Melanoma : Major Advances in Treatment for High Risk Patients
“ There is nothing more important to me as a physician than your cancer treatment . I ’ ve been in practice for over two decades and have had the privilege of telling many patients that there is life beyond cancer . As president of The Center for Cancer and Blood Disorders , I want to lead by example , practicing a firm belief that all patients should receive the finest medical care available , with the same concern and compassion as a cherished member of the family .”
Ray Page , D . O ., Ph . D . President and Medical Oncologist The Center for Cancer and Blood Disorders
Schedule appointments by calling 817-596-0637 or online at www . thecentertx . com
Support services provided by :
For the last 10 years I have served on the Via Melanoma Pathways Committee along with the world experts developing and updating national melanoma treatment recommendations . What an amazing decade of advancement I have seen for melanoma treatment !
Melanoma is a cancer that I have historically despised and feared more than any other cancer . In recent years we have made huge advances in treatments , so I am now feeling much better about this dangerous cancer .
Why do I not like melanoma ? There are several reasons . Melanoma diagnosis rates are rising , whereas most cancers are declining . It is a cancer that even though it is common in the elderly , it can strike younger people in the prime of their life . Melanoma is highly unpredictable on how it behaves and can show up anywhere at any time . And , for decades the treatments have been horrifically toxic and poorly effective .
However , by cracking the genome of melanoma , we have been able to find targets , such as BRAF , where we have drugs that can alter the biological nature of mutated pathways and kill the melanoma . Furthermore , melanoma does not respond to our “ classic ” chemo drugs , but the newer immunotherapies have given us profound and unprecedented responses !
For most people diagnosed with melanoma , they do not have metastatic cancer to other parts of the body but they instead have a surgically resected melanoma that is considered “ high risk ”. High risk characteristics include the resected melanoma being “ thick ” in depth in the skin , or removed regional lymph nodes that show the presence of melanoma .
So , in “ high risk ” patients , all visible melanoma is resected surgically . However , if followed over the next 5 years 40-70 % will show metastatic recurrence of the melanoma – which can potentially take their lives ! Therefore , we have tried a number of post-surgical adjuvant therapies to try to kill those hidden cancer cells and improve the odds of cure . Adjuvant “ classic ” chemo ( like what we give in colon and breast cancer ) does not work in melanoma . What works best is to augment our own immune system to kill the melanoma since it is very “ immunogenic ”. For two decades the best drug we had and used was Interferon . Unfortunately , this is a drug that makes you feel like you have the flu for an entire year , and the clinical improvements are minor .
I am extremely happy that we now have two new FDA approved drug combinations for the post-surgical adjuvant treatment of melanoma . There is a 2-drug oral combination that works best in melanoma patients with the BRAF mutation . Alternatively , one of the new immune-oncology drugs , Nivolumab , can also be used to stimulate our own immune cells to kill the melanoma cells in this setting .
These are huge advances saving lives for melanoma !!
To learn more about cancer care issues or to consult with a physician about a cancer diagnosis , contact us at 817.596.0637 .
FEBRUARY 2018 PARKER COUNTY TODAY
37