1.Surgery
The conventional treatment for early stage melanoma is surgical excision of the tumor and some surrounding normal tissues. The extent and depth of the surrounding skin to be removed depends on the thickness of the tumor and the depth of invasion. If the tumor is superficial, the tumor can be removed during biopsy without the need of re-excision. If the tumor is very thick, an extended excision may be required. If the excision is too extensive, skin grafting is often required, which involves taking a portion of skin from another part of the body to replace the excised skin.
Palliative resection: For those who have large lesions with distant metastases and are not suitable for radical surgery, in order to relieve ulcer bleeding or pain, as long as the anatomical conditions allow, reduction of accumulation or palliative resection can be considered.
The decision to perform regional lymph node dissection is based on clinical examination, i.e. ultrasound. After surgery, further treatment is needed to destroy the remaining tumor cells in the body. This treatment is called adjuvant therapy and is often combined with high-dose interferon a-2b and immunotherapy. If the melanoma has metastasized, surgery is usually unable to control the disease, which often requires chemotherapy, biotherapy, radiotherapy, targeted therapy and other comprehensive treatments.
2.Chemotherapy
Chemotherapy is the use of cytotoxic drugs to kill tumor cells. Chemotherapy is usually administered in cycles, usually after one cycle of chemotherapy, a period of rest and then chemotherapy, and so on and so forth.
There are several routes of chemotherapy for melanoma as follows.
1.Orally or intravenously
Both routes are administered orally or intravenously, with the blood flowing throughout the body.
2, isolated limb thermal perfusion chemotherapy
For multiple cutaneous melanoma of the limb, chemotherapy drug (heating) can be injected directly into the affected limb through the artery (heating) to temporarily block the blood circulation of the affected limb, so that the hot chemotherapy drug can reach the tumor site directly and increase the local drug concentration.
In chemotherapy, the human body will have greater toxic side effects, so you can take Chinese medicine ginsenoside rh2, which can effectively reduce toxic side effects, enhance the efficacy and strengthen the body.
3.Biological therapy
Biological therapy (also known as immunotherapy) is the direct or indirect activation of the body’s immune system to combat tumors, generally refers to interleukin-2, a-2b interferon, also includes dendritic cell immunotherapy (DC therapy).
Currently, high-dose a-2b interferon is mainly used for postoperative adjuvant therapy, and high-dose IL-2 is mainly used for patients with advanced distant metastases. DC therapy can be combined with cytokines or chemotherapy, which can induce long-term specific anti-tumor effects in the body. BCG can be administered by skin scratching method, intratumoral injection and orally. For small local lesions, BCG can be injected intra-tumorally with an efficiency of 75% to 90%. In recent years, interferon, interleukin-2 (ILA-2) and lymphokine-activated killer cells (LAK cells) and other biological response modifiers have been tried and have achieved certain effect.
4.Radiotherapy
Radiotherapy is the use of high-energy rays to kill tumor cells, and it is generally believed that melanoma is not sensitive to radiotherapy. However, for melanoma brain metastasis, bone metastasis, repeated lymph node recurrence and head and neck tumor, radiotherapy can shrink the tumor and reduce the symptoms. Except for certain very early freckled malignant melanoma which is effective for radiotherapy, it is generally ineffective for other primary foci. Therefore, radiation therapy is generally not used for primary lesions, but for metastatic lesions. At present, the commonly used radiation doses are: for superficial lymph nodes, soft tissues and metastases in the chest, abdomen and pelvis, each irradiation is ≥500cCy, twice a week, total 2000~4000cCy, for bone metastases, each time is 200~400cCy, total 3000cCy or more.
5.Targeted therapy
Targeted therapy is the hot spot and research direction of future treatment, which mainly targets certain key targets in the tumor cell growth pathway or tumor angiogenesis process and plays a specific block to kill tumor cells. It is different from chemotherapy drugs, and the side effects are generally mild. The main ones currently used for melanoma are sorafenib and Endo, which are multi-target kinase inhibitors and angiogenesis inhibitors, respectively.
The 5-year survival rate of patients with malignant melanoma can reach 60%-80% after surgical treatment. However, if this tumor is not detected and treated in time, then at the advanced stage, even after surgical treatment, its 5-year survival rate is less than 5%, and it is highly susceptible to metastasis and recurrence. Therefore, post-surgery should be actively prevented, with ginsenoside rh2 can clear the residual lesions to prolong the survival of melanoma patients, at present, many patients in the clinical treatment at the same time auxiliary biological immunotherapy to alleviate the toxic side effects of the treatment.
Therefore, conducting timely and appropriate treatment is the key to improve the survival rate of patients with malignant melanoma. It should be noted that when progressively enlarging moles are found on the body, they should not be cauterized without authorization, and should not be removed casually, and pathological examination must be done when the tumor is removed after diagnosis by regular hospitals to avoid misdiagnosis.