NCCN Guidelines for Patients® | Melanoma - page 36

NCCN Guidelines for Patients
: Melanoma
Version 1.2013
Part 4: Overview of melanoma treatments
A pathologist will examine the removed tissue with a
microscope to see if there is any cancer in the surgical
margins. If the margins have cancer, you may need more
surgery. A positive margin means there is cancer in the
surgical margin. A negative margin means there is no
cancer in the surgical margin.
Lymph node dissection
A lymph node dissection is surgery to remove some or all
of the lymph nodes near the tumor. These may be in the
neck, armpit, or groin. Your doctor may perform a lymph
node dissection if tests suggest that cancer cells have
spread to these lymph nodes. This surgery is done with
general anesthesia.
4.2 Treatment with drugs
Cancer doctors use drugs to treat melanoma in different
ways. When drugs are given to treat melanoma in a
specific, small area of the body, it is called local or
regional treatment. When drugs are given to treat
melanoma throughout the body, it is called systemic
treatment or systemic therapy. Doctors use systemic
drugs to treat cancer cells that may have spread
beyond the skin to distant sites. The different types of
drugs used to treat melanoma include chemotherapy,
immunotherapy, vaccine therapy, and targeted therapy.
Chemotherapy is a type of drug commonly used to treat
cancer. Many people refer to this treatment as “chemo.”
Chemotherapy drugs kill all cells that grow rapidly,
including cancer cells and normal cells. When only one
drug is used, it is called a single agent. However, different
types of chemotherapy drugs attack cancer cells in
different ways. Therefore, more than one drug is often
used. A combination regimen is the use of two or more
chemotherapy drugs.
Chemotherapy can be used as systemic treatment or
regional treatment for melanoma. For systemic treatment,
the drug is given as a pill that is swallowed or as a
liquid that is injected into a vein or under the skin with
a needle. When given this way, the drugs travel in the
bloodstream to treat cancer throughout the body. For
regional treatment, the drug is given as an injection into a
limb (arm or leg) in a way that it does not reach or affect
the rest of the body. This is called isolated limb infusion/
perfusion. The chemotherapy drug melphalan is given
this way for melanoma. Table 2 lists the chemotherapy
drugs used for melanoma.
1...,26,27,28,29,30,31,32,33,34,35 37,38,39,40,41,42,43,44,45,46,...108
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