Systemic chemotherapy, given through a vein or orally, attacks cancer cells that have already spread beyond the skin to involve lymph nodes or other organs.
Several types of systemic chemotherapy can be used for advanced melanoma. Although chemotherapy is usually not as effective in treating melanoma as in some other types of cancer, it may relieve symptoms or extend survival of some patients with advanced melanoma. Chemotherapy drugs often used to treat melanoma include dacarbazine (DTIC), carmustine (BCNU) and cisplatin. These three chemotherapy drugs may be used together with tamoxifen, a drug often used to treat breast cancer. Cisplatin, vinblastine and DTIC is another chemotherapy combination for treating melanoma. Recent studies have found that combining several chemotherapy drugs with one or more immunotherapy drugs (see below) is much more effective than a single chemotherapy drug alone.
An experimental type of chemotherapy called isolated limb perfusion is sometimes used for treating melanomas on arms or legs. A tourniquet temporarily stops the flow of blood to and from the limb. During the procedure, blood and oxygen are usually supplied to the limb by a bypass machine. High doses of chemotherapy are then injected into the artery feeding the limb.
This allows very high doses of chemotherapy to be administered to the tumor area without exposing internal organs to the drugs, which would cause severe side effects. Isolated arterial infusion therapy, may be useful for treating regional melanoma. This therapy involves infusing drugs through a catheter into an artery that supplies the affected area, where it delivers a high concentration of cancer-killing drugs.
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