How to treat metastasis of melanoma?
Skin cancer (melanoma) is considered to be one of the most aggressive malignant tumors. The frequency of occurrence of melanoma is 0.3-1% of all malignant tumors. Melanoma can affect people of any age.
Initially, melanoma develops in skin cells responsible for melanin production. So often the tumor has a dark color. But sometimes melanoma can be pigmentless. Most (90%), melanoma appears on the skin, melanoma can also appear in the mucosa of the nose or in the mouth, vagina or rectum, in the choroidal layer of the eye or in the conjunctiva.
Melanoma may be in for a long time to develop symptoms. The tumor is usually similar to a mole or nevus, unusual shapes, colors and with blurred boundaries.
Dangerous melanoma is not only oligosymptomatic course, but early metastasis to lymph nodes. Well as metastases of melanoma can affect the brain, liver and lungs. Somewhat less metastases of melanoma are striking bone. Tumor nodules can be detected on the whole surface of the body and on the skin of the extremities. Melanoma of the trunk, head and neck metastasize more often than melanoma of the extremities.
Melanoma on the 2-3rd stage of the malignant process often metastasize to regional lymph nodes. In the presence of one metastasis probability of a patient surviving for 5 years is only 51%, and in the presence of four metastases, this probability decreases to 17%. Melanoma with metastases in lymph nodes may manifest these symptoms:
- increase of regional lymph nodes;
- reduced body mass;
- the patient gets tired quickly;
- deteriorating eyesight.
Signs of metastases in melanoma that spreads hematogenous route, largely depend on their localization. Separated detection of melanoma metastases talks about the 4th stage of the disease.
In the diagnosis of metastatic melanoma can be used in such diagnostic methods.
- computed tomography;
- Ultrasound (lymph nodes and organs);
- samples with radioactive phosphorus;
- MRI of the whole body;
In the melanomas with a thickness of up to 0,76 mm rare metastasis to lymph nodes and other organs. In tumors with a thickness greater than 3 mm, the recurrence of the disease 50% chance of developing over the years and with a probability of 90% within 5 years.
Treatment of melanoma at the initial stage has a favorable prognosis if it has not metastasized. When melanoma metastasis to the lymph nodes, along with the removal of the primary tumor, there is a mandatory resection of the regional lymph nodes, as the probability that malignant cells spread to them. It is not known whether lymph node dissection on life expectancy with melanoma, but the removal of lymph nodes, which are infiltrated by malignant cells, can at least get rid of the pain that will arise with growth in the lymph nodes of cancerous tumors. The chances of recovery in the metastasis of tumors in the lymph nodes are significantly reduced.
With the proliferation of melanoma metastases to other organs, the chances of survival decrease sharply. The most common cause of death of these patients become melanoma metastases in the brain, and the melanoma metastases in the lungs. If the melanoma metastases may be removed surgically without compromising the quality of life of the patient, do it. Surgical treatment of metastases in melanoma allows you to take the disease under control and to improve the duration and quality of life of the patient.
alt="surgical treatment">in addition to surgical treatment in melanoma metastasis is applied radiosurgical and radiation therapy and chemotherapy. Metastezirovanii treatment of melanoma depends on the number of metastases, their rate of growth, results of previous therapy, patient's condition and his desire to survive.
Life expectancy with melanoma, metastezirovanii in a body that is 7 months in two 4 month three or more on – only 2 months. The reason for this are restrictions on the use of surgical method in the treatment of melanoma metastases in other organs (e.g., the appearance of liver metastases surgical treatment and not held). But a small number of patients who appeared and were removed by the isolated skin metastases, can expect to survive for an extended period.
Radiosurgical treatment of metastatic melanoma is justified for metastasis of skin cancer in the brain or bones, when to use a surgical method of treatment is impossible. The application of radiation therapy for the treatment of melanoma total focal dose should be 4000-4500 rad., and the optimal total dose of 10000 rad. Radiation therapy is used as an independent method of treatment of disseminated melanoma or as an additional method for destruction of cancer cells remaining after surgery.
Chemotherapy for melanoma with metastases is carried out using various chemotherapeutic agents and hormones. Of the new chemotherapeutic agents in the treatment of cutaneous melanoma is well established the drug. Chemotherapy for metastatic melanoma is highly efficient and allows not likely to cure the person and to prolong his life.
Also in the treatment of melanoma applied immunotherapy (interferon-alpha and interleukin-2). It was experimentally confirmed that the use of α-interferon at maximum tolerated doses prolongs a relapse-free period and increases the period of overall survival.
The prognosis of metastases melanoma
The prognosis of melanoma depends on many factors: tumor thickness (the thicker the melanoma, the higher the risk of metastasis), its localization (melanoma of the mucous membranes are more aggressive than melanoma of the skin). Most adverse events differ melanoma of the neck, occipital region and upper back.