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43

NCCN Guidelines for Patients

®

Mycosis Fungoides, Version 1.2016

3

DCIS

Genetic counseling | Treatment

4

Treatment guide

Stages IB a d IIA tr t

t

Chart 4.2.1

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

needed.

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

results.

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

the chart.

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.

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.