Breakthroughs in Melanoma Detection and Treatment

This type of skin cancer has become much more common in recent years. But we’ve made great strides in the tests doctors use to diagnose melanoma and the tools they have to treat and cure it.

It’s Easier to Spot

The best way to diagnose melanoma is with a biopsy. That’s when a doctor takes a small piece of your skin and sends it to a lab. Doctors there study it under a microscope for signs of cancer.

Biopsies aren’t risk-free, so researchers have been working on better ways to diagnose melanoma. One commonly used tool, developed decades ago, is a dermascope. It’s a handheld device that doctors use to light up and magnify your skin so they can see it better.

More advanced tools are available, too:

MoleMate and SIMSYS: These handheld devices scan moles and skin lesions for signs of melanoma. They put out a special light that lets your doctor see 2 millimeters below your skin’s surface. The devices then take digital pictures of the area. Your doctor will use special software to check them for signs of cancer. SIMSYS can track changes in your moles over time, too.

MelaFind: This handheld device also scans moles for cancer signs. But because it sometimes flags harmless lesions as being potentially cancerous, doctors reserve it for special use.

Confocal scanning laser microscope. This low-powered, handheld laser reflects light off your skin’s surface to create a 3D image of the area. It’s expensive and requires a lot of training, so not many dermatologists use it.

Making the Call

Some types of melanoma spread faster and are more dangerous than others. These new technologies help doctors analyze cells taken during a biopsy.

  • Comparative genomic hybridization testing (CGHT) and Early fluorescence in situ hybridization (FISH). These tests check for genetic features linked to serious melanoma.
  • DecisionDx-Melanoma test. This test can tell which genes inside the cells are turned on. It uses that to predict the chances that melanoma will spread to other parts of your body.

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New Treatment Methods

If you have melanoma, your doctor may recommend several different treatments, including surgery, radiation, chemotherapy, or drugs. Recently, researchers have made headway in developing therapies that specifically target cancer cells, called “targeted therapies.” Here are some of the latest:

Dabrafenib (Tafinlar) and vemurafenib (Zelboraf): About half of all melanomas are made up of cells with an altered gene called BRAF. It makes a protein that helps the cancer cells grow. These two drugs, taken as pills, attack the altered BRAF protein, which stops cancer growth.

Trametinib (Mekinist) and cobimetinib (Cotellic):  These drugs, taken as pills, also treat cancers with altered BRAF genes, but they don’t work the same way. They block a protein called MEK, which works with BRAF to help the cancer grow. 

Imatinib (Gleevec) and nilotinib (Tasigna): These drugs, taken as pills, treat the small number of melanoma tumors that have an altered gene called c-kit. The protein made by this gene is found on the surface of some melanoma cells and helps blood cells grow, which feeds the cancer.

Imlygic (talimogene laherparepvec): This is what’s known as an oncolytic virus therapy. That means it’s genetically engineered to seek out and destroy cancer cells without harming other cells. You’d get this injected into your melanoma lesions. After your first treatment, you’ll get another about 3 weeks later and more every 2 weeks after that for about 6 months.

Anti-CTLA-4 (ipilimumab): CTLA-4 is a molecule on the surface of T-cells that blocks their ability to attack cancer. This drug frees up your T-cells to fight the disease. You'd get four doses of this this through an IV every 3 weeks. It can help you live longer.

Rarely, this drug can cause an allergic reaction. If you have any of the symptoms below, get medical help right away:

  • Rash
  • Itching or swelling, particularly of the face, tongue or throat
  • Dizziness
  • Trouble breathing

Pembrolizumab (Keytruda): This drug also blocks proteins (called PD-1 and PD-L1) that keep your immune system from fighting cancer as strongly as it could. You’d get this through an IV every 3 weeks.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on July 02, 2018

Sources

SOURCES:

American Melanoma Foundation: “2009 Skin Cancer Fact Sheet.”

Melanoma Research Foundation: “Diagnosing Melanoma.”

Marghoob, A. American Family Physician, Oct. 1, 2013.

MedX: “About SIMSYS-MoleMate.”

Stevenson, A. Dermatology Practical & Conceptual, October 2013.

American Cancer Society: “Tests for melanoma skin cancer,” “Targeted therapy for melanoma skin cancer.”

National Comprehensive Cancer Network: “NCCN Guidelines for Patients: Melanoma.”

National Cancer Institute: “NCI Dictionary of Cancer Terms.”

Melanoma Research Alliance: “Pembrolizumab (Keytruda).”

FDA: “FDA Approves First-of-its-kind Product for the Treatment of Melanoma;” "FDA approves Yervoy to reduce the risk of melanoma returning after surgery;" and "FDA Approves Keytruda for Advanced Melanoma.”

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