Surgery

To remove any cancer remaining after the biopsy. The procedure is called wide local excision.Wide local incision is recommended for small, easily removable recurrent tumors and for patients with a limited number of in-transit tumors.

The surgeon removes the tumor, including the biopsy site, as well as a surgical margin, (a surrounding area of normal-appearing skin), and underlying subcutaneous tissue.

Most surgeons today follow the guidelines adopted and recommended by the National Institutes of Health and the World Health Organization Melanoma Program.

• Primary tumors associated with Stage III disease - 2-4 cm margin - about 3/4 inch to 1 1/2 inch - according to their thickness.

Therapeutic Lymph Node Dissection (TLND)

Surgery to remove all regional lymph nodes from the area where cancerous lymph nodes were found. If your melanoma was found by sentinel lymph node biopsy, then no additional testing is necessary.

The goal of the surgery is to prevent further spread of the disease through the lymphatic system. Current studies are underway to determine whether TLND may also prolong survival.

TLND also plays an important role in controlling the pain often caused by untreated lymph node disease.

Sentinel Lymph Node 

Biopsy

(SLNB)

Generally not done on patients who have already been diagnosed with Stage III.

Recommended only for patients where it is suspected that there might be melanoma in another nodal basin.

The results of the biopsy will guide the course of treatment.

For more on Sentinal Lymph Node Biopsy click here

Treatment given in addition to a primary cancer treatment is recommended for Stage III Melanoma. These are systemic therapies that go through the bloodstream to reach and affect cancer cells throughout the body.

• Interferon is a protein produced by normal cells to fight viral infections and disease

Purpose 

• Interferon therapies have been shown to help the body's immune system fight disease more effectively.

• Studies indicate that high dose interferon alfa-2b is the only adjuvant treatment to significantly prolong disease-free and probably overall survival in patients with Stage III Melanoma.

• Although there are well-documented benefits of treatment with interferon, the therapy is associated with side effects, and it lasts 12 months
• Recently there has been some use of a shorter course of the therapy or the use of a long-acting, pegylated form of interferon. The results of these studies have not been strong enough to change the current practice.

For more information on Immunotherapy click here

Radiation Therapy

Radiation therapy has not been proven to be of benefit in randomized, controlled studies.

It is sometimes recommended when the tumor has grown outside the lymph nodes and the doctor is trying to control further spread.

For more information on Radiation Therapy click here

Clinical trials are research studies to evaluate new therapies and improve cancer care. These studies are responsible for most of the advances in cancer prevention, diagnosis, and treatment. If you have melanoma, you may be eligible to participate in a clinical trial.

Several experimental treatments are currently being tested in clinical trials.

• Experimental vaccines, GM-CSF, CTLA4-blocking antibodies, interleukins, and others therapies designed to boost the immune system to fight the return of melanoma

• Chemotherapy treatments

Except for chemotherapy, all of these treatments are designed to boost the immune system. These therapies have not yet been shown shown to extend overall survival in any randomized, controlled, trials in any stage of melanoma and in some cases may even worsen survival rates. Scientists are constantly working to improve the efficacy of these treatments.

For more information on Clinical Trials click here