Melanoma is the most dangerous form of skin cancer. In stages I and II, melanoma may be effectively treated with surgical removal of the lesions.
However, in stage III the melanoma has spread to the lymph nodes that are located close by the lesion. In stage IV, it has spread to lymph nodes that are farther away and to other internal organs. Advanced stages of melanoma are more difficult to treat.
According to MD Anderson Cancer Center, about 8 percent of patients with melanoma are diagnosed as stage III. They have a 5-year relative survival rate of about 62 percent.
Patients who present with stage IV, metastatic disease, have a 5-year survival rate of only about 16 percent. Only 4 percent of melanoma patients are diagnosed as stage IV.
In stage III, removal of the lesion and a wide area of normal skin surrounding the lesion is standard treatment. Lymph nodes will also be removed in the area close to the melanoma site.
Depending on what subclass of stage III melanoma has been determined, various therapies may be tried.
Immunotherapy with Interferon may be used as an added protective measure. If there are several melanomas then other immunotherapies such as a Bacille Calmette-Guerin (BCG) vaccine, interferon-alpha, or interleukin-2 (IL-2) may be tried.
Some immunotherapies have serious side effects so may not be appropriate for everyone.
Targeted therapy is a method of treating the gene changes that make skin cells turn into melanoma cells. Targeted therapy may work when chemotherapy doesn’t, and it may have fewer side effects.
Half of melanoma changes come from mutations of the BRAF gene. Drugs can target this gene if a person’s BRAF gene shows abnormalities. Use of other drugs can affect the MEK gene and C-KIT gene.
Radiation therapy uses high energy x-rays and may be used in areas where lymph nodes were removed, to treat recurrent melanoma or to shrink tumors to increase comfort.
Stereotactic radiosurgery (SRS) is a special radiation therapy that is used to treat brain tumors.