Treatment of Metastatic Melanoma

Effective treatment of metastatic melanoma in Israel carried out by experts at the Oncology Department of leading private hospital Herzliya Medical Center. The application of innovative technologies and conservative and surgical treatment of metastatic melanoma, as well as early detection, have allowed HMC to achieve excellent results in survival and long-term remission in the majority of patients. Metastatic melanoma is also termed advanced melanoma or stage IV melanoma.

How Does Metastatic Melanoma Spread?

Metastatic cancers involve the secondary spread of cancers from their primary location, to other parts of the body via the lymph nodes. Recurrence of melanoma is also possible to develop within 2cm of the initial melanoma scar. Metastatic cancers are harder to treat; therefore, early detection is imperative for a patient’s complete recovery.

Melanoma is a highly malignant tumor originating in the pigment cells (melanocytes) of the skin, mucous membranes and the retina of the eye (rarely). This type of cancer is highly invasive (penetrating) and has the ability and propensity for early dissemination of metastases. The main routes of metastasis of melanoma are:

  • Contact Distribution - tumor invasion into adjacent organs and tissues
  • Lymphatic spread - malignant cells spread through the lymphatic system to regional lymph nodes, where the melanoma can then spread to distant organs like the brain, lungs or liver
  • Hematogenous spread - malignant cells enter the bloodstream. Melanoma metastases in the liver, lungs, bones and brain are usually characteristic of hematogenous melanoma

Metastatic melanoma develops in late diagnosis of melanoma, or by ineffective use of treatment methods. This highlights the importance of patients being diagnosed early for effective treatment of melanoma in Israel will help prevent the risk of secondary spread.

Metastatic Melanoma Treatment

Modern methods of complex therapies, including the treatment of metastatic melanoma apply to cancer treatment in Israel:

  • Surgical removal of the metastatic process – includes single and localized outbreaks. Subject to removal as the lymph nodes, and secondary tumor parenchymal organs. In some cases, patients with metastatic melanoma have cytoreductive (debulking) surgery, which reduces the mass of malignant cells and increases the effectiveness of complex anti-cancer therapy.
  • Chemotherapy is indicated in the vast majority of metastatic melanoma cases. Specialists Clinic uses modern protocols that include high anticancer drugs (dacarbazine, temozolomide). Along with the traditional methods of application of chemotherapeutic agents, clinic’s oncologists electrochemotherapy mastered innovative method using electrical pulses to increase the effectiveness of drug treatment
  • Immunotherapy for melanoma metastases is a new and highly promising method and effective in treating recurrent forms of the disease. Drugs such as Interleukin-2 and Imiquimod help the immune system to recognize and destroy cancer cells throughout the body. This area of medicine is being thoroughly investigated for improved targeted treatment
  • Immunotherapy TIL activates the natural immune response. Several melanoma metastases are removed by surgery, tumor and TIL cells (tumor infiltrating lymphocytes) are extracted. These TILs are unique in that they are able to infiltrate and target the destruction of tumor cells. These cells are artificially propagated in the laboratory for 2-4 weeks, after which they are introduced back into the blood plasma
  • The possibility of applying targeted therapy for metastatic melanoma is determined in the laboratory of Herzliya Medical Center. The Oncologist Clinic has extensive experience in the successful application of targeted drugs such as ipilimumab, sorafenib, dabrafenib, vemurafenib, nivolumab and pembrolizumab
  • Radiation therapy is used when melanoma metastases involve skin manifestations, and when it spreads to the internal organs. Herzliya Medical Center use unique methods of radiosurgery, the Gamma Knife - brain and the CyberKnife – remaining organs to help remove metastatic foci in remote areas that are otherwise difficult to access surgically

Treatment of Melanoma Metastases of the Lymph Nodes

It is possible to surgically remove single lymph nodes or main lymph node groups that are involved in the disease process. Typically, surgery is performed in conjunction with radiation therapy and medication; this increases the likelihood of destroying the malignant cells. Treatment of melanoma metastases in the lymph nodes is carried out under the control of high-precision diagnostic methods that are sensitive to metabolic changes of tissues using PET-CT scan.

Treatment of Melanoma Metastases of the Liver

Herzliya Medical Center conducts surgeries to remove the melanoma metastases in the liver. In addition to surgical treatment, the possibility of a minimally invasive procedure using a high-frequency ablation of the tumor. Chemosensitivity of the tumor treated by hepatic artery chemoembolization. The high sensitivity of hepatocytes (liver cells) to radiation limits the use of irradiation of metastatic lesions; however, recently a technique of radiosurgery for inoperable metastatic melanoma to the liver was developed.

Treatment of Lung Melanoma Metastases

Surgical removal of isolated foci is undertaken, as a rule, after preliminary (neoadjuvant) therapy, which aims to reduce the size of the pathological process. Herzliya Medical Center utilizes a combinative approach using traditional methods that are applied with innovative technologies of precision irradiation (CyberKnife), intensity modulated radiation therapy, can significantly reduce the side effects in the treatment of melanoma metastases in the lungs.

Treatment of Metastatic Melanoma in the Brain

Prognosis of patients with metastatic melanoma to the brain fundamentally change the innovative technique of radiosurgery (stereotactic radiotherapy). The use of intensive and high-precision radiation precisely focused on metastatic lesions enables the patient’s safety in order to remove deep and inoperable metastases. Radiofrequency (Gamma Knife) is used in single or in multiple metastases of melanoma of the brain and is highly efficient in recurring cases.

Integrative Treatment Approach at HMC

Recurring melanoma affects many organs and systems, and requires a comprehensive approach in diagnosis and selection of optimal treatment strategies. Herzliya Medical Center use the results of recent discoveries of the world's leading centers for the study of melanoma and guarantee an individual approach to the treatment of each patient, taking into account characteristics of the disease, response to previous therapy, and the presence of concomitant medical problems. The hospital’s main priority is to ensure the patient’s optimal health and remission from the disease.

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