Cancer Innovations: Advances in Melanoma Treatment

Advances in

Melanoma Treatment

Innovative surgical approaches and immunotherapies at Maroone Cancer Center effectively treat melanoma, with less of an effect on quality of life.

Maroone Cancer Center is on the melanoma treatment vanguard, offering a range of cutting-edge therapies that can cure this aggressive type of skin cancer and prolong survival in advanced cases—all while minimizing treatment-related side effects.

For certain early-stage melanomas, our dermatologic surgeons perform detailed Mohs micrographic surgery to excise the cancer precisely in a more cosmetically appealing way.

And, for people with more advanced melanomas, our medical oncologists offer newer immunotherapies, as well as targeted therapies based on an individual person’s genetic makeup, that have reshaped the melanoma treatment landscape for the better.

Surgical Solutions

A longstanding treatment for basal cell or squamous cell skin cancers, Mohs surgery is now used at Maroone Cancer Center to treat early-stage melanomas such as melanoma in situ and lentigo maligna, especially in sun-damaged areas of the head and neck.

In Mohs, the surgeon removes a thin slice of tissue and examines it under a microscope. The specialist repeats this process until no cancer cells remain along the edges or the underside of the tissue samples. As part of the surgery, our experts use specialized immunochemical staining to identify melanoma cells more effectively and limit the treatment area, thus minimizing the effects on adjacent noncancerous tissue.

“Melanoma in situ can be a challenge because there’s a lot of subclinical spread of these lesions, and they can often be difficult to identify,” explains Maroone Cancer Center dermatologist Paul X. Benedetto, MD. “These specific types of immunochemical stains allow us to identify cancer cells more easily under a microscope and be more accurate in removing these lesions during Mohs surgery.

“Performing Mohs surgery for melanoma in situ, and potentially certain invasive ones, is a relatively new front,” he continues. “The benefit is that it allows for higher accuracy and smaller scars as a curative treatment for noninvasive melanomas.”

Immunotherapy Innovations

In 2015, former President Jimmy Carter revealed that he had melanoma with liver and brain metastases. By the end of that year, he announced he was cancer-free, thanks to a combination of treatments that included immunotherapy.

For people with advanced melanomas, Maroone Cancer Center specialists offer the latest immunotherapies, which help the immune system recognize and target melanoma cells. Our experts also perform special molecular testing on melanomas to determine if they carry certain genetic alterations that make them amenable to targeted therapies, which include drugs such as BRAF inhibitors and MEK inhibitors, among others.

These immunotherapies and targeted therapies treat melanomas that can’t be removed completely by surgery or have metastasized. In some instances, they may be used to prevent a recurrence of melanoma after surgery. With the rise in the use of immunotherapies and targeted therapies, use of chemotherapy to treat advanced melanoma has declined greatly, according to Maroone Cancer Center medical oncologist David Grossman, MD.

“For localized disease, immunotherapies—or even the targeted therapies if you have the right mutation in your melanoma— can halve the recurrence rate or even more, which is amazing, and they’re much better tolerated than chemotherapy,” Dr. Grossman explains. “Immunotherapy has changed the world of melanoma. It has been life-changing for patients and the doctors who take care of them.”

“There are so many new cutting-edge medications that are immunotherapies for treating invasive or metastatic melanoma,” Dr. Benedetto adds. “Hopefully the future is always brighter for people with melanoma.”

Prevention Remains Key

Despite the advanced treatments available at Maroone Cancer Center, both Dr. Grossman and Dr. Benedetto emphasize that the mainstay of melanoma management is prevention—using sunscreen and sun-protective clothing, avoiding the use of tanning beds and undergoing routine skin exams by a dermatologist.

“If you find a thin melanoma and remove it, it’s curative, but if it progresses and metastasizes, it can be quite aggressive,” Dr. Benedetto cautions. “We’re making great strides in surgery and immunotherapy, but I would love to help patients avoid the need for those treatments through early identification and removal of the melanoma.”

In Mohs surgery, the surgeon removes a thin slice of tissue and examines it under a microscope. The specialist repeats this process until no cancer cells remain along the edges or the underside of the tissue samples.