Melanoma Therapy

Most melanoma skin cancer tumors are treated surgically. Adjuvant therapy refers to medication or therapy provided after the surgical removal of the tumor. Adjuvant therapy is used to prevent recurrences of melanoma, and to kill cancer cells that may have escaped surgical removal.

Interferon-Alpha 2b

Interferon-alpha 2b is an immune system modulator: the medication stimulates the immune system, making it a more effective cancer defense. Interferons are naturally occurring proteins that bind to cells and produce specific immune system responses. The proteins suppress a cell’s ability to replicate, slowing cancer growth. Interferon also enhances phagocytic immune cells — white blood cells, such as macrophages, that surround and engulf foreign bodies. In addition, interferon increases the cancer-fighting properties of lymphocytes, another form of white blood cells.

Interferon is the only adjuvant therapy proven in clinical trials to increase melanoma survival rates and prevent the cancer’s recurrence. The FDA has approved interferon for use in patients with a high risk of melanoma recurrence.

Interferon therapy lasts a year, and bears a high risk of side effects. Almost all people who take interferon experience symptoms similar to the flu. Twenty to thirty percent experience chronic fatigue, sometimes so debilitating that they are forced to stop taking the medication. An additional two to ten percent develop psychological difficulties, most commonly depression and anxiety.

Side effects can be managed, however. Flu-like symptoms are managed by altering interferon medication levels. Antidepressants may be required for associated psychological difficulties. Chronic fatigue is perhaps the most problematic side effect. Clinical trials are investigating the use of methylphenidate as a treatment for fatigue.

Radiation Therapy, Lymph Nodes, and Metastases

Radiation therapy is not usually used as adjuvant therapy for melanoma, although it is occasionally used when metastases have been detected in the lymph nodes. However, its ability to prevent melanoma recurrence and the spread of cancer through the lymph nodes remains unproven.

Clinical trials are investigating the use of radiation therapy to treat metastases. Investigations are underway to evaluate the safety and efficiency of stereotactic radiosurgery. Stereotactic radiosurgery uses narrowly focused radiation beams to destroy tumors. The procedure may have applications when treating melanoma that has metastasized to the brain.

Resources

American Cancer Society. (nd). How is melanoma skin cancer treated? Retrieved May 20, 2003, from www.cancer.org/docroot/cri/content/cri_2_2_4x_

how_is_melanoma_skin_cancer_treated_50.asp.

McMasters, K., Swetter, S. (2003, April). Current management of melanoma: Benefits of surgical staging and adjuvant therapy. Journal of Surgical Oncology, 82(4), 209-216.

National Cancer Institute. (updated 2002). Melanoma (PDQ) treatment. Retrieved May 20, 2003, from www.cancer.gov/cancerinfo/pdq/treatment/

melanoma/patient/.National Cancer Institute. (2003). What you need to know about melanoma. Retrieved May 20, 2003, from www.cancer.gov/cancerinfo/wyntk/melanoma#13.

Oncology Channel. (updated 2003). Melanoma. Retrieved May 20, 2003, from www.oncologychannel.com/melanoma/treatment.shtml.