Melanoma is a malignant skin cancer with treatment goals focused on completely removing cancer cells, preventing metastasis, and improving patients' quality of life. Treatment plans should be tailored based on the stage of the disease, lesion location, and overall health status of the patient. Common treatment methods include surgical excision, pharmacotherapy, and immunotherapy.
Early-stage melanoma is primarily treated with surgical removal, while advanced cases may require a combination of approaches. In recent years, targeted therapy and immune checkpoint inhibitors have significantly improved prognosis, but treatment options should be evaluated by professional oncologists based on individual cases.
Surgery is the preferred treatment for early melanoma, usually involving wide local excision and lymph node assessment. Surgeons will preserve 1-2 centimeters of normal tissue around the primary lesion to ensure complete removal of cancer cells. If there are signs of metastasis in the axillary or inguinal lymph nodes, sentinel lymph node biopsy or lymphadenectomy may be performed.
Patients with stage III and IV often require systemic treatment, including chemotherapy, immunotherapy, and targeted drugs. Treatment of metastatic melanoma should be combined with molecular biology testing results to select the most appropriate drug combination. Genetic testing such as BRAF mutation analysis can guide the use of targeted therapies and improve treatment precision.
Traditional chemotherapeutic agents like Dacarbazine are common in advanced patients, with response rates of only about 10-15%. Newer drugs such as Temozolomide are convenient for oral administration and have milder side effects, making them common alternatives. Recent studies show that combining chemotherapy with immunotherapy can enhance efficacy.
Drugs like Pembrolizumab and Ipilimumab can release the immune system's suppression of cancer cells. These drugs may cause immune-related side effects such as dermatitis or gastrointestinal inflammation, requiring regular monitoring of liver function and blood parameters.
Patients with BRAF gene mutations can use targeted drugs like Vemurafenib or Dabrafenib, with response rates reaching 50-60%. Common side effects include skin toxicity and elevated liver enzymes; regular monitoring of liver function and tumor markers is necessary during treatment.
Although not primary treatments, radiotherapy can be used to relieve bone metastasis pain or as adjuvant therapy post-surgery. Photodynamic therapy (PDT) is used in some cases for superficial lesions but has limited effect on deep metastases.
Participating in clinical trials for new drugs or therapies is an important option for advanced patients. Current trials include CAR-T cell therapy, tumor vaccines, and combination therapies. Physicians will evaluate the eligibility and risks based on the patient's specific condition.
Care during treatment is crucial for improving outcomes. Patients should strictly avoid UV exposure, use SPF50+ sunscreen daily, and wear protective clothing. Nutritionists recommend an anti-inflammatory diet, increasing intake of deep-sea fish and antioxidant-rich foods.
Post-treatment, full-body CT or PET-CT scans should be performed every 3-6 months. Dermatologists will regularly examine the entire skin to detect new lesions early. Patients with genetic mutations need ongoing monitoring of specific biomarkers.
Gene editing technologies like CRISPR may eventually correct carcinogenic gene mutations. Research into the tumor immune microenvironment suggests that combining oncolytic viruses with immunotherapy can enhance anti-tumor effects. Personalized medicine will tailor treatment plans based on individual genetic profiles.
Nanoparticle drug delivery systems can precisely target tumors, reducing systemic toxicity. Clinical trials of magnetic nanoparticles combined with hyperthermia have shown tumor shrinkage effects.
If skin lesions rapidly enlarge, ulcerate, or bleed, immediate medical attention is necessary. During treatment, if persistent fatigue, skin rashes, or difficulty breathing occur, contact the medical team promptly. If surgical wounds become increasingly itchy or painful, or if fever exceeds 38.5°C, schedule follow-up promptly.
For metastatic patients with neurological symptoms (such as headache, balance disorder) or elevated liver function tests, treatment adjustments may be needed. Regular communication with oncologists regarding treatment response and side effect management is essential.
It is recommended to perform a full-body skin self-examination monthly, paying special attention to changes in moles. Use the ABCDE rule: Asymmetry, Border irregularity, Color variation, Diameter over 6mm, and Evolution in shape or size. If lesions with these features are found, seek medical attention immediately.
What are the key factors in choosing surgery or drug therapy for melanoma?The choice depends on the stage of the disease, tumor location, and overall health. Early-stage patients are usually treated with surgical excision; if metastasis or specific gene mutations (such as BRAF) are present, immunotherapy or targeted drugs may be used. Doctors will develop personalized treatment strategies based on pathology reports and genetic testing results.
What are common side effects of immunotherapy, and how can they be managed?Immunotherapy may cause side effects such as dermatitis, liver dysfunction, or endocrine disorders. Mild symptoms can be alleviated with medication, while severe cases may require dose adjustment or treatment interruption. Regular monitoring of blood indicators and symptoms is necessary. Patients should report discomfort proactively and follow medical advice for follow-up.
How long should melanoma patients undergo follow-up examinations after treatment?Follow-up should continue for at least 5 to 10 years. Early-stage patients typically undergo skin examinations and imaging every 3-6 months; high-risk or advanced patients may require more frequent monitoring. Doctors will adjust the frequency based on recurrence risk and recommend maintaining good sun protection habits to reduce the chance of recurrence.
Can sunburn or skin damage directly cause melanoma to worsen?Excessive sun exposure may trigger new lesions or accelerate existing ones but does not directly cause metastasis of existing tumors. Patients should strictly avoid UV exposure, use SPF50+ sunscreen, and wear UV-protective clothing. If skin burns or redness occur during treatment, report immediately to the medical team.
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