At relapse of melanoma are various treatment options in the hospital Assuta. The tumor may be in the same place where the original hearth (local recurrence), or in another part of the body (metastatic melanoma).
Local recurrence is shown as follows:
- localization becomes scar after excision of malignancy;
- metastases develop satellite - within 2 cm from the original tumor;
- transient metastases - involve the skin or the subcutaneous tissue at a distance of 2 cm from the primary neoplasm or a scar.
In patients with local recurrent melanoma there is a low level of survival. The disease can come back after a few months or even years after surgical removal of the primary tumor.
Relapse in a remote location identified as "metastatic melanoma," which means that the cancer has spread. Secondary foci - a new tumor that develops elsewhere in the patient's body, either simultaneously or after complete removal of the initial focus. All patients diagnosed with melanoma has a risk of developing these tumors. It increases if there are atypical moles (dysplastic nevi) or a family history of melanoma.
Treatment at the clinic Assuta developed taking into account the individual characteristics of each patient.
Surgery for recurrent melanoma
Surgery used to treat recurrent melanoma.
Re-excision is performed to remove the tumor, which arose in the place of the original focus or scar after resection.
Surgical intervention may be recommended in malignant formation, which recurred in the skin (satellite or transient metastases) or to lymph nodes. If melanoma is inoperable, it may be considered the use of isolated perfusion or infusion limb.
Operations carried out to remove tumors in the brain, liver, lung, intestine, and subcutaneous tissue of the pancreas, in the absence of other metastases. Pre performed a thorough diagnostic tests for the presence of other lesions by CT, MRI and PET.
Relapse of melanoma - the chemotherapy
Chemotherapy used to treat unresectable recurrent melanoma in order to control the growth and spread of cancer. It can also help prolong life and relieve symptoms (palliative chemotherapy) in the later stages of the disease. The most common drugs used in clinic Assuta: dacarbazine (DTIC), and temozolomide (Temodal) (melanoma metastases in the brain).
Regional chemotherapy for recurrent melanoma
Regional chemotherapy is prescribed for metastases in the lymph nodes, transient outbreaks, recurrent in the arms or legs, which can not be surgically removed. Most often used melphalan (Alkeran, L-PAM).
This type of treatment of melanoma in Israel may include isolated perfusion or infusion limb.
Targeted therapy for recurrent melanoma
The indications for targeted therapy of melanoma is inoperable metastatic melanoma. Supplementation is made orally. Appointed by the following types of medicines: vemurafenib (Zelboraf), dabrafenib (Tafinlar), trametinib (Mekinist).
Biological therapy for recurrent melanoma
Biological therapy may be offered to patients with advanced melanoma not amenable to surgical treatment. Immunotherapy involves the use of the following drugs:
- BCG - at local or regional metastases. It is administered directly into the tumor. Characterized lower toxicity as compared with systemic therapy.
- Interleukin-2 (Aldesleukin, Proleukin) - for the treatment of local recurrence of melanoma in the arm or leg. Injections are made in the affected area. For the drug is characterized by fewer side effects than regional chemotherapy. In addition, there is no need to perform the procedure in a specialized center. Interleukin-2 may be assigned as a systemic treatment, in the form of infusion.
- Ipilimumab (Yervoy) - monoclonal antibody for the treatment of advanced or metastatic melanoma. Administered in the form of an intravenous infusion.
Radiation therapy for recurrent melanoma
Teletherapy used in melanoma, which recurs in the skin and subcutaneous tissue, and the lymph nodes after surgery. It is recommended for the treatment of advanced cancer stages and control symptoms. Stereotactic radiotherapy is carried out at unresectable brain metastases.
Clinical trials for recurrent melanoma
Patients with melanoma offer the opportunity to participate in clinical trials. More information can be found at the clinic doctors.