a period of three months. This is at the discretion of your doctor.
Stage One
During stage one melanoma, the amount of healthy skin removed removed depends on the thickness of the melanoma. If the melanoma is less than 1mm thick, the American Cancer Society states that 1cm of healthy skin should be removed with it. If the melanoma is between 1 and 2mm thick, 1 to 2cm of healthy skin should also be removed. The American Cancer Society also states that it is unnecessary to remove more than 2cm of normal skin when diagnosed with stage one melanoma.
Stage Two
Stage two brings about additional treatments due to the nature of the melanoma. More healthy skin is removed at the tumor site to start. For example, if the tumor is between 1 and 2mm, then 1 to 2cm of normal skin will also be removed. If the tumor is equal to or greater than 2mm thick, then 2cm of healthy skin will also be taken. In certain situations, the tumor may be 4mm thick. If this is the case, your doctor may recommend additional therapy or treatments after surgery to prevent melanoma recurrence.
Stage two represents the possibility of the melanoma spreading to nearby lymph nodes. As a precautionary measure, your doctor may choose to perform a biopsy of the sentinel lymph node, or the lymph node closest to the tumor. Should the results return positive, he may choose to remove all the lymph nodes in that area
Stage Three
The same type of tumor removals are performed during stage three as in stage two, however your doctor will usually remove your lymph nodes at this time as well. Depending on your individual situation, your doctor may feel that treating you with interferon, a manufactured drug that mirrors a substance produced by the body to fight infection and prevent the growth of cancer cells, will help prevent a recurrence of melanoma for a longer period of time.
Stage three also poses the threat of more than one melanoma being present. If so, they all need to be removed. In some cases this may not be an option and so your doctor may choose to treat the tumors with the chemotherapy drug melphalan or inject the sites with a a vaccine called Calmette-Guerin. For the melanomas that were removed, radiation may be ordered to ensure all cancer cells are destroyed.
Stage Four
This stage of melanoma is difficult to treat, according to the American Cancer Society. This is because the cancer has spread to various areas and organs of the body. Some cancers that have spread may be removed through surgery, while others cannot and require chemotherapy and radiation as treatment.
In many cases, doctors recommend using biochemotherapy. This is the combination of chemotherapy with either interferon or interleukin-2, another drug that naturally occurs in your immune system. It is man-made, and taking it boosts your immune system, helping it destroy cancer cells.
With current therapies, this stage of melanoma is difficult to treat and as stated by the American Cancer Society, patients may want to consider taking part in clinical trials for new cancer drugs and treatments.
