NCCN Guidelines for Patients® | Melanoma - page 74

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
72
Chart 5.4.4
shows the adjuvant treatment options
that are recommended after surgery for regional
lymph node recurrence. Adjuvant treatment is
additional treatment given after the main one to try to
kill any remaining cancer cells and lower the chance
of recurrence. Read Part 4 on page 34 for more
details on each treatment listed in the chart.
If all of the cancer was removed with surgery,
then you have four adjuvant treatment options.
You can join a clinical trial—a type of research that
studies a test or treatment to assess its safety or
how well it works. You can begin observation—a
period of scheduled follow-up tests to watch for
cancer metastases or recurrence. Or, you can
receive interferon alfa, a type of immunotherapy,
if you haven’t had it before. Your doctor may also
consider radiation therapy to the nodal basin—the
area near the tumor where the group of lymph nodes
was removed. For more details, read about radiation
therapy on page 40 or read
Principles of radiation
therapy
on page 79.
If all of the cancer wasn’t removed with surgery,
then you also have four adjuvant treatment options.
You can join a clinical trial—a type of research that
studies a test or treatment to assess its safety or
how well it works. Or, you can have radiation therapy,
systemic therapy, or best supportive care. Supportive
care is treatment to relieve the symptoms caused
by the cancer or side effects of cancer treatment.
Systemic therapy options are listed in Chart 6 on
page 81. For more details, read
Principles of radiation
therapy
on page 79 or
Principles of systemic therapy
on page 80.
5.4
Treatment guide
Persistent melanoma and nonmetastatic recurrence
Initial treatment results
Adjuvant treatment
All cancer was removed with complete lymph
node dissection and/or tumor excision
Chart 5.4.4 Lymph node recurrence adjuvant treatment
All of the cancer was not removed
Clinical trial,
Radiation therapy,
Systemic therapy, or
Best supportive care
Clinical trial,
Observation, or
Interferon alfa, and/or
Possible radiation therapy to nodal basin
1...,64,65,66,67,68,69,70,71,72,73 75,76,77,78,79,80,81,82,83,84,...108
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