Options for treating melanoma can include surgery, chemotherapy, radiation therapy, and/or biologic therapy depending on the size, spread, and aggressiveness of the cancer. The location of the skin cancer will also affect surgical decisions and the general health of the patient plays a major role in determining the best course of action to address melanoma.
Where the cancer is caught early it may be fairly routine in terms of removing the localised tumour and then monitoring for further signs of skin cancer. More progressed cases can involve a number of cancer treatments and a lengthy period of time during which the patient may need to stay in hospital.
Surgery for Skin Cancer
The size and depth of the melanoma will determine the appropriateness of surgery, as will the location of the cancer. The whole tumour may be able to be removed during the biopsy itself, using local anaesthetic to freeze/numb the area, or further surgery may be needed once the sample is determined to be cancerous. A margin of healthy skin is usually taken around the area of melanoma in such surgeries but where large tumours have spread further across the skin a skin graft may be required to cover the exposed area. The skin is taken from another area of the body, such as the thigh or behind the ear. A local or general anaesthetic may be used in this procedure and patients are usually required to stay in the hospital for several days after surgery.
Lymph Node Tests in Skin Cancer Surgery
Nearby lymph nodes may also be removed during surgery for skin cancer in order to check if the cancer has spread. This lymph node dissection may involve a newer procedure designed to remove fewer lymph nodes and called sentinel lymph node biopsy. Some swelling and fluid build-up after lymph node removal is common and is known as lymphoedema. Such a symptom can, unfortunately, occur months or even years after surgery, as well as immediately after the procedure.
Treating Melanoma – Chemotherapy for Skin Cancer
Chemotherapy is a common skin cancer treatment which inhibits the cancer cells’ ability to grow and spread. Unfortunately, the treatment also damages healthy cells, although healthy cells usually recover given time.
Side-effects of chemotherapy are a result of this damage to healthy cells and included nausea, vomiting, loss of appetite, hair loss, fatigue, and susceptibility to infections. Chemotherapy is unlikely to be prescribed for a patient with localised melanoma but is reserved instead for skin cancer that has spread to the lymph nodes and other organs and systems in the body.
The skin cancer treatment may be given as pills or by injections and where the melanoma is present on an arm or leg the drugs may be infused directly into that limb in a procedure called isolated limb perfusion.
Biological Therapy for Skin Cancer
Immunotherapy, or biological therapy, is a skin cancer treatment that harnesses the power of the immune system to fight cancer itself or to ameliorate the side-effects of other cancer treatments. Natural skin cancer treatments may include drugs made from the body’s natural chemicals which can then target certain cells without damaging the healthy cells. Side-effects do still occur in some patients and may include skin rashes, swelling, and flu-like illness. Such symptoms usually dissipate after treatment stops.
Radiation Therapy for Skin Cancer
Once the tumour has been identified it may be treated with radiation therapy using an external beam of radiation. The treatment damages the cells in the beam’s path (which can include healthy cells), and inhibits their growth and spread. Depending on where the skin cancer is and where the radiation is targeted, the side-effects can include hair-loss in the area of treatment, fatigue, and dry, tender, or itchy skin at the treatment site.
Melanoma that has spread to other body organs and systems may be able to be treated with radiation therapy. This type of therapy may also help address pain and other symptoms of melanoma, as well as symptoms that arise when treating melanoma.