Chemotherapy (chemo) is a treatment using drugs that are usually injected into a vein or taken as a tablet. The drugs travel throughout the body and attack cancer cells that have already spread beyond the initial (primary) melanoma. Chemotherapy is usually given in cycles and is often associated with side effects. The goal of chemotherapy is to slow the growth of the cancer cells that have spread. It is rare that a cure is achieved. Chemo is usually not as effective in melanoma as it is in some other types of cancer, but it may relieve symptoms or extend survival for some patients.
Whilst chemo can still be used to treat advanced melanoma, it is no longer routinely used as the first treatment due to the recent development and availability of newer forms of immunotherapy and targeted drugs.
Possible side effects of chemotherapy
Chemotherapy works by attacking cells that are dividing quickly, which is how cancer cells behave. Unfortunately chemo cannot act on the cancer cells alone and also affects other rapidly dividing cells such as bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles.
The side effects of chemo depend on the type and dose of drugs and the length of time they are given. These side effects may include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Diarrhea or constipation
- Increased risk of infection
- Easy bruising or bleeding
- Neuropathy (nerve pain, tingling, burning, heat/cold sensitivity)
Side effects are usually temporary and steps can be taken to prevent or reduce them, however the impact on a patient’s quality of life whilst undergoing chemo can be considerable.
External beam radiation therapy uses x-rays to kill cancer cells by damaging their DNA. The treatment is much like getting an x-ray, but the radiation is stronger. The procedure itself is painless. Each treatment lasts only a few minutes, however more time is involved in the initial planning and setup for each treatment.
The number of radiotherapy treatments required can vary depend on the size and location of the area being treated.
Radiotherapy is rarely used to treat a primary (initial) melanoma. It is however, often given after surgery in an area where lymph nodes were removed to try and lessen the likelihood of a recurrence, or return, of the cancer. It is also used to treat melanoma that has recurred after surgery or to help treat disease that has spread (metastasised) to other areas. This treatment is referred to as palliative therapy. Palliative radiotherapy is not given with the intent to cure the cancer, but it might help shrink it or slow its growth for a time to help control some of the symptoms.
Possible side effects of radiation therapy
Common side effects depend on where the radiation is aimed and can include:
- Sunburn-like skin problems
- Hair loss where the radiation enters the body
- Loss of appetite and weight loss
- Often these go away after treatment.
Radiation therapy to the brain can sometimes cause memory loss, headaches, trouble thinking, or reduced sexual desire.
What is Immunotherapy?
This is the name given to any treatment that utilises the body’s own immune system to fight disease. This may occur by eliciting, enhancing or suppressing a natural immune response. There are a number of treatments that fall in this category.
Anti PD1 drugs:
In the simplest possible terms, these drugs are antibodies that block the on/off switch on a type of white cell (T-cell). Specifically, melanoma tumors produce a substance that ‘turns off’ these T cells, so they do not attack the melanoma. These drugs block that action so that the T-cells stay switched on and can now attack melanoma cells.
Another of the body’s white cells are the cytotoxic T lymphocytes (CTLs) which can recognize and destroy cancer cells. However, another inhibitory process, similar to that described above, interrupts this destruction. These drugs turn off this inhibitory mechanism and allow CTL’s to function and attack the melanoma cells.
Immunotherapy Side Effects
This youtube clip of a presentation by Dr Lipson from Johns Hopkins University talks about the side effects associated with the newer immunotherapy treatments and how they differ from chemotherapy side effects.
What is Biological Therapy?
Biological therapy involves the use of living organisms, substances derived from living organisms, or laboratory-produced versions of such substances to treat disease. In the case of cancer treatment most biological therapies take the form of vaccines or bacteria. These therapies stimulate the body’s immune system to act against cancer cells rather than target them directly. This is why most biological therapies are also a type of immunotherapy.
Enhancing melanoma outcomes using a timed immunotherapy vaccine
Recruiting Patients With Advanced Melanoma
The AMRF is a major sponsor of the EMOTIV trial for patients with advanced melanoma, which is continuing at the Royal Adelaide Hospital.
Eligibility: The study is for South Australian patients with advanced (Stage IV or III) melanoma, which cannot be removed by surgery.
Aims: To test a new approach to administering a melanoma vaccine, which had excellent results in a previous study, when it was given at regular intervals (18% complete response rate and 13% 5-year survival times). The vaccine doses will be either ‘timed’ or ‘not-timed’ with the patients own immune system fluctuations. The potential is to improve the effectiveness of the vaccine. The vaccine has virtually no side effects and early results of this study are remarkable.
Contact: If you are interested, would like to know if you are eligible for entry, or would like more information then please contact Julie Calvert firstname.lastname@example.org and 0419 822 969
Note: Eligibility criteria apply.
Vaccine Trial Testimonials:
What is Targeted Therapy?
Targeted cancer therapies work by interfering with specific molecules (“molecular targets”) that are involved in the growth, progression and spread of the cancer. Most targeted therapies are ‘cytostatic’ meaning they block cancer cell proliferation, rather than cytotoxic (eg. chemotherapy), which kills tumour cells.
Approximately 40% of melanoma patients contain an altered form of a growth signalling protein known as the B-Raf protein. If a patient’s tumor is shown to contain this protein, the patient is deemed B-Raf positive and may receive a treatment that targets this specific altered protein. Unfortunately cancer cells tend to become resistant to these therapies. For this reason, they are often used in combination ie. more than one drug at a time.
Targeted Therapy Side Effects
Targeted cancer therapies can have substantial side effects. They are most commonly
- Skin problems (acneiform rash, dry skin, nail changes, hair depigmentation)
- Liver problems such as hepatits and elevated liver enzymes
- Problems with blood clotting and wound healing
- High blood pressure
- Gastrointestinal perforation (a rare side effect of some targeted therapies)
What to look for
It is very important to check your skin regularly in order to detect any changes in the SIZE, COLOUR or SHAPE of a mole or skin lesion.
An easy way to detect potentially harmful moles or lesions is by using the ABCDE guidlines.
Your exposure to ultra violet (UV) light from the sun is one of the major risk factors for melanoma that you can control. UV levels are highest in summer, late spring and early autumn.
UV levels are not dependent on the temperature or cloud cover. A colder, cloudy day will still have high UV levels in summer. The following tips can help prevent melanoma…
Catching a melanoma in its early stages is one of the most important factors in improving the outcome of a melanoma diagnosis. It can literally SAVE A LIFE.
Why is catching it early so important?
Did you know...
AUSTRALIANS WHO WILL
BE DIAGNOSED WITH
MEN WHO WILL BE
WOMEN WHO WILL BE
IN AUSTRALIA AFTER
PROSTATE & COLORECTAL CANCER (MEN), BREAST