In addition to surgery, there are four other types of therapies used to treat melanoma. Here is a little more information on these approaches.
Chemotherapy is the term used to describe the use of chemicals, or 'chemotherapeutic agents', to kill cancerous cells in the body. Chemotherapy drugs target living cells in the body that are dividing rapidly, which is what cancer cells do, and so this is why other cells in the body that reproduce rapidly normally are also affected, leading to hair loss, decreased production of blood cells and inflammation of the cells lining the digestive tract. A course of chemotherapy will typically include one or more drug types, which can be delivered orally or directly into the bloodstream, and on occasion directly to the organ or tissue affected. Unfortunately chemotherapy is not very effective in treating melanoma.
Immunotherapy (or 'Biological Therapy')
Immunotherapy is a relatively new approach to treating all cancers, including melanoma. Its main advantages over other treatments is that side effects are minimal and the positive benefits of the immunotherapy last a lot longer than other therapies.
Drugs used in immunotherapy contain antibodies (called Biological Response Modifiers, or 'BRMs') that in effect assist the body's own immune system to fight cancer cells. The immune system reacts when it detects cancer cells, but is often overwhelmed by the cancer and immunotherapy almost 'trains' the immune system to continue to attack the cancer cells itself. At the moment immunotherapy is only used in advanced cases of melanoma in Australia that have not responded to other types of treatment, or as part of clinical trials.
As immunotherapy is so new, only one drug is available on the PBS – Yervoy (Ipillimumab), although another – Keytruda (Pembrolizumab) – is due to be added soon.
Radiation Therapy (or 'Radiotherapy')
Some types of cancer cell are very rapidly killed by small amounts of radiation. Radiotherapy is used to treat primarily advanced melanoma to help reduce the size of the tumour and to control symptoms. It is also occasionally used to reduce the risk of the melanoma returning after surgery. It is also used to control melanoma that has spread elsewhere in the body, often to the brain and to bones, and to control symptoms and pain.
As the name implies, a 'targeted therapy' is one where the specific genetic mutations responsible for the growth of particular types of cancer are targeted directly. Melanoma is one of the cancer types where targeted therapies are available, but they are only effective for some genetic mutations. The three genetic mutations discovered so far where targeted therapies can block their ability to create cancer cells are called BRAF, NRAS and C-KIT.
Scientists are continuing to discover more mutations, and, as targeted therapies are such a new type of treatment, some treatments can only be accessed via clinical trials.
Medical teams often combine two or more of these different types of treatment to maximise the effectiveness of the course of treatment for melanoma.