• Chemotherapy for Melanoma

    Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body where they target cancer and kill cells. Chemotherapy is not as effective in treating advanced melanoma. However, it may slow the growth of the cancer and help to relieve some of the symptoms.
    Chemotherapy may be given either alone or along with surgery, immunotherapy medications, or radiation therapy.

    Chemotherapy Drugs and Delivery

    There are a variety of chemotherapy drugs. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for melanoma may include:
    • Dacarbazine
    • Temozolomide
    • Paclitaxel—may or may not be albumin-bound
    • Carboplatin
    • Cisplatin
    • Carmustine
    • Melphalan
    Some treatments will be given in combination with other drugs. Chemotherapy is usually given through an IV. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.
    With a technique called isolated limb perfusion, high-dose chemotherapy is delivered directly into a limb that contains the tumor. It is done during a surgical procedure that isolates an artery and vein that supply and drain blood. A tourniquet is applied to the limb to block it off from general circulation. The chemotherapy drugs are circulated between the limb and a heating machine. Once the treatment is completed, the blood vessels are washed out and general circulation is restored. This helps limit the amount of healthy tissue that is harmed while delivering a high dose to cancer cells.

    Side Effects and Management

    Though the drugs are designed to target cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:
    • Fatigue due to anemia
    • Nausea and vomiting
    • Low white blood cell counts, which increase the risk of infection
    • Numbness, pain, or burning sensation in the hands and feet—peripheral neuropathy
    • Cognitive and/or memory problems
    • Gastrointestinal problems, including diarrhea, constipation, or loss of appetite
    A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.

    References

    Melanoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115302/Melanoma. Updated August 26, 2016. Accessed October 20, 2016.

    Melanoma skin cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003120-pdf.pdf. Accessed October 20, 2016.

    Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq#section/%5F135. Updated July 22, 2016. Accessed October 20, 2016.

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