ABOUT DRUG THERAPY FOR MELANOMA
Drug therapy, also known as systemic therapy, refers to several types of medication that travel through the bloodstream to attack cancer cells anywhere in the body. You can receive drug therapy orally as a pill or intravenously through an injection or infusion into a vein. Your medical oncologist, a doctor who specializes in anticancer medications, manages your drug therapy.
Drug therapy can treat melanoma at any stage in the body. In general, drug therapy stops the growth of cancer cells by destroying the cells or stopping them from dividing and multiplying.
Types of drug therapy
At the Stanford Skin Cancer Program, our medical oncologists use several types of drug therapy, including:
- Topical medications: When a patient has skin cancer on their head or neck, surgery may not be feasible. Doctors may use a skin cream, which is very effective for certain subtypes of melanoma or non-melanoma skin cancer.
- Targeted therapy: For melanoma that has spread beyond the skin or lymph nodes, doctors may prescribe drugs that aim for specific mutations in the melanoma cancer cells. Often, these drugs are MAP kinase inhibitors (or a BRAF inhibitor).
- Immunotherapy: For melanoma that has spread beyond the skin or lymph nodes, doctors may prescribe drugs that unleash the patient’s own immune system to attack the melanoma. Often, the drugs used are called checkpoint inhibitors.
Uses for drug therapy
Depending on your case, your doctor may use drug therapy for treatment:
- When melanoma has spread beyond the spot to lymph nodes or to other parts of the body (stage III or Stage IV melanoma)
- To delay or prevent melanoma from coming back (recurring) after treatment
- To manage symptoms of incurable (advanced) melanoma, and to help you live longer and more comfortably
Many people who have stages 1, 2, or 3 melanoma have surgery, either to remove the tumor itself or the entire affected area. Our skin cancer teams pair drug therapy with surgery in different ways:
- Before surgery: Neoadjuvant drug therapy can shrink tumors, to make surgery possible or easier and more effective. Sometimes, neoadjuvant therapy can shrink the tumor almost completely. If the pathologist (doctor who specializes in testing) cannot find any remaining cancer cells, this result is called a pathologic complete response.
- After surgery: We often use drug therapy as an adjuvant treatment to destroy any remaining cancer cells after surgery. Studies have shown that drug therapy can help you live longer and prevent or delay cancer from returning.
Conditions treated with drug therapy
- Melanoma skin cancers
- Non-Melanoma skin cancers
Risks and side effects of drug therapy
The side effects of drug therapy vary depending on the type of drug and the dose. Your doctor will discuss the specific medications you will be taking, their side effects, and ways to manage them.
Most side effects go away after your treatment ends, but some side effects continue after treatments finish and could start months or even years later. The common side effects that you may experience include:
- Colitis (inflammation of the colon)
- Changes in hormones
- Toxicity to heart cells
- Hair loss
- Hot flashes
- Loss of appetite
- Mood disturbances
- Mouth sores
- Changes to fingernails and toenails
- Nausea and vomiting
- Vaginal bleeding, discharge, or dryness
Other, rare side effects include:
- Blood clots
- Bone thinning (loss of bone mass), which can lead to osteoporosis
- Heart attack or damage that can lead to congestive heart failure
- Joint stiffness
- Muscle pain
- Shortness of breath
- Uterine cancers
- Nerve injury
If you experience side effects, let your care team know.