NCCN Guidelines for Patients® | Melanoma - page 71

NCCN Guidelines for Patients
Melanoma, Version 1.2014
the edge of the tumor removed during surgery.
Your doctor may consider doing a sentinel lymph
node biopsy during the surgery. (See page 35 for
details.) If surgery isn’t possible, local therapy options
include BCG, interferon alfa, or IL-2 injections into
the tumor, imiquimod cream rubbed onto the tumor,
and laser/ablative therapy. Your doctor may consider
palliative radiation to relieve symptoms if the cancer
can’t be removed by surgery. A regional therapy
option is isolated limb infusion/perfusion with the
chemotherapy drug melphalan. Systemic therapy
options are listed in Chart 6 on page 81.
If there are no signs of cancer after initial recurrence
treatment, you may have adjuvant treatment.
There are three options for adjuvant treatment.
You can join a clinical trial—a type of research on
a test or treatment to assess its safety or how well
it works. You can begin observation with follow-up
tests. Or, you can receive interferon alfa, a type of
immunotherapy. (Read Part 4 on page 34 for details
on each type of treatment.)
Next steps:
Recommended follow-up tests are
based on the cancer stage—see
Chart 5.2.3 for stage 0, I, or II, and
see Chart 5.3.3 for stage III. For
metastatic melanoma, see Part 5.5 for
recommended tests and treatments. 
Treatment guide
Persistent melanoma and nonmetastatic recurrence
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