Professional removal of melanoma includes comprehensive treatment consisting of surgery, radiotherapy, chemotherapy, immunotherapy or targeted therapy. The selection of specific procedures and medications in modern clinics is based on the results of modern diagnostics, including full-body 3D screening.
Diagnosis before removal of melanoma
First, the doctor performs a physical examination and checks for enlarged lymph nodes. To examine every millimeter of the skin, a three-dimensional photograph of the entire body can be assigned. A system consisting of more than 40 cameras is used for this purpose. A three-dimensional model is created from the obtained photos, which can be viewed from all sides with the possibility of zooming in. After this test, a dermoscopy is often performed. The doctor uses a special lens with a light source to examine suspicious areas of the skin.
If melanoma is suspected, a biopsy is performed. The tissue sample is checked for the presence of malignant cells, which in turn are tested for known gene mutations (for example, BRAF). If there is a risk of developing metastases, immunotherapy is prescribed based on these tests after removal of the melanoma. To confirm the diagnosis of ocular melanoma, a complete ophthalmological examination is performed: optical coherence tomography, ultrasound and fluorescence angiography.
Ways to remove melanoma
With a localized tumor, the main treatment is to remove the melanoma with a laser, scalpel, or cryosurgery. In the case of extensive surgery, the tumor itself and a small area of surrounding healthy tissue, including some deep layers, are excised. Surgery can lead to scarring. Reconstructive surgery may be prescribed to restore the skin to its former aesthetics.
Laser removal of melanoma is considered the safest and is prescribed even when surgery is contraindicated. The laser allows you to destroy the entire neoplasm in a few minutes without bleeding and with minimal risk of scarring.
If cancer is suspected to have spread, a sentinel node biopsy is performed. During surgery, the surgeon removes a nearby lymph node to check for the presence of tumor cells in it. If there are no signs of metastasis, the remaining nodes remain. Surgery for the treatment of metastatic melanoma can be combined with other methods such as immunotherapy or chemotherapy.
Non-surgical treatment of melanoma
Radiation or drug therapy is prescribed for the treatment of metastatic melanoma after surgery. In modern clinics, radiation is performed using a very precise technology – intensive modulated radiation therapy. The drugs Ipilimumab, Keytruda and Opdivo are used as immunotherapy for melanoma. If the patient has a BRAF mutation in the melanoma genes, targeted therapy (Zelboraf, Tafinlar, and a MEK inhibitor) may be prescribed.
Many patients are concerned about the question: how long do they live after melanoma removal? In this case, not only proper treatment is of great importance, but also a mandatory systemic check for disease recurrence after remission.
