Melanoma

Expert Melanoma Care, Close to Home

Melanoma is a type of cancer that mainly affects the skin. In some cases, it may impact the eye and/or mucous membranes (vulva, vagina, lip, throat, esophagus, and perianal region). This cancer develops from melanocytes, which are cells that produce melanin, the pigment that gives skin its color. At Texas Oncology, we are here to provide trusted expertise, advanced treatments, and individualized care every step of the way.  

What sets Texas Oncology apart is our collaborative, patient-centered approach. With more than 550 physicians across the state, we offer world-class care close to home.

When you seek care with us, you can expect a personalized care plan, a dedicated team alongside you, and the latest advancements in cancer treatment, all designed to support you.  

Melanoma Diagnosis at Texas Oncology

Texas Oncology specialists are equipped to diagnose melanoma and may use the following tests:

Skin biopsy

This procedure involves removing a small sample of skin to examine under the microscope. This is most often performed by the patient’s primary dermatologist or primary care physician to establish a new diagnosis.  

Sentinel lymph node biopsy  

A technique used to detect small amounts of melanoma in lymph nodes. During this procedure, a tracer (blue dye) is injected into the area of the primary melanoma. This tracer identifies the sentinel lymph node, which is the first lymph node that could potentially be involved with melanoma. The sentinel lymph node is surgically removed and examined under a microscope.  

Genomic or biomarker testing  

The goal of this test is to find specific markers and changes in a cancer’s DNA to find targets that can be treated with specialized cancer medicines.  

Computed tomography (CT) scan  

A CT scan provides detailed images of body tissues and organs to determine the extent and spread of melanoma.  

Magnetic resonance imaging (MRI)

Using magnetic fields and radio waves, MRIs produce detailed images of tumors and distinguish between healthy and diseased tissue.  

Positron emission tomography (PET)

A PET scan is an imaging test that injects a radioactive substance called tracers to create images of the body, showing how the body is functioning on a metabolic level.  

Bone scan

Used to detect cancer spread to the bones. A radioactive substance is injected, which collects in areas of abnormal bone growth and is then scanned to measure radioactivity. These tests assist in diagnosing melanoma and assessing its spread, which is crucial for determining the appropriate treatment plan.  

Treatments for Melanoma  

Melanoma treatment is not one size fits all. That is why we personalize your treatment plan based on factors like age, medical history, general health, and treatment goals. Treatment for melanoma may involve the following:  

Surgery

Early stage melanomas are highly curable; therefore, surgery may be utilized to treat the disease before it spreads. Most commonly, doctors may need to make wide local excisions (to remove) of the melanoma tumor and some healthy tissue to ensure complete removal and to prevent the cancer from returning. For those with higher risk, early stage melanomas, a sentinel lymph node biopsy may be performed to determine if there has been spread of melanoma to the lymph node tissue.  

Radiation therapy 

Using high-energy rays, radiation damages and destroys cancer cells. Radiation is sometimes used in the treatment of melanoma to decrease the risk of melanoma coming back or to kill tumors in a specific place such as the brain.  

Systemic therapy  

Systemic therapy involves the use of medications that travel through the bloodstream to reach and affect cancer cells all over the body. It includes treatments such as immunotherapy, targeted therapy, or chemotherapy, which can be used to treat more advanced melanoma.  

Immunotherapy  

Melanoma is thought to be a very immunogenic cancer, which means that the body’s immune system can recognize and attack it. Immunotherapy utilizes drugs, vaccines, and other therapies to activate the body's natural defenders to fight cancer. Several different types of immunotherapies have been approved and are currently used for treatment of melanoma:

Checkpoint inhibitors

These are drugs that help unlock the ability for the immune system to recognize and attack melanoma.

• Opdivo (nivolumab)
• Keytruda (pembrolizumab)
• Yervoy (ipilimumab)
• Yervoy + Opdivo (ipilimumab + nivolumab)
• Opdualag (nivolumab + relatlimab)
• Tecentriq (atezolizumab)

Oncolytic viruses

Modified viruses injected into tumors that help enhance the immune system’s response to the melanoma.

• Imlygic (Talimogene laherparepvec/T-Vec)

Tumor infiltrating lymphocytes

Specific white blood cells that are removed from the tumor environment, modified, and reinfused to help the immune system specifically target melanoma tumors.

• Amtagvi (Lifileucel)

Bispecific therapies

Drugs engineered to bind to both cancer cells and to the immune system to help generate a targeted immune response against cancer.

• Kimmtrak (tebentafusp-tebn) used for metastatic uveal melanoma in patients who have an HLA-A*02:01 antigen.

Precision cancer medicines

These targeted therapies are designed to target melanomas that are driven by specific mutations. Nearly 40 to 50% of cutaneous melanomas will have a BRAF mutation. BRAF inhibitors combined with MEK inhibitors can be used to specifically target these mutations. The following combinations are approved by the FDA and used for the treatment of BRAF-positive melanoma:

• BRAFtovi (encorafenib) + MEKtovi (binimetinib)
• Tafinlar (dabrafenib) + Mekinist (trametinib)
• Zelboraf (vemurafenib) + Cotellic (cobimetinib)

Chemotherapy  

Chemotherapy are medications administered through an IV and delivered to the entire body to shrink and kill cancer cells. While chemotherapy is not used frequently for melanoma treatment, it can be an option if immunotherapy or targeted therapy are no longer options.  

Why Choose Texas Oncology

Our team of specialists are dedicated to your health and well-being. When you come to us for care, you will find: