Melanoma is a malignant skin cancer, with treatment goals aimed at completely eliminating cancer cells, preventing metastasis, and improving the quality of life for patients. Treatment plans must be tailored based on the stage of the disease, the location of the lesions, and the overall health status of the patient. Common treatment methods include surgical excision, pharmacotherapy, and immunotherapy.
Early-stage melanoma primarily utilizes surgical excision as the main treatment method, while late-stage may require a combination of various approaches. In recent years, emerging therapies such as targeted therapy and immune checkpoint inhibitors have significantly improved prognosis, but treatment options must be evaluated by a professional oncologist based on individual case circumstances.
Surgery is the preferred treatment method for early-stage melanoma, typically involving wide local excision and lymph node assessment. The surgeon will leave 1-2 cm of normal tissue around the primary lesion to ensure complete removal of cancer cells. If there are signs of metastasis in the axillary or groin lymph nodes, a sentinel lymph node biopsy or lymph node dissection may be performed.
Patients with stage III and IV melanoma often require systemic treatment, including chemotherapy, immunotherapy, and targeted drugs. Treatment for metastatic melanoma must combine molecular biology testing results to select the most appropriate drug combinations. Genetic testing such as BRAF mutation analysis can guide the use of targeted drugs, enhancing treatment precision.
Traditional chemotherapy agents like Dacarbazine are commonly used in advanced patients, but the response rate is only about 10-15%. New-generation drugs like Temozolomide, which are convenient for oral administration and have milder side effects, have become common alternatives. Recent studies have shown that chemotherapy is often used in combination with immunotherapy to enhance efficacy.
Pembrolizumab and Ipilimumab are drugs that can relieve the suppression of cancer cells on the immune system. These drugs may cause immune-related side effects, such as dermatitis or gastrointestinal inflammation, necessitating regular monitoring of liver function and blood markers.
Patients with BRAF gene mutations can use targeted drugs such as Vemurafenib or Dabrafenib, with response rates reaching 50-60%. However, common side effects include skin toxicity and elevated liver enzymes, requiring regular monitoring of liver function and tumor markers during treatment.
Radiation therapy, while not a primary treatment method, can be used to relieve bone metastasis pain or as adjuvant therapy post-surgery. Photodynamic therapy (PDT) is used in some cases for local control of superficial lesions, but its effectiveness is limited for deep metastases.
Participating in clinical trials for new drugs or therapies is an important option for advanced patients. Current trials cover CAR-T cell therapy, tumor vaccines, and combination therapy research. Physicians will assess the indications and risks of trials based on the patient's specific condition.
Care during treatment is crucial for enhancing efficacy. Patients should strictly avoid ultraviolet exposure, using SPF 50+ sunscreen daily and wearing protective clothing. Nutritionists recommend adopting an anti-inflammatory diet, increasing intake of deep-sea fish and antioxidant-rich foods.
After treatment, full-body CT or PET-CT scans should be performed every 3-6 months, and dermatologists will conduct regular full-body skin examinations to detect new lesions early. Patients with genetic mutations need continuous monitoring of specific biomarker changes.
Gene editing technologies like CRISPR may potentially correct oncogenic gene mutations in the future. Research on the tumor immune microenvironment has found that combining oncolytic viruses with immunotherapy can enhance anti-tumor effects. Personalized medicine will tailor treatment plans based on the patient's genetic profile.
Nanodrug delivery systems can precisely deliver chemotherapy drugs to tumor sites, reducing systemic toxicity. Clinical trials combining magnetic nanoparticles with hyperthermia have shown tumor shrinkage effects.
If skin lesions rapidly enlarge, ulcerate, or bleed, immediate medical attention is required. During treatment, if persistent fatigue, skin rashes, or breathing difficulties occur, the healthcare team should be contacted immediately. If post-surgery incision itching or pain worsens, or if fever exceeds 38.5°C, prompt outpatient follow-up should be arranged.
For metastatic patients experiencing neurological symptoms (such as headaches or balance disorders) or elevated liver function abnormality indices, this may indicate a need to adjust the treatment plan. Regular communication with the oncologist regarding treatment responses and side effect management is crucial.
It is recommended to perform a full-body skin self-examination monthly, paying particular attention to changes in moles. The "ABCDE rule" can be utilized: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolution in shape or size. If lesions exhibiting these characteristics are found, immediate medical attention should be sought.
What are the key factors in choosing surgery or pharmacotherapy for melanoma treatment?The treatment method depends on the stage of the disease, the tumor's location, and the patient's overall health status. Early-stage patients typically undergo surgical excision; if there is metastasis or specific gene mutations (such as BRAF mutations), immunotherapy or targeted drugs may be combined. Physicians will develop personalized treatment strategies based on pathology reports and genetic testing results.
What are common side effects for patients receiving immunotherapy, and how can they be managed?Immunotherapy may cause side effects such as dermatitis, liver function abnormalities, or endocrine disorders. Mild symptoms can be alleviated with medication, while severe cases may require dosage adjustments or treatment pauses. Physicians will regularly monitor blood markers and symptom changes, and patients should proactively report discomfort and follow medical advice for subsequent follow-ups.
How long do patients need to undergo follow-up examinations after melanoma treatment?Post-treatment follow-up should continue for at least 5 to 10 years. Initially, patients undergo skin examinations and imaging studies every 3-6 months; late-stage or high-risk patients may require more frequent follow-ups. Physicians will adjust the frequency of examinations based on recurrence risk and advise patients to maintain good sun protection habits to reduce the likelihood of recurrence.
Does skin inflammation or damage after sun exposure directly lead to the worsening of melanoma?Excessive sun exposure may induce new lesions or accelerate the deterioration of existing ones, but it does not directly cause metastasis of pre-existing lesions. Patients should strictly avoid ultraviolet exposure, use SPF 50+ sunscreen, and wear UV-protective clothing. If skin burns or redness occur during treatment, the healthcare team should be notified immediately.
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