Our Treatment Approach
Our Center for Melanoma Oncology is committed to world-class care and innovative research. Our 50-50 balance of research and patient care uniquely positions us to develop and deploy promising new treatments. This dual focus fosters collaboration among researchers, clinicians, and patients to help translate discoveries made in the lab to new and more effective treatment options.
Our physician-scientists' investigations into immunotherapies and the genetic underpinnings of melanoma are paving the way for personalized medicine. We have numerous melanoma-related clinical trials currently underway, testing new immunotherapies, vaccines, and novel, targeted drugs.
Experts from a wide variety of specialties come together to evaluate and treat your particular melanoma, no matter how simple or complex. We regularly treat patients with many forms of melanoma, including intraocular melanoma and mucosal melanoma.
Multidisciplinary Team
When you come to our Center, you receive care from a multidisciplinary team of doctors and other clinical providers. Working together as one singularly-focused team, our medical and surgical oncologists, radiation oncologists, dermatologic oncologists, dermatopathologists, radiologists, plastic and reconstructive surgeons, and nurses evaluate and treat your melanoma together. Because of our specialists' close integration, our team offers you their collective expertise when formulating and executing an optimal, highly coordinated care plan.
Patients with melanoma often require a combination of surgery, chemotherapy, and radiation therapy. For this reason, our coordinated team approach is the best way to manage these complicated cases. Our team holds:
- Weekly tumor boards to discuss patients' cases.
- Monthly lectures to discuss the latest advances in the clinical and research aspects of melanoma.
- Pigmented Lesion Clinics.
We collaborate with other specialists at Dana-Farber Brigham Cancer Center to treat patients with central nervous system, lung, liver, and other metastases.
Personalized Treatment Plans
As a highly specialized Center, we focus on the distinct needs of people with melanoma. This enables us to provide a very personalized approach to your care.
Your team works to ensure that your care plan will offer the best possible outcomes, and that all your needs are met. We view every patient as an individual with unique needs and expectations, so we take the time to involve you and your family in each step of the treatment process. As you go through treatment and recovery, you have access to a wide range of resources – from nutritional services to integrative therapies – to support you and your family.
Immunosuppression and Skin Cancer Clinic
Immunosuppressed people have an elevated risk of skin cancer, a factor particularly relevant for light-skinned people who have had several sunburns in their lifetime. We specialize in the prevention and treatment of skin cancer in patients who are immunosuppressed because of certain diseases or immune-suppressing medications.
Our Clinic provides topical or oral treatments when appropriate to slow down or reverse sun damage. With proactive treatments and monitoring, even patients who have had multiple cancers can have a marked decrease in the number of new cancers they develop.
Treatment for Melanoma
When you begin your treatment, you will have access to many of the world's leading melanoma specialists, who work closely together to evaluate and treat patients with confirmed or suspected melanoma. Our Center offers novel interventions, including minimally-invasive surgical approaches, adjuvant medical therapy, and advanced radiation techniques.
The goal of treatment is to remove or destroy the cancer completely. If all of the melanoma was removed during your biopsy, you may not need any further treatment.
Certain Factors Affect Your Treatment Options
Your prognosis (chance of recovery) and treatment options depend on:
- The thickness of the tumor.
- How quickly the cancer cells are dividing.
- Whether there was ulceration at the primary site.
- Whether cancer has spread to the lymph nodes or other places in the body.
- The number of locations where cancer has spread in the body, and the level of lactate dehydrogenate (LDH) in your blood.
- Whether the cancer has certain mutations (changes) in a gene called BRAF V600E.
- Your general health.
Potential Treatments
Surgery
Treatment of melanoma is considered a highly specialized field of cancer surgery. At Dana-Farber Brigham Cancer Center's Center for Melanoma Oncology, our surgical oncologists are among the world's leading surgical specialists treating complex and advanced-stage melanoma. And our plastic and reconstructive surgeons are pioneers in groundbreaking procedures. The size and experience of our surgical group allow us to tailor specific, individual care to each patient.
Surgery to remove the tumor is the usual treatment of all stages of melanoma. The goal of surgery is to remove the melanoma, while leaving as much of the nearby skin as intact as possible.
Your surgeon may perform the following procedures:
- Wide local excision: Surgery to remove the melanoma and some of the normal tissue around it.
- Lymphadenectomy: A surgical procedure in which all of the lymph nodes are removed from an area (for example, cervical, axillary, external iliac, or femoral).
- Sentinel lymph node biopsy: Removal of the sentinel lymph node (the first lymph node the cancer is likely to reach) during the wide local excision. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove additional lymph nodes.
If your regional cancer has spread to the lymph nodes, the surgeon may remove some or all of the nearby lymph nodes. Our Center is unique in that our surgical oncologists closely collaborate with plastic surgeons for reconstruction. If you have a large area of tissue to be removed, you may have reconstruction done by plastic surgeons from Brigham and Women's Hospital.
Radiation Therapy
You will receive a carefully considered, customized plan to use radiation therapy when and where it is likely to be most effective. The goal of radiation is to destroy cancer cells. It may be used:
- After surgery to eliminate any cancer cells that may be left.
- To treat melanoma that has come back after initial treatment, or has spread to other parts of the body.
- If your melanoma is located in an area that makes it hard to remove by surgery.
We offer a range of radiation therapies for advanced melanoma.
Radiation therapy uses high-energy X-rays to destroy cancer cells or keep them from growing:
- External radiation therapy uses a machine outside the body to direct radiation to the cancer site or sites.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.