AN EXPERT BY YOUR SIDE
Our doctors have been providing compassionate, comprehensive cancer care for melanoma patients and their families since 1992. Melanoma diagnosed in its early stages can be cured. As avid researchers with access to the latest treatment options, including national clinical trials, we are able to offer treatments that may not be available elsewhere. Our cancer treatment centers are easily accessible, reducing travel time and expense and allowing you to receive treatment close to home or work. As a affiliate of The US Oncology Network, our doctors have been providing compassionate, comprehensive cancer care for melanoma patients and their families since 1992.
Clinical research trials represent some of the most advanced treatment options. Click here to learn more.
The management of melanoma typically requires the involvement of multiple specialties
- Primary care providers and dermatologists examine the skin of their patients; educate them about prevention and screening, biopsy concerning lesions.
- A dermatopathologist (a doctor who specializes in dermatology and pathology) will work closely with the dermatologist to diagnose the disease from the biopsy.
- The majority of in situ (localized) or thinner melanomas are removed by a dermatologic surgeon and no further treatment is required. Complicated or thick melanomas of the face, head and neck region are typically removed by an otolaryngologist (ear, nose and throat surgeon), with general surgeons removing tumors found elsewhere on the body such as the back, legs or middle section.
- Plastic surgeons may need to get involved when the melanoma involves a sensitive area.
- Radiologists interpret the imaging studies used for staging and perform directed biopsies of nodules, lymph nodes and occasionally distant metastases.
- Medical oncologists administer drug therapy in the adjuvant and metastatic settings, evaluate patients for clinical trials, manage symptoms in the later phases of the disease, and help monitor patients in remission.
- Radiation oncologists may provide adjuvant therapy in selected cases and palliative therapy for metastatic disease.
- Genetic counselors may be sought to closely evaluate patients with significant family history of melanoma and other cancers and discuss the need for genetic testing which may provide important information for family members regarding surveillance and prevention.
To help ensure coordinated care for our patients among these multiple specialties, our physicians are often part of multidisciplinary clinics where the patient meets collectively, in one place, with their team of doctors to develop a treatment plan.
NEW THERAPIES IN DEVELOPMENT
For a long time, melanoma proved to be resistant to most cancer drug therapies that were used. It is relatively resistant to chemotherapy, with only a handful of conventional chemotherapy drugs having activity against it. Use of older immune stimulating therapies such as interferon and high-dose IL-2 has been limited, by their toxicities. Recently, significant advances in the treatment of metastatic melanoma have been made. Ipilimumab was the first drug approved by the FDA for the treatment of metastatic melanoma. It is a monoclonal antibody that works by activating the immune system and binding the CTLA-4 molecule. It was approved in 2011 after clinical trials showed improved overall survival in patients with metastatic melanoma.
Other breakthroughs in melanoma include the discovery of driving mutations in metastatic disease, such as BRAF, and development of targeted drug therapy to block these pathways. The BRAF inhibitors vemurafenib (approved in 2011) and dabrafenib (approved in 2013) have both shown significant tumor shrinkage and symptom improvement in clinical trials. Trametinib is a MEK inhibitor which works in combination with BRAF inhibitors to enhance responses and in some cases decrease side effects.
On the horizon, the addition of immune antibodies targeting PDL-1 and PD-1 offers great promise to improve outcomes for patients even further. Early phase trials have shown even greater anti-tumor activity with these new agents and less toxicity compared to currently available immunotherapies. Whenever feasible and appropriate we encourage our eligible patients with melanoma to take part in clinical trials.