How is a malignant melanoma treated?

If a malignant melanoma is diagnosed, it must first be determined if it has already spread cancer cells into other organ systems. For this purpose, various tests are usually performed in a clinic: above all, a check of the entire skin and a physical examination of the organ systems - with a special view of the lymph nodes, the liver and the lungs.

Flat tumors without metastases have an excellent prognosis

Although there is no evidence of secondary tumors in ultrasound and X-rays, the removal of the tumor is usually sufficient. With a melanoma thickness of 2 mm (or less), the surgeon will usually keep a safety distance of 1 cm to the healthy tissue; with a tumor thickness of more than 2 mm, this usually takes a distance of 2 cm. The prognosis for malignant melanoma, which has not penetrated too deeply into the tissue and that has not yet formed metastases (secondary tumors), is extremely good after surgical removal. With a tumor thickness of less than 0.75 mm without scattering, you can even expect up to 100% chance of recovery. Even limited tumors with a thickness of up to 1.5 mm have a good prognosis: according to studies, the survival rate here is over 90%. Nevertheless, or for that very reason, it is important in the first years after diagnosis and surgery to take regular check-ups at the doctor. In this case, the check-ups are initially usually half-yearly, then scheduled for a few years once a year.

Guardian lymph nodes are important indicators

By the way, a special examination method for "black skin cancer" is the targeted biopsy of the so-called guardian lymph nodes. It is usually recommended if the tumor thickness exceeds one millimeter. Here, the lymph nodes that lie directly in the area of ​​influence of the tumor are identified by injecting special markers and then examined more closely: If these are attacked by cancer cells, there is a high probability that other lymph nodes are affected. If these sentinel lymph nodes, also referred to as sentinel lymph nodes, are free of cancer cells, then it is usually all subsequent lymph nodes as well. This relatively simple method can therefore provide important information about a possibly existing spread of tumor cells.

Surgery is the most important therapeutic measure in almost all stages

If dislocations of cancer cells are found in the above-mentioned controls, further investigations usually still have to be carried out in order to determine the exact extent of the disease. Again, the removal of the tumor with sufficient distance to the healthy tissue is the drug of choice. Unfortunately, there is currently no further therapy option that promises a cure. Depending on the exact clinical picture, various chemotherapeutic agents (Fotemustin, DTIC) or immunotherapy with interferon are used. Also radiotherapy, surgical reduction of the tumor mass or some experimental new therapies are tried in individual cases.

Exact amount of dispersion is crucial

The prognosis for sole involvement of adjacent lymph nodes is a maximum of 50% 5-year survival. But this also means that almost one out of every two people affected can expect to be permanently cancer-free. However, if many and even more distant lymph nodes are affected, this rate drops steadily. Here are the regular, usually in the 3-month interval recommended follow-up appointments are particularly important.

If malignant melanoma has already spread to various organ systems (lung, liver, brain or bone), the probability of survival is unfortunately only slight. In very advanced cases, the affected person can only stay for a few months or weeks. However, it depends on the exact individual findings.

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Author: Dr. med. Monika Steiner