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The most important form of therapy is primarily surgical resection of the primary tumor. This should be always removed the tumor as a whole. To avoid the spread in the bloodstream, biopsies are not taken in cases of suspected malignant melanoma. When surgical removal is necessary to ensure an adequate safety margin, depending on tumor thickness of one or two inches, all layers of the skin should also be removed under the tumor. In melanomas, which are located on the face or the extremities, can be performed instead of maintaining a large safety margin and an excision with microscopically-controlled surgery, is ensured in the control of margins by complete removal of healthy tissue.
Many researchers propose to identify the sentinel lymph node and examined histologically, as this in some of the cases are not the general removal of lymph nodes would be necessary.
In later stages, in which the tumor has already metastasized to lymph nodes and internal organs, the chance of a cure is low. Nevertheless, there is a whole range of therapeutic alternatives that are applied and tested, and usually offer only temporary relief, but usually have no chance of recovery. These include chemotherapy with DTIC and fotemustine, immunotherapy with interferon, a vaccine therapy with antigen-presenting cells, surgery to reduce tumor mass or radiation therapy. New therapeutic approaches to blocking the molecular processes of signal transduction in the cell, eg, there are promising studies of combination chemotherapy with a classic b-raf kinase inhibitors such as sorafenib.
A once already suffering from skin cancer, should undergo regular follow-up necessarily. In high-risk melanoma should be an additional chemotherapy or interferon therapy should be performed.
Late metastases and CUP (Cancer of Unknown Primary, unknown primary cancer) are common in malignant melanoma.
Prophylaxis - How can you protect yourself?
Incurred suspicion should be clarified as soon as possible by a dermatologist, if necessary, the melanoma early - to be able to remove - before metastasis. The cost of an investigation on the basis of micrographs are free of charge since 01.03.2007 for the patient and is accepted by the insurance company. A digital archiving is not paid by a fund supported by the patient but usually costs about 60 EUR.
Regular self-examination to changes in moles to help detect melanoma early, especially is this for people with sick relatives or important to melanoma with a variety of melanocytic nevi.
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