management and treatment of malignant melanoma

stage 1 :
-Wide Local Excision
>surgically removing the melanoma as well as a small area of skin around it
>removes at least 1cm of skin all around the melanoma
>leave significant scarring
>Skin Grafts
---removing a patch of healthy skin , it is then connected, or grafted, to the affected area.

Stage II and III
-Lymph Node Dissection
-Adjuvant treatment :Treatment after surgery to try to reduce the risk of the melanoma coming back
-Drug – Interferon

Lymph node dissection :
-an operation to remove all the lymph nodes in the area, Just in case they contain cancer cells
>>Block dissection
-Risk : disruption of the lymphatic system.leading to a build-up of fluids in your limbs ---> lymphoedema

Drug -interferon
-It is given after surgery has been completed
-is administered by injection under the skin (subcutaneously )
-require three injections a week
-helps stimulate the body’s own immune system to fight any remaining cancerous cell
-cause side effects similar to flu symptoms (fever, chills, headache, tiredness)

Stage IV
-Surgery
>Sentinel lymph node biopsy
>Lymph node dissection
-Biological therapy
>Interferon
>Interleukin
-Chemotherapy
>Isolated limb perfusion
-Radiotherapy

Surgery
-removes the tumor and some normal tissue around it (margin)
-Lymph nodes near the tumor may be removed
>Sentinel lymph node biopsy
*To determine whether further surgery is needed by checking whether there are cancer cells in the lymph nodes
>Lymph node dissection

Biological therapy
-Interferon
-Interleukin
>part of the immune system.

chemotherpy
-damage the DNA of the cancer cells, interrupting their ability to reproduce
-cancer drugs to destroy cancer cells
>dacarbazine (DTIC)
>temozolomide (Temodal)
-is given by an infusion (drip) into one of the veins in your arm (intravenously)
-three or four weeks
-Side effects of chemotherapy can include:
>nausea,
>vomiting,
>hair loss, and
>fatigue.
-weaken your immune system, making you more vulnerable to infection
-Isolated limb perfusion
>secondary melanoma is confined to just an arm or a leg
>allows chemotherapy to be given to just one limb

Radiotherapy :
-Using high speed ionising radiation to destroy cancer cells
-Most effective : the cancer cell needs to be dividing at the time of the radiotherapy
>treatments often take place daily for a number of weeks
-There are internal and external radiotherapy
-Side effects :
>tiredness,
>nausea,
>loss of appetite,
>hair loss,
>sore skin, and
>a lack of interest in sex.

complementary treatment :
-Nutrition therapy – nutrition plan, diet, supplements, education
-Pain management - pharmacological and non-pharmacological
-Naturopathic Medicine - botanical med. , eastern med., psychological med.
-Mind-body medicine - stress management, relaxation and imaginary training, spiritual meditation, support group, counseling
-Oncology Rehabilitation – physical therapy, manual therapy, occupational therapy, speech therapy
-Spiritual Support - group prayer
-Image enhancement – cosmetic image enhancement, plastic/reconstructive support

http://www.cancercenter.com/melanoma/complementary-alternative-melanoma-treatment.cfm

Palliative care :
-improves the quality of life of patients and their families facing the problem associated with life-threatening illness through the prevention and relief of suffering by means of early identification,impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

-provides relief from pain and other distressing symptoms;
-affirms life and regards dying as a normal process;
-intends neither to hasten or postpone death;
-integrates the psychological and spiritual aspects of patient care;
-offers a support system to help patients live as actively as possible until death;
-offers a support system to help the family cope during the patients illness and in their own bereavement;
-uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;
-will enhance quality of life, and may also positively influence the course of illness;
-is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
http://www.who.int/cancer/palliative/definition/en/