Tests, Treatments & Therapies for Melanoma at the University of Colorado Cancer Center

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of Melanoma. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging and Detection Tests

Tests are only as good as the doctors who report and interpret them. That’s why our doctors - who work together as your care team – are the highest trained specialists in the state.

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

  • Different types of scans
  • Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans and other tests may also be used:

  • In a “surveillance program” looking for any signs of relapse after treatment
  • In a “screening program” to detect cancer early in individuals at high-risk
  • To monitor responses to treatment

Tests

Skin examination – A doctor or nurse checks the skin for bumps or spots that look abnormal in color, size, shape, or texture.

Biopsy – All or part of the abnormal-looking growth is removed from the skin and viewed under a microscope by an expert skin pathologist to see if cancer cells are present. There are three main types of skin biopsies:

  • Punch biopsy – A special instrument called a punch is used to remove a circle of tissue from the abnormal-looking growth.
  • Excisional biopsy – A scalpel is used to remove the entire growth.

Dermoscopy – A technique for viewing skin lesions to distinguish accurately between between suspicious moles and other pigmented lesions. A drop of mineral oil is placed on the lesion to reduce light reflection and make the skin more translucent.

  • Using a dermoscope – the doctor can view the lesion down to the dermo-epidermal junction, the area where melanomas usually develop and that is not visible to the naked eye. Also known as epiluminescence microscopy.

Lymphoscinitgraphy plus sentinel node biopsy – A method used to identify the sentinel lymph node (the first draining lymph node near a tumor). A radioactive substance that can be taken up by lymph nodes is injected at the site of the tumor, and a doctor follows the movement of this substance on a computer screen. Once the lymph nodes that have taken up the substance are identified, they can be removed and examined to see if they contain tumor cells.

Mole Mapping – A valuable tool that helps determine which moles need to be removed. A full-body photograph is taken and analyzed digitally to identify mole locations and different features in order to rate a mole’s potential. These images also are used to detect new moles and subtle changes in existing moles from visit to visit.

Computed Tomography (CT) Scan – A technique for imaging body tissues and organs. X-ray transmissions are changed into detailed images using a computer.

Magnetic Resonance Imaging (MRI) – An imaging technique that provides detailed images of body structures. It uses a radio waves and a powerful magnet linked to a computer. These pictures can show the differences between normal and diseased tissues.

PET scan (positron emission tomography) – An imaging test used most often to detect cancer and to examine the effects of cancer therapy. Patients are injected with a radioactive substance before undergoing the scan. Cancerous tissue will accumulate more of the substance and appear brighter than normal tissue on the PET images. This test can be performed simultaneously with a CT scan on a special machine to provide detailed information as to the cancer’s exact location.

Surgery

Operations and procedures to remove Melanoma are done by doctors who have specialized training, called surgical oncologists. In most cases, the surgeon removes a tumor and some tissue around it. The surgeon also may remove some nearby lymph nodes.

  • Surgery is the usual treatment for melanoma. The surgeon removes the tumor and some normal tissue around it to make sure all the cancer cells are removed. Lymph nodes near the tumor may be removed because cancer can spread through the lymphatic system.
  • Surgery is generally not effective in controlling melanoma that has spread to other parts of the body. In such cases,  chemotherapy, biological therapy, radiation therapy, or a combination of these methods is used.

Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

  • Kill cancer cells
  • Prevent cancer cells from developing or recurring
  • Improve many of the symptoms caused by cancer

Radiation therapy can be:

  • Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
  • Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
  • Almost as effective as surgery in people who are not fit enough for an operation
  • Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments: Chemotherapy – and new “targeted therapies – involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.

View current cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

  • Single drugs or combinations of drugs
  • Intravenous injections or tablets/capsules
  • Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
  • Taking some drugs every day or only on a few days within the cycles
  • Taking other medicines to reduce or eliminate side effects associated with chemotherapy
  • Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
  • Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials

Chemotherapy and targeted therapies can:

  • Be given before surgery to make the operation easier
  • Be given in combination with radiotherapy to make both treatments more effective
  • Be given after surgery to reduce the chances of cancer coming back
  • Successfully control advanced cancer and many cancer-related symptoms

Biologic Therapy

Biologic therapy involves using a drug to stimulate your own immune system to fight cancer. An example is a vaccine.

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

  • New drugs
  • New combinations of therapies
  • New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center – one of only 39 in the United States – your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC

New treatments being tested

  • Targeted therapies that use small molecules to block cell signaling pathways that are hyperactive in melanoma cells
  • Anti-angiogenesis agents that block tumors from forming new blood vessels that they need in order to grow