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Tratamiento del melanoma

Access exceptional care for melanoma at Montefiore Einstein Comprehensive Cancer Center. As one of the ​nation’s ​first ​National Cancer Institute (​NCI​)​-designated cancer centers, we've been a leader in the research, diagnosis and treatment of over 200 types of cancer. We’re one of only a few cancer centers in the region to offer ​i​nterleukin-2 ​(IL-2) ​for the treatment of metastatic melanoma. We also provide immunotherapies and targeted therapies, including the newly ​Food and Drug Administration (​FDA​)​-approved cellular immunotherapy treatment​,​ ​​tumor-infiltrating lymphocyte (TIL) therapy. Patients also have the opportunity to participate in early-stage clinical trials where they can receive the latest treatments long before they are available anywhere else.

Our cancer specialists and researchers are passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

You can expect compassionate, personalized care that meets the highest standards for quality and safety. Montefiore Einstein Comprehensive Cancer Center’s melanoma care is one of the most comprehensive in the nation, and we’re committed to whole person care. We also offer a full choice of support services, from nutritional guidance to complementary and alternative therapies.

When you need melanoma care, turn to our providers who are passionate about ending cancer and addressing your whole health needs.

El Montefiore Einstein Comprehensive Cancer Center, designado como centro integral del cáncer por el National Cancer Institute (NCI), apoya la misión y las normas del NCI. La siguiente información sobre los tipos de cáncer, prevención y tratamientos ha sido facilitada por el NCI.

Melanoma Treatment (PDQ®)–Patient Version

General Information About Melanoma

Puntos clave

  • Melanoma is a disease in which malignant (cancer) cells form in melanocytes (cells that color the skin).
  • There are different types of cancer that start in the skin.
  • Melanoma can occur anywhere on the skin.
  • Unusual moles, exposure to sunlight, and health history can affect the risk of melanoma.
  • Signs of melanoma include a change in the way a mole or pigmented area looks.
  • Tests that examine the skin are used to diagnose melanoma.
  • After melanoma has been diagnosed, tests may be done to find out if cancer cells have spread within the skin or to other parts of the body.
  • Algunas personas deciden buscar una segunda opinión.
  • Hay ciertos factores que afectan al pronóstico (probabilidad de recuperación) y a las opciones de tratamiento.

Melanoma is a disease in which malignant (cancer) cells form in melanocytes (cells that color the skin).

The skin is the body's largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis (upper or outer layer) and the dermis (lower or inner layer). Skin cancer begins in the epidermis, which is made up of three kinds of cells:

  • Squamous cells: Thin, flat cells that form the top layer of the epidermis.
  • Basal cells: Round cells under the squamous cells.
  • Melanocytes: Cells that make melanin and are found in the lower part of the epidermis. Melanin is the pigment that gives skin its natural color. When skin is exposed to the sun or artificial light, melanocytes make more pigment and cause the skin to darken.
Anatomy of the skin with melanocytes; drawing shows normal skin anatomy, including the epidermis, dermis, hair follicles, sweat glands, hair shafts, veins, arteries, fatty tissue, nerves, lymph vessels, oil glands, and subcutaneous tissue. The pullout shows a close-up of the squamous cell and basal cell layers of the epidermis above the dermis with blood vessels. Melanin is shown in the cells. A melanocyte is shown in the layer of basal cells at the deepest part of the epidermis.

Anatomía de la piel, que muestra la epidermis, la dermis y el tejido subcutáneo. Los melanocitos se encuentran en la capa de células basales, en la parte más profunda de la epidermis.

There are different types of cancer that start in the skin.

There are two main forms of skin cancer: melanoma and nonmelanoma.

Melanoma is a rare form of skin cancer. It is more likely to invade nearby tissues and spread to other parts of the body than other types of skin cancer. When melanoma starts in the skin, it is called cutaneous melanoma. Melanoma may also occur in mucous membranes (thin, moist layers of tissue that cover surfaces such as the lips). This summary is about cutaneous (skin) melanoma and melanoma that affects the mucous membranes.

Before age 50, rates of melanoma are higher in women than in men. After age 50, rates of melanoma are much higher in men. Melanoma is most common in adults, but it is sometimes found in children and adolescents. Learn more about Childhood Melanoma Treatment.

The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. They are nonmelanoma skin cancers. Nonmelanoma skin cancers rarely spread to other parts of the body. Learn more about Skin Cancer Treatment.

