Melanoma treatment

Melanoma

Melanoma is a type of cancer that develops from melanocytes, the cells responsible for producing the pigment melanin, which gives skin its color. Although melanoma can occur anywhere on the body, it most commonly appears on the skin, making it one of the most serious forms of skin cancer. Unlike other skin cancers, such as basal cell carcinoma and squamous cell carcinoma, melanoma is particularly dangerous due to its ability to spread (metastasize) to other parts of the body, including vital organs like the lungs, liver, and brain.

Melanoma can develop in existing moles or appear as a new, unusual growth on the skin. It is often identified by changes in a mole's appearance, such as asymmetry, irregular borders, color variations, a diameter larger than 6 millimeters, and evolving shape or size. The ABCDE rule is a commonly used guideline for identifying potential melanomas. Melanomas can be brown, black, or even skin-colored, red, pink, purple, blue, or white, depending on the amount of melanin they produce.

Exposure to ultraviolet (UV) radiation from the sun or tanning beds is a major risk factor for melanoma. However, genetics also play a significant role, as individuals with a family history of melanoma, fair skin, a high number of moles, or certain genetic mutations are at increased risk. Early detection is critical for effective treatment and improving survival rates, which is why regular skin checks and professional evaluations of any suspicious lesions are essential.

Types of Melanoma

Melanoma can be categorized into several different types, each with distinct characteristics and growth patterns. Understanding these types is crucial for diagnosis, treatment planning, and prognosis.

1. Superficial Spreading Melanoma: This is the most common type of melanoma, accounting for about 70% of all cases. Superficial spreading melanoma typically begins as a flat or slightly raised discolored patch on the skin, often with irregular borders and color variations. It usually grows horizontally across the surface of the skin before invading deeper layers. This type is most commonly found on the trunk in men and the legs in women and is associated with intermittent sun exposure.

2. Nodular Melanoma: Nodular melanoma is a more aggressive form of melanoma that accounts for 15-20% of cases. Unlike superficial spreading melanoma, nodular melanoma tends to grow vertically from the start, penetrating deeper into the skin and underlying tissues quickly. It often appears as a dark, raised bump, though it can also be colorless (amelanotic). Nodular melanoma is most commonly found on the trunk, head, or neck and is more likely to spread to other parts of the body, making early detection critical.

3. Lentigo Maligna Melanoma: Lentigo maligna melanoma typically occurs in older adults, particularly in areas of the skin that have experienced long-term sun exposure, such as the face, ears, and arms. It starts as a large, flat, tan or brown patch, often with irregular borders. This type of melanoma grows slowly, sometimes over many years, before becoming invasive. While it has a slower growth rate compared to other types, it can still be dangerous if not treated early.

4. Acral Lentiginous Melanoma: Acral lentiginous melanoma is a rare type of melanoma that occurs on the palms of the hands, soles of the feet, or under the nails (subungual melanoma). It is more common in people with darker skin tones and is not associated with sun exposure. This type often presents as a dark, unevenly pigmented patch or streak and is frequently diagnosed at a more advanced stage due to its unusual location and lack of association with sun exposure.

5. Amelanotic Melanoma: Amelanotic melanoma lacks the pigment melanin, making it appear pink, red, or flesh-colored rather than the typical dark brown or black. Because of its lack of pigmentation, it can be easily overlooked or mistaken for a benign skin condition. Amelanotic melanoma can occur in any of the main melanoma subtypes and requires careful examination and biopsy to confirm the diagnosis.

6. Desmoplastic Melanoma: Desmoplastic melanoma is a rare and challenging type to diagnose, often occurring in sun-damaged areas of the skin, such as the head and neck. It is characterized by fibrous, scar-like tissue within the tumor, which can resemble a benign scar or growth. This type of melanoma tends to grow slowly but can be highly invasive and may require more extensive surgical treatment.

Treatment of Melanoma

The treatment of melanoma depends on various factors, including the stage of the cancer, its location, and the patient’s overall health. Early-stage melanomas are often treatable with surgery alone, while more advanced cases may require a combination of treatments.

