Melanoma

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Treatments for locoregional melanoma skin cancer

The following are treatment options for locoregional melanoma skin cancer. Locoregional melanoma skin cancer means the cancer has spread to nearby lymph nodes, or it has spread to nearby areas of skin (satellite tumours) or lymph vessels (in transit metastasis). This includes any stage 3 melanoma skin cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery

Surgery is a standard treatment for locoregional melanoma skin cancer.

Wide local excision is done to remove the tumour and a small amount of healthy tissue around it (called the surgical margin). The size and depth of the surgical margin depends on how thick the tumour is and where it is located on the skin.

Complete lymph node dissection is done to remove a group of lymph nodes. It is usually done if the doctor feels any enlarged lymph nodes and a lymph node biopsy or imaging tests show that lymph nodes contain cancer cells. It may also be done if a sentinel lymph node biopsy shows there are cancer cells in the sentinel lymph node (or lymph nodes). A complete lymph node dissection can be done at the same time as the wide local excision or during a second surgery. The type of lymph node dissection done depends on which and how many lymph nodes contain cancer.

Reconstructive surgery may be done if a large area of skin has been removed when the doctor wants to make sure the cancer is completely gone. Reconstructive surgery repairs the skin and nearby area after melanoma skin cancer is removed. The doctor takes a piece of skin from another part of the body, called a skin graft or skin flap, to rebuild the area.

Immunotherapy

You may be offered immunotherapy for locoregional melanoma skin cancer. It is used after surgery to lower the risk of the cancer coming back (recurring). Interferon alfa-2b (Intron A) is the immunotherapy drug used. High doses of the drug are given by injection several days each week for 1 year.

Radiation therapy

Radiation therapy may be offered after surgery for certain cases of locoregional melanoma skin cancer. It is used to lower the risk of the cancer coming back in the same area where the cancer was removed (local recurrence) if:

  • cancer cells are still in the surgical margin around the tumour but more surgery is not possible
  • it is desmoplastic melanoma
  • the tumour is more than 4 mm thick, especially when there is ulceration
  • the melanoma skin cancer is on the head or neck, especially when it is mucosal melanoma

External beam radiation therapy is aimed at the area of skin where the cancer and lymph nodes were removed. It is usually given daily for several weeks.

Clinical trials

Some clinical trials in Canada are open to people with melanoma skin cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

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