Melanoma can occur anywhere on the skin.

In men, melanoma is often found on the trunk (the area from the shoulders to the hips) or the head and neck. In women, melanoma forms most often on the arms and legs.

When melanoma occurs in the eye, it is called intraocular or ocular melanoma. Learn more about Intraocular (Uveal) Melanoma Treatment.

Unusual moles, exposure to sunlight, and health history can affect the risk of melanoma.

A risk factor is anything that increases the chance of getting a disease. Some risk factors for melanoma, such as tanning bed use, can be changed. However, risk factors also include things people cannot change, like their genetics and their family history. Learning about risk factors for melanoma can help you make changes that might lower your risk of getting it.

Risk factors for melanoma include:

  • Tener una tez clara, lo cual puede ser:
    • Piel clara que se llena de pecas y se quema fácilmente, no se broncea o se broncea mal.
    • Ojos azules, verdes o de color claro
    • Cabello rojo o rubio
  • being exposed to natural sunlight or artificial sunlight (such as from tanning beds)
  • being exposed to certain factors, such as radiation, solvents, vinyl chloride, and PCBs, in the environment (the air, your home or workplace, and your food and water)
  • having a history of many blistering sunburns, especially as a child or teenager
  • having several large or many small moles
  • having a family history of unusual moles (atypical nevus syndrome)
  • having a family or personal history of melanoma
  • ser blanco
  • having a weakened immune system
  • having certain changes in the genes that are linked to melanoma

Being White or having a fair complexion increases the risk of melanoma, but anyone can have melanoma, including people with dark skin.

Learn more about risk factors for melanoma at Genetics of Skin Cancer and Skin Cancer Prevention.

Signs of melanoma include a change in the way a mole or pigmented area looks.

These and other signs and symptoms may be caused by melanoma or by other conditions. Check with your doctor if you have:

  • a mole that:
    • changes in size, shape, or color
    • has irregular edges or borders
    • is more than one color
    • is asymmetrical (if the mole is divided in half, the 2 halves are different in size or shape)
    • itches
    • oozes, bleeds, or is ulcerated (a hole forms in the skin when the top layer of cells breaks down and the tissue below shows through)
  • a change in pigmented (colored) skin
  • satellite moles (new moles that grow near an existing mole)

The acronym ABCDE can help you remember the signs of melanoma:

  • Asymmetrical
  • Border
  • Color
  • Diameter (melanoma is usually larger than 6 millimeters)
  • Evolving (the mole changes in size, shape, or color over time

Find pictures and descriptions of common moles and melanoma at Common Moles, Dysplastic Nevi, and Risk of Melanoma.

Tests that examine the skin are used to diagnose melanoma.

Melanoma is usually diagnosed with tests that examine the skin. The process used to find out if cancer cells have spread beyond the skin is called staging. To plan treatment, it is important to know the stage of the disease.

In addition to asking about your personal and family health history and doing a physical exam, your doctor may perform the following tests and procedures to find and diagnose melanoma:

  • Skin exam is an exam where a doctor or nurse checks the skin for moles, birthmarks, or other pigmented areas that look abnormal in color, size, shape, or texture.
  • Biopsia is the removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. It can be hard to tell the difference between a colored mole and an early melanoma lesion. Patients may want to have the sample of tissue checked by a second pathologist. If the abnormal mole or lesion is cancer, the sample of tissue may also be tested for certain gene changes. This may help to plan treatment. Learn about the type of information that can be found in a pathologist's report about the cells or tissue removed during a biopsy at Pathology Reports.

    There are four main types of skin biopsies. The type of biopsy done depends on where the abnormal area formed and the size of the area.

    • Shave biopsy uses a sterile razor blade to "shave off" the growth.
    • Punch biopsy uses a special instrument called a punch or a trephine to remove a circle of tissue from the growth.
      Punch biopsy; drawing shows a sharp, hollow, circular instrument being inserted into a lesion on the skin of a patient’s forearm. The instrument is turned clockwise and counterclockwise to cut into the skin and remove a small, round piece of tissue. A pullout shows that the instrument cuts about 4 millimeters (mm) down to the layer of fatty tissue below the skin.

      Punch biopsy. A sharp, hollow, circular instrument is used to remove a small, round piece of tissue from a lesion on the skin. The instrument is turned clockwise and counterclockwise to cut about 4 millimeters (mm) down to the layer of fatty tissue below the skin and remove the sample of tissue. Skin thickness is different on different parts of the body.