1. Surgical Excision: The primary treatment for most melanomas is surgical excision, where the tumor and a margin of surrounding healthy tissue are removed. The size of the margin depends on the thickness and location of the melanoma. For melanomas that have not spread beyond the skin, surgery can often be curative. In cases where the melanoma has spread to nearby lymph nodes, these may also be surgically removed through a procedure called lymphadenectomy.

2. Sentinel Lymph Node Biopsy: For melanomas thicker than 1 mm or those with other high-risk features, a sentinel lymph node biopsy is often performed to determine whether the cancer has spread to the lymphatic system. This involves injecting a dye near the tumor site to identify the first lymph node (the sentinel node) that drains from the tumor. If cancer cells are found in this node, additional lymph nodes may be removed, and the patient may require further treatment.

3. Immunotherapy: Immunotherapy has revolutionized the treatment of advanced melanoma. This approach involves using medications to stimulate the body's immune system to recognize and attack cancer cells. Checkpoint inhibitors, such as pembrolizumab (Keytruda) and nivolumab (Opdivo), are commonly used in melanoma treatment. These drugs work by blocking proteins that prevent the immune system from attacking melanoma cells, thereby enhancing the body's ability to fight the cancer. Immunotherapy has been shown to significantly improve survival rates in patients with advanced melanoma.

4. Targeted Therapy: Targeted therapy is used to treat melanomas with specific genetic mutations, such as the BRAF mutation, which is found in about 50% of melanoma cases. Drugs like vemurafenib (Zelboraf) and dabrafenib (Tafinlar) target the abnormal proteins produced by these mutations, inhibiting the growth and spread of cancer cells. These treatments are often combined with MEK inhibitors, such as trametinib (Mekinist), to improve effectiveness. Targeted therapy has proven to be particularly effective in shrinking tumors and prolonging survival in patients with metastatic melanoma.

5. Radiation Therapy: Radiation therapy uses high-energy rays to kill cancer cells and shrink tumors. It is not typically used as a primary treatment for melanoma but may be employed in specific situations, such as when the cancer has spread to the brain, bones, or other areas where surgery is not feasible. Radiation can also be used as an adjunct treatment after surgery to reduce the risk of recurrence.

6. Chemotherapy: While chemotherapy is less commonly used in melanoma treatment today, it may still be an option for certain patients, particularly those whose melanoma has not responded to other treatments. Chemotherapy drugs, such as dacarbazine (DTIC) and temozolomide, work by killing rapidly dividing cancer cells. However, due to the emergence of more effective treatments like immunotherapy and targeted therapy, chemotherapy is generally reserved for specific cases.

7. Clinical Trials: Clinical trials are a critical part of melanoma research and treatment. They offer patients access to new and experimental therapies that are not yet widely available. Participation in a clinical trial may provide an opportunity to receive cutting-edge treatments that could be more effective than standard therapies. For patients with advanced or treatment-resistant melanoma, clinical trials can be an important option to explore.

8. Follow-Up and Monitoring: After treatment, regular follow-up care is essential to monitor for signs of recurrence or new melanoma development. This typically includes routine skin exams, imaging tests, and blood work. Patients are also advised to practice diligent sun protection, perform regular self-examinations, and report any new or changing skin lesions to their healthcare provider promptly.

Why should you trust the Herzliya clinic (Israel)?

Despite the serious diagnosis, many are interested in the question: how much does the removal operation cost melanoma? We hasten to please you that the price in the clinic Herzliya Medical Center (Israel) is quite affordable for Ukrainians, the cost of treatment will vary, depending on the necessary manipulations:

diagnosis,

surgery to remove melanoma ;

chemotherapy (radiation, targeted):

immunotherapy;

supervision of specialists.

Highly qualified doctors select treatment personally, according to the stage of the disease. You can find out more by leaving a request on the clinic's website medlogist.com/oncology/melanoma. Here you can also read real patient reviews regarding the effectiveness of the proposed treatment for melanoma, removal of malignant tumors, as well as other manipulations that are carried out at Herzliya Medical Center.

Remember that health is the main value in the life of every person and in it depends a lot on timely access to specialists!