NCCN Guidelines for Patients
Mycosis Fungoides, Version 1.2016
Genetic counseling | Treatment
Stages IB a d IIA tr t
lists treatment options for stages IB and
IIA cancer. However, some people with folliculotropic
or large-cell transformed subtype of mycosis
fungoides may receive stage IIB treatments. Also,
some research suggests that treatment for stage
III cancer works better for stage IB and IIA cancers
with blood involvement. However, more research is
Treatment for stage IB and IIA cancers starts with
generalized skin treatment. Topical steroids and
mechlorethamine can be used to treat larger lesions.
Phototherapy and total skin electron beam therapy
are options, too.
After generalized skin treatment, local skin treatment
may be used to treat any small lesions that remain.
Local treatment options include radiation therapy,
topical retinoids, and topical imiquimod. If skin
treatment works, you may stay on your treatment for
a while or slowly stop treatment to prolong the good
Start skin treatment again if the cancer was fully
treated but came back as stage I or IIA. People often
have good results with the same treatment as before.
If a new treatment will be received, the choice of
which treatment will be partly based on how much of
your skin has lesions. If one or two courses of skin
treatment didn’t work, try another treatment listed in
You may have already tried multiple courses of skin
treatment without much change. Despite treatment,
the cancer may be worse. In either case, options are
listed in Chart 4.2.2.
lists second-line options for cancers
that were stage IB or IIA at diagnosis. There are
three options. You could join a clinical trial. Another
option is one or more systemic treatments. A third
option is combination treatment with or without skin
treatment. Examples of combination treatments
include phototherapy with a retinoid, extracorporeal
photopheresis with an interferon, and total skin
electron beam therapy with photopheresis.
If second-line treatment works, you may stay on
your treatment for a while or slowly stop treatment to
prolong the good results. Start treatment again if the
cancer was fully treated but came back as stage I or
IIA. If one or two courses of second-line treatment
didn’t work, try another treatment listed in the chart.
If multiple second-line treatments didn’t work or the
cancer got worse, your next options are a clinical trial,
total skin electron beam therapy, or chemotherapy
used for stage III or IV.