    • Incisional biopsy uses a scalpel to remove part of a growth.
    • Excisional biopsy uses a scalpel to remove the entire growth.

After melanoma has been diagnosed, tests may be done to find out if cancer cells have spread within the skin or to other parts of the body.

The process used to find out whether cancer has spread within the skin or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

For melanoma that is not likely to spread to other parts of the body or recur, more tests may not be needed. For melanoma that is likely to spread to other parts of the body or recur, the following tests and procedures may be done after surgery to remove the melanoma:

  • El mapeo de ganglios linfáticos y la biopsia del ganglio centinela incluyen la extirpación del ganglio centinela durante la cirugía. El ganglio centinela es el primer ganglio linfático de un grupo que recibe el drenaje linfático del tumor primario . Es el primer ganglio linfático al que es probable que se disemine el cáncer desde el tumor primario. Se inyecta una sustancia radiactiva o un tinte azul cerca del tumor. La sustancia o el tinte fluye a través de los conductos linfáticos hacia los ganglios linfáticos. Se extirpa el primer ganglio linfático que recibe la sustancia o el tinte. Un patólogo examina el tejido al microscopio para buscar células cancerosas. Si no se encuentran células cancerosas, puede que no sea necesario extirpar más ganglios linfáticos. A veces, se encuentra un ganglio centinela en más de un grupo de ganglios.
  • CT scan (CAT scan) is a procedure that makes a series of detailed pictures of areas inside the body taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. For melanoma, pictures may be taken of the neck, chest, abdomen, and pelvis.
  • PET scan (positron emission tomography scan) is a procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • MRI (magnetic resonance imaging) with gadolinium is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the brain. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Ultrasound exam is a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues, such as lymph nodes, or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
  • Blood chemistry studies is a procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. For melanoma, the blood is checked for an enzyme called lactate dehydrogenase (LDH). High LDH levels may predict a poor response to treatment in people with metastatic disease.

The results of these tests are viewed together with the results of the tumor biopsy to find out the stage of the melanoma.

Algunas personas deciden buscar una segunda opinión.

You may want to get a second opinion to confirm your melanoma diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. They may agree with the first doctor, suggest changes or another treatment approach, or provide more information about your cancer.

To learn more about choosing a doctor and getting a second opinion, see Finding Cancer Care. You can contact NCI's Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor, hospital, or getting a second opinion. For questions you might want to ask at your appointments, see Questions to Ask Your Doctor about Cancer.

Hay ciertos factores que afectan al pronóstico (probabilidad de recuperación) y a las opciones de tratamiento.

El pronóstico y las opciones de tratamiento dependen de los siguientes factores:

  • the thickness of the tumor and where it is in the body
  • whether there was bleeding or ulceration of the tumor
  • how much cancer is in the lymph nodes
  • the number of places and where cancer has spread to in the body
  • the level of lactate dehydrogenase (LDH) in the blood
  • whether the cancer has certain mutations (changes) in a gene called BRAF
  • La edad y salud general del paciente

Stages of Melanoma

Puntos clave

  • The stage of melanoma depends on the thickness of the tumor, whether cancer has spread to lymph nodes or other parts of the body, and other factors.
  • The following stages are used for melanoma:
    • Stage 0 (melanoma in situ)
    • Stage I (also called stage 1) melanoma
    • Stage II (also called stage 2) melanoma
    • Stage III (also called stage 3) melanoma
    • Stage IV (also called stage 4) melanoma
  • Melanoma can recur (come back) after it has been treated.

Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the melanoma stage to plan treatment.

There are several staging systems for cancer that describe the extent of the cancer. Melanoma staging usually uses the TNM staging system. The cancer may be described by this staging system in your pathology report. Based on the TNM results, a stage (I, II, III, or IV, also written as 1, 2, 3, or 4) is assigned to your cancer. When talking to you about your diagnosis, your doctor may describe the cancer as one of these stages.

Learn about tests to stage melanoma. Learn more about Cancer Staging.

The stage of melanoma depends on the thickness of the tumor, whether cancer has spread to lymph nodes or other parts of the body, and other factors.

To find out the stage of melanoma, the tumor is completely removed and nearby lymph nodes are checked for signs of cancer. The stage of the cancer is used to determine which treatment is best. Check with your doctor to find out which stage of cancer you have.

