Melanoma is a serious form of skin cancer, and it requires prompt treatment to ensure the best possible outcomes. At the OSUCCC – James, our team of experts provides the latest advancements in melanoma cancer care. From leading-edge surgical techniques to innovative therapies, we offer the latest in personalized treatment approaches.
With a focus on individualized, comprehensive, compassionate care, we strive to support you during every step of your cancer journey.
Treatment for melanoma
There are several types of treatment for melanoma, including many new U.S. Food and Drug Administration (FDA)-approved therapy drugs. The OSUCCC – James team of subspecialists will determine the best treatment for you based on your individual needs. You may receive one treatment or a combination of treatments.
The OSUCCC – James offers highly specialized treatments for those who have been diagnosed with melanoma, including:
Surgery
Surgery is used most often to treat melanoma. The OSUCCC – James surgical oncologists may perform one or more of the following procedures:
Wide local excision
Our surgical oncologists will remove the melanoma and some of the healthy tissue around it. Nearby lymph nodes may also be removed.
Sentinel lymph node biopsy
During a sentinel lymph node biopsy, the surgeon removes only the first lymph node or nodes in which melanoma likely has spread and analyzes samples from the nodes for signs of cancer. The cancerous lymph nodes are identified using a special injected dye.
Lymphadenectomy
During this procedure, lymph nodes are removed and a specially trained OSUCCC – James pathologist will analyze the lymph node tissue under a microscope for signs of melanoma.
Mohs surgery
Mohs surgery is a surgical technique in which layers of cancer-containing skin are removed by a specially trained doctor, usually a dermatologist. As layers are removed, they’re examined under a microscope until only cancer-free tissue remains. This procedure ensures the complete removal of melanoma while preserving as much of the healthy tissue as possible.
Reconstruction
Depending on the amount of skin and tissue that must be removed to treat the melanoma, sometimes the surgeon will need to complete extra steps in the operating room to help close the area where the cancer was removed. Reconstruction options include:
- Skin grafting: Healthy skin from another part of the body is used to replace skin that is removed to cover the wound from melanoma surgery.
- Flap reconstruction: This means that nearby skin and tissue is rearranged and repositioned to close the incision. Sometimes your surgical oncologist will perform this part of the operation, and sometimes a separate plastic/reconstructive surgeon will be involved.
- Simple healing: Sometimes the best option is just to let your own skin grow over the melanoma removal site.
Cryosurgery
During cryosurgery, liquid nitrogen is used to destroy and freeze cancerous skin cells. This procedure is usually limited to specific subtypes of melanoma.
Intralesional therapies
This includes T-VEC, which is an injectable immunotherapy that kills tumor cells in melanoma patients.
Immunotherapy
Immunotherapy, also called biologic therapy, helps boost a person’s immune system to fight cancer. Your immune system helps protect your body against infection and diseases. In immunotherapy, substances made by the body or made in a laboratory are used to stimulate your immune system to attack cancer cells.
Today, checkpoint inhibitors, a type of immunotherapy, are used to help your immune system find and attack cancer cells by blocking the signals that stop the immune system from working properly. Checkpoint inhibitors block specific proteins called “checkpoint proteins.” This treatment blocks proteins that signal the immune system to stop attacking, enabling it to fight off cancer cells. For melanoma, PD-1 checkpoint inhibitors can be used alone or with anti-LAG3 or anti-CTLA4 inhibitors.
Tumor infiltrating lymphocytes (TIL) therapy
Tumor-infiltrating lymphocytes (TIL) therapy is a form of cell therapy treatment for advanced melanoma. It uses your own immune cells, called lymphocytes, to fight off cancerous cells. Doctors take these lymphocytes from your tumor (which already know the location of your tumor and how to fight it) and grow more of them in a laboratory setting. These cells are then reintroduced into your body, along with immunotherapy, to help fight the cancerous cells found in melanoma.
TIL therapy aims to boost the body’s natural ability to fight melanoma more effectively. This treatment has shown promising results.
Targeted therapy
Our bodies are made of cells. Cells have “instructions” called DNA which tell cells how to grow and replicate. Over time, the DNA in these cells can change. When this happens, it’s called a mutation. Melanoma cells often have mutations in them.
In advanced cases of melanoma, targeted therapies may be a treatment option. Targeted therapies are designed to identify, target and attack specific cancer cells while sparing normal, healthy cells. Some targeted therapies can “correct” the growth signal from these mutations so the melanoma either stops growing or shrinks.
There are two important genetic mutations that scientists have found in melanoma tumors. To “fix” these mutations, doctors may use specific targeted therapies. One of these uses drugs called BRAF inhibitors. Doctors combine BRAF inhibitors with other drugs called MEK inhibitors. Using both drugs together works better than just using one alone. Your doctor may use different treatments depending on your individual needs.
These drugs tend to have less severe side effects and are usually better tolerated than chemotherapy drugs.
Radiation therapy
Radiation therapy uses high-energy X-rays or other types of radiation targeted directly at the cancer cells to destroy those cells or keep them from growing. A person with melanoma may receive radiation therapy before or after surgery to remove tissue or a tumor. Radiation can shrink a tumor to make surgery more successful, and it’s delivered to the tumor to prevent damage to surrounding healthy tissue.
Chemotherapy
In select cases, chemotherapy may be used in conjunction with other melanoma treatments. It’s usually used after immunotherapy or other targeted therapies fail. Chemotherapy drugs stop cancer cell growth by either destroying the cells or by preventing them from dividing and making new cells. Chemotherapy may be given several ways, but is usually given by mouth, injected into a vein (intravenously) or placed directly into an organ or body cavity.
Clinical trials
The OSUCCC – James has more than 500 open clinical trials at any given time, with some of the world’s latest discoveries available to those with melanoma, right here in Columbus, Ohio.
The OSUCCC – James is one of only a few comprehensive cancer centers funded by the National Cancer Institute (NCI) to conduct phase I, phase II and phase III clinical trials on novel anticancer drugs. These trials go only to centers that demonstrate an exemplary capacity for research and clinical care, the expertise to deliver the latest in treatments and the infrastructure to interpret and track treatment results.
If you’ve been diagnosed with melanoma or would like a second opinion, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.