Melanoma Skin Cancer Treatment Details

While melanoma was historically considered radio-resistant, Radiation Therapy plays a specific role. It is rarely used as a primary cure. Still, it is valuable as Adjuvant Radiation after lymph node dissection if there is a high risk of local recurrence (e.g., many positive nodes or extracapsular extension). It is also widely used for Palliation, shrinking tumors that are causing pain, bleeding, or pressing on vital structures like the spinal cord or brain. Stereotactic Radiosurgery (Gamma Knife) is highly effective for treating melanoma brain metastases.

For melanoma confined to a limb (e.g., multiple nodules on a leg) that cannot be surgically removed, Isolated Limb Perfusion (ILP) or Infusion (ILI) may be used. These procedures involve surgically isolating the blood flow of the affected limb and circulating high-dose chemotherapy (Melphalan) and heat only through that leg. This delivers a potent dose to the tumor without exposing the rest of the body to toxic side effects.

Talimogene laherparepvec (T-VEC) is an oncolytic virus therapy injected directly into melanoma nodules. It is a modified herpes virus that infects cancer cells, causing them to burst, and simultaneously stimulates the immune system to attack nearby tumor cells.

• Radiation serves as an adjuvant and a palliative role.
• Stereotactic radiosurgery is effective for brain metastases.
• Isolated limb therapies deliver regional high-dose chemotherapy.
• ILP/ILI spares the systemic circulation from toxicity.
• Oncolytic viral therapy (T-VEC) provides local tumor lysis and immune stimulation.