When people think of skin cancer, they often think of basal cell and squamous cell cancers. But the deadliest form is melanoma.
As surgical oncologist Adam Berger, MD, FACS, explains, melanoma comes from a different type of cell in the skin. Unlike basal cell and squamous cell cancers, which usually do not spread, melanoma is much more aggressive. In fact, while melanoma accounts for less than 2 percent of skin cancer cases, it causes a large majority of skin cancer deaths.
In addition to melanoma excisions (surgical removal of lesions), Dr. Berger performs a diagnostic procedure known as a sentinel lymph node biopsy. With certain melanoma tumors most likely to spread to the lymph nodes, this procedure involves removal and testing of a single node. Regardless of tumor type, all melanoma patients need to be followed closely over the long term due to the aggressive nature of this cancer.
Jefferson participates in clinical research to help advance the diagnosis and treatment of melanoma. One such trial is the MSLT-2 study – a follow-up to the landmark MSLT-1 study that established the sentinel node biopsy as the standard for patients with melanomas greater than a certain depth. With patients across North America, Europe and Australia – including about 15 enrolled through Jefferson – the MSLT-2 trial is testing further surgical treatment following a positive sentinel node biopsy.
“Today, when evidence of melanoma is found in a lymph node, the next step is to remove more lymph nodes,” Dr. Berger explains. “In the MSLT2 trial, one group of patients is having more nodes removed, but the other is undergoing a less invasive approach. Instead of having more surgery, these patients are being watched closely through ultrasound examination.” Patients in this trial are now being followed, with results expected in the next two to three years.
Jefferson is also preparing to participate in another clinical trial related to melanoma. Sponsored by biotechnology company Amgen, this trial will test a vaccine designed to help a patient’s own immune system fight the spread of melanoma. The vaccine will be injected in patients’ melanoma lesions and their lymph nodes.
“The hypothesis is that the vaccine will shrink the lesions themselves, and will also offer protection for the rest of the body,” Dr. Berger explains, adding that the vaccine trial is slated to begin patient enrollment later this year.
For more information about clinical trials related to melanoma, please contact Jamie Rothstein, clinical research nurse and project manager for the Department of Surgery, at 215-955-9359.
"Jefferson Combats Deadliest Form of Skin Cancer,"
Jefferson Surgical Solutions: Vol. 9
, Article 4.
Available at: http://jdc.jefferson.edu/jss/vol9/iss2/4