NCCN Guidelines for Patients® | Melanoma - page 69

69
NCCN Guidelines for Patients
®
: Melanoma
Version 1.2013
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Part 6: A step-by-step treatment guide
Part 6.5.2 describes the recommended treatments for metastatic melanoma. The
treatment options depend on whether or not all of the cancer can be removed
by surgery. Limited metastatic disease can be treated with surgery because the
cancer is only in one or a few distant sites. Widespread metastatic disease can’t be
treated with surgery because the cancer is in many distant sites.
Widespread
stage IV
(Unresectable–
can’t be treated
with surgery)
No cancer
in brain
Cancer
in brain
Possible surgery
and/or radiation
therapy
Systemic therapy, or
Clinical trial, or
Best supportive care, and/or
Possible surgery and/or
radiation therapy for symptoms
Treatment
6.5.2 Treatment
Stage
Surgery to
remove tumor
Limited stage IV
(Resectable–
can be treated
with surgery)
Clinical trial, or
Observation
No
other
cancer
Tumor
surgery
No signs
of cancer
Signs of
cancer
Treat as
widespread
Observe or
systemic
therapy,
then repeat
imaging tests Other
cancer
Treat as
widespread
Clinical trial, or
Observation
Definitions:
Biopsy:
Removal of small
amounts of tissue to test for
disease
Excisional biopsy:
Surgery that removes the
entire tumor to test for
cancer cells
FNA biopsy:
Use of a thin
needle to remove fluid or
tissue from the body to be
tested for disease
Genetic testing:
Tests of
the instructions in cells for
making and controlling cells
Staging:
Grouping of
cancer based on the tumor
size and how far the cancer
has spread in the body
Targeted therapy:
Drugs
that specifically target and
kill cancer cells
!
See page 16 for test
details and page 34
for treatment details.
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