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Health February 2015

Aid for Age

Melanoma Care and Treatment Advancing Rapidly

By Tait Trussell

But he was lucky enough to be diagnosed in 2008. Surgery gave him enough time to make it to 2010, when an incredible transformation of melanoma care began.

Scientists have developed breakthrough drugs that cure skin cancer. The treatment is already having “spectacular” effects in seriously ill melanoma patients. It could soon be used to defeat other types of cancer in Britain, according to British scientists.

One scientist said it was amazing that researchers could talk of “using the C-word – cure –  for the first time,” while another said trials among kidney and lung cancer patients are “very exciting.”

It was reported in Britain that a former hotel and restaurant owner, developed an unusual type of a rare skin cancer that strikes only about 500 Americans a year. By the time doctors found it, the cancer had spread beyond the tumor in his nose. When the patient was diagnosed, doctors had only three treatments to choose from for stage 4 melanomas like his, none of which had been shown to extend lives. Only four in 25 patients survived five years.

But he was lucky enough to be diagnosed in 2008. Surgery gave him enough time to make it to 2010, when an incredible transformation of melanoma care began. Since then, four new treatments for advanced melanoma have won federal approval, another two are likely to be approved fairly soon, and a few more are working their way through the process the Food and Drug Administration indicates.

Millions of Americans — young and old — will be exposed to melanoma if they are exposed to the sun’s rays too long. This seismic shift in melanoma care — largely brought about by enlisting the immune system in the fight could eventually be used to treat other cancers. Smoking-related lung cancers, among others, are now starting to respond to similar treatments, according to researchers.

“We really are in a historical time right now,” said Dr. F. Stephen Hodi, director of the Melanoma Treatment Center at the Dana-Farber Cancer Institute. “Cancer treatment five years ago compared to five years from now — it’s going to be completely different, a spokesman from Dana-Farber said. The payoff has come from decades of basic research that led to a fuller understanding of the genetics of cancer and how tumors interact with a patient’s immune system.

In many cancers now are so-called targeted therapies, to attack tumors that have specific genetic mutations. Many advanced melanomas have mutations in a gene called BRAF. It is involved in cell growth, division, communication, and death, the scientists said. Different types of treatment are available for patients with melanoma. Some treatments are standard (the currently used treatment).

Some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or dig up information on new treatments for cancer patients. When clinical trials show that a new treatment is better than the standard one, new treatments are open only to patients who have not started treatment.

Surgery to remove the tumor is the primary treatment for all stages of melanoma. The doctor may remove the tumor using the following operations, for those interested in the different treatments.

  • Wide local excision: Surgery to remove the melanoma and some of the tissue around it. Some lymph nodes may also be removed.
  • Lymphadenectomy: A surgical procedure whereby the lymph nodes are removed and a tissue sample is checked under a microscope for cancer.
  • Sentinel lymph node biopsy is the removal of the sentinel lymph node (the first lymph node the cancer is likely to spread to from the tumor) during surgery. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, he may not have to remove more lymph nodes.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by blocking them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the whole body. When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly attack the cancer cells in those areas.

You have radiotherapy treatment in the hospital radiotherapy department. For advanced melanoma, a single treatment or a few treatments may be appropriate. For radiotherapy after surgery you may have a course of treatments a week for a number of weeks. You usually have the treatment once a day from Monday to Friday. The amount of treatment you have depends on the cancer.

The essential thing to remember is: Don’t stay in the sun too long and avoid melanoma altogether.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

Meet Tait