NCCN Guidelines for Patients® | Melanoma - page 67

67
NCCN Guidelines for Patients
®
: Melanoma
Version 1.2013
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Part 6: A step-by-step treatment guide
Definitions:
Clinical trial:
Research
on a test or treatment to
assess its safety or how
well it works
Lymph nodes:
Groups of
special disease-fighting
cells throughout the body
Negative margins:
There
are no cancer cells in
the normal-looking tissue
around the tumor removed
during surgery
Observation:
A period of
testing to check for signs
of cancer growth or return
(recurrence)
Supportive care:
Treatment for symptoms of
a disease
Systemic therapy:
Drugs
used to treat cancer cells
throughout the body
!
See Part 4 on page
34 for more treatment
details and definitions.
Part 6.4.3 describes the recommended treatments for cancer that came back
in the lymph nodes near the first melanoma. This is called regional lymph node
recurrence.
The treatment options for regional lymph node recurrence depend on whether
or not you had a lymph node dissection with treatment before. A lymph node
dissection is surgery to remove some or all of the lymph nodes in the area near
the tumor. If you didn’t have one, then a complete lymph node dissection is
recommended.
If you already had a lymph node dissection and you are able to have surgery,
then surgery to remove the cancer (tumor excision) with negative margins is
recommended. All of the lymph nodes in the affected area should be removed if
you didn’t have a “complete” lymph node dissection before.
After tumor surgery and/or complete lymph node dissection, you have four
treatment options. You can choose treatment within a clinical trial, observation,
or interferon alfa injections if not received before. Or, you can choose to receive
radiation therapy alone or along with one of the other three treatment options.
For more information, read
Principles of radiation therapy
on page 74. High-
dose interferon alfa for 1 year or peginterferon alfa-2b for up to 5 years may
prevent recurrence.
If you are unable to have surgery or if surgery didn’t remove all of the cancer,
you have four treatment options. You can choose treatment within a clinical trial,
radiation therapy, systemic therapy, or best supportive care. Systemic therapy
regimens are listed in Table 5 on page 73. For more information, read
Principles
of systemic therapy
on page 72 and
Principles of radiation therapy
on page 74.
Next steps:
For recommended follow-up tests based on cancer stage, see
Part 6.2.3 or Part 6.3.3. For metastatic melanoma, see Part 6.5 for
recommended tests and treatments.
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