Patient Resources

Melanoma

OVERVIEW

Melanoma is the most serious type of skin cancer. In 2007, the American Cancer Society estimates that about 60,000 men and women will be diagnosed with melanoma. Melanoma begins in the cells that produce skin coloring (melanocytes). The disease is almost always curable in the early stages, but frequently spreads to other parts of the body. Melanoma accounts for about only four percent of skin cancer cases, but it causes about 79 percent of skin cancer deaths.

The best way to prevent melanoma is to limit unprotected exposure to the sun. When you are out in the sun, remember to wear a wide-brimmed hat, use sunblock, and limit your time in the sun to before 10 a.m. and after 3 p.m.

If detected early, when it is localized, melanoma is highly curable. The five-year survival rate for localized melanoma is 98 percent. The five-year survival rate for all stages combined is 92 percent. If you are diagnosed with melanoma, dermatologists and other skin cancer experts at The Cancer Center at Hackensack University Medical Center are highly skilled in providing several treatment options. Researchers in the Division of Sarcoma and Skin Cancer are also conducting innovative research using cellular medicine techniques to treat melanoma that has not responded to standard treatments. This treatment for melanoma skin cancer can include cancer vaccines and combinations of chemotherapy, gene therapy, and hormonal therapy.

The Cancer Center features:

  • board-certified dermatologists and surgeons skilled in Mohs surgery, laser surgery, cryosurgery, and other surgical options
  • clinical research studies that are investigating new types of treatment for melanoma skin cancer
  • a full range of support services

 

RISK FACTORS

Exposure to ultraviolet radiation present in sunlight and artificial sources such as tanning booths and sun lamps puts you at risk for melanoma. Other risk factors include:

  • fair skin, especially if you freckle or burn easily (The rate of skin cancer is 10 times higher for Caucasians than dark-skinned African-Americans.)
  • being male
  • age, the rate for melanoma in a 70-year-old person is double that of a 45-year-old
  • family history (about 10 percent of all cases)
  • chemical exposure (especially arsenic)
  • long-term or severe skin inflammation or injury
  • treatment for psoriasis
  • a weakened immune system

 

SYMPTOMS

Melanoma most often appears on the trunk of fair-skinned men and on the lower legs of fair-skinned women, but it can appear in other places as well. Symptoms include:

  • any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot
  • scaliness, oozing, bleeding, or a change in the appearance of a bump or nodule
  • the spread of pigmentation beyond its border
  • a change in sensation, itchiness, tenderness, or pain

 

TREATMENT SERVICES

There are a number of treatment approaches, which include surgery, radiation therapy, chemotherapy, isolated limb perfusion, and immunotherapy using cancer vaccines.

Surgery

Surgery is the most common primary treatment for melanoma skin cancer. The type of surgery used depends on the size of the tumor, the location, whether it has spread to nearby or distant areas of the body, and the patient's overall health:

  • simple excision (tumor and some surrounding normal tissue are removed)
  • wide excision (tumor is removed after biopsy)
  • amputation (if a finger or toe is involved)
  • lymph node removal (if melanoma has spread)
  • surgery for metastatic melanoma (removal of tumors in lungs, brain, or other organs to extend life or improve the quality of life)

Radiation Therapy

Radiation therapy is not commonly used to treat primary melanoma tumors, but it may be used to treat tumors that recur either in the skin or lymph nodes. It may also be used to treat tumors that cannot be removed with surgery or tumors that have spread to distant locations of the body. The main role of radiation therapy in the treatment of melanoma skin cancer is palliative care to temporarily relieve symptoms caused by metastases to the brain and/or bones. Stereotactic radiosurgery - a same-day treatment that uses precise beams of radiation therapy to destroy tumors - may also be used to treat melanoma that has spread to the brain.

Chemotherapy

Chemotherapy may be used to treat stage IV melanoma, to relieve symptoms, or to extend survival. Combinations of chemotherapeutic drugs are often more effective. Chemotherapy may also be combined with immunotherapeutic drugs (interferon-alpha and/or interleukin-2) to encourage a patient's own immune system to recognize and destroy cells. Researchers at The Cancer Center are also investigating the use of a combination of chemotherapy, gene therapy, and hormonal therapy to treat melanoma that has not responded to standard treatments.

Isolated Limb Perfusion

Isolated limb perfusion is an experimental treatment that is sometimes used to treat metastatic melanoma when it is confined to the arms and legs. This treatment involves separating the circulation of the involved limb from the rest of the body. High doses of chemotherapy are then injected into the artery that feeds the limb.

Immunotherapy

Our  Chief of Cutaneous Malignancy, Andrew L. Pecora, M.D., is currently conducting clinical trials using innovative immunotherapy techniques to treat melanoma that has not responded to standard treatments. These studies involve vaccines using PV701, a virus that safely stimulates a patient's own system to fight the melanoma. Dr. Pecora is also investigating the use of patients' own melanoma cells that have been genetically altered to attack the cancer. Another treatment under study is a combination of chemotherapy (to destroy the patient's own immune system), gene therapy (putting the patient's own cells back into the body after they have been genetically altered to fight cancer), and hormonal therapy (using interleukin-2 hormones to keep the new cells active and fighting).