The stage of melanoma depends on:

  • The tumor's thickness, which is measured from the surface of the skin to the deepest part of the tumor.
    Ampliar Melanoma staging (tumor thickness); drawing shows different depths of cancer invasion (0, 1.0, 2.0, 3.0, 4.0, and 5.0 mm) into the epidermis (outer layer of the skin), the dermis (inner layer of the skin), and the subcutaneous tissue below the dermis.
  • Whether the tumor is ulcerated (has broken through the skin).
    Ampliar Melanoma staging (tumor ulceration); drawing shows a tumor that is ulcerated (has broken through the skin) and a tumor that is not ulcerated.
  • Whether cancer is found in lymph nodes by a physical exam, imaging tests, or a sentinel lymph node biopsy.
    Ampliar Melanoma staging (lymph node involvement); drawing shows cancer that has spread from the primary tumor to the lymph nodes.
  • Whether the lymph nodes are matted (joined together).
    Ampliar Melanoma staging (matted lymph nodes); drawing shows matted lymph nodes with cancer.
  • Whether there are:
    Ampliar Melanoma staging (in-transit metastases, satellite tumors, and microsatellite tumors); drawing shows in-transit metastases in a lymph vessel more than 2 centimeters away from the primary tumor and satellite tumors within 2 centimeters of the primary tumor. Microsatellite tumors are not shown because they can only be seen with a microscope.
  • Whether the cancer has spread to other parts of the body, such as the lung, hígado, brain, tejido blando (including muscle), digestive tract, and/or distant lymph nodes.
    Ampliar Melanoma staging (cancer spread to other parts of the body); drawing shows cancer cells spreading from the primary cancer, through the blood and lymph system, to another part of the body where a metastatic tumor has formed.

The following stages are used for melanoma:

Stage 0 (melanoma in situ)

In stage 0, abnormal melanocytes are found in the epidermis. These abnormal melanocytes may become cancer and spread into nearby normal tissue. Stage 0 is also called melanoma in situ.

Stage 0 melanoma; drawing shows an abnormal area on the surface of the skin and abnormal melanocytes in the epidermis (outer layer of the skin). Also shown are the dermis (inner layer of the skin) and the subcutaneous tissue below the dermis.

Stage 0 melanoma. Abnormal melanocytes are found in the epidermis (outer layer of the skin). These abnormal melanocytes may become cancer and spread into nearby normal tissue.

Stage I (also called stage 1) melanoma

En la etapa I, el cáncer ya se ha formado. La etapa I se divide en etapas IA y IB.

Millimeters; drawing shows millimeters (mm) using everyday objects. A sharp pencil point shows 1 mm, a new crayon point shows 2 mm, and a new pencil-top eraser shows 5 mm.

Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.

  • Stage IA: The tumor is not more than 1 millimeter thick, with or without ulceration.
  • Stage IB: The tumor is more than 1 but not more than 2 millimeters thick, without ulceration.
    Two-panel drawing of stage I melanoma; the panel on the left shows a stage IA tumor that is not more than 1 millimeter thick, with ulceration (a break in the skin) and without ulceration. The panel on the right shows a stage IB tumor that is more than 1 but not more than 2 millimeters thick, without ulceration. Also shown are the epidermis (outer layer of the skin), the dermis (inner layer of the skin), and the subcutaneous tissue below the dermis.

    Stage I melanoma. In stage IA, the tumor is not more than 1 millimeter thick, with or without ulceration (a break in the skin). In stage IB, the tumor is more than 1 but not more than 2 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.

Stage II (also called stage 2) melanoma

Stage II is divided into stages IIA, IIB, and IIC.

  • Stage IIA: The tumor is either:
    • more than 1 but not more than 2 millimeters thick, with ulceration; or
    • more than 2 but not more than 4 millimeters thick, without ulceration.
      Two-panel drawing of stage IIA melanoma; the panel on the left shows a tumor that is more than 1 but not more than 2 millimeters thick, with ulceration (a break in the skin). The panel on the right shows a tumor that is more than 2 but not more than 4 millimeters thick, without ulceration. Also shown are the epidermis (outer layer of the skin), the dermis (inner layer of the skin), and the subcutaneous tissue below the dermis.

      Stage IIA melanoma. The tumor is more than 1 but not more than 2 millimeters thick, with ulceration (a break in the skin); OR it is more than 2 but not more than 4 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.

  • Stage IIB: The tumor is either:
    • more than 2 but not more than 4 millimeters thick, with ulceration; or
    • more than 4 millimeters thