Melanoma - New Therapies to Fight Skin Cancer
Assoc. Prof. Priv.-Doz. Dr. Julia Valencak
Dermatology, skin and venereal diseases
How does melanoma develop?
In 80% of cases, melanoma develops “de novo”, i.e. on healthy skin. Only about 10-20% of melanomas arise in / from an existing birthmark. There is also a genetic component. People with a large number of birthmarks have a higher risk of melanoma than people with less than 25 birthmarks. UV light or exposure to the sun is a high risk factor.
What are the symptoms?
First and foremost, the patient recognizes a newly appeared mole that may show signs of atypia and does not appear to be similar to the other moles.
How does the doctor make the diagnosis?
The suspected diagnosis can be made with a magnifying examination lamp, the final diagnosis is then based on the histological findings after removal.
What can you do about prevention?
You can have your moles checked regularly and, if necessary, saved digitally so that you can check them once a year.
How often should you have birthmarks checked by a dermatologist?
As a rule, you should see a dermatologist once a year if you have a lot of moles, plenty of sun exposure and / or a family member with melanoma.
When and how is drug therapy for melanoma carried out?
Drug therapy is usually necessary if the penetration depth of the malignant cells is greater than 0.8 - 1.5 mm Breslow index and / or lymph nodes are also involved, if there is an increased risk of the formation of metastases or these have already occurred.
What new therapeutic approaches are there?
The treatment of metastatic malignant melanoma has changed significantly in recent years. Instead of hardly effective cytostatics, new targeted drugs and immunologically effective substances are the means of choice today. They achieve significantly better survival rates and open up the chance of long-term survival.
For the advanced stages there are adjuvant interferon-alpha therapy, immunotherapy with ipilimumab or anti-PD1 antibodies (nivolumab, pembrolizumab). Patients who show a BRAF mutation – the most common mutation which accelerates the growth of the tumor - can also be treated with BRAF inhibitors such as vemurafenib. The decision about the therapy must be made in conjunction with many other factors such as lymph nodes or organ involvement, mitotic rate, depth of penetration, age of the patient and comorbidities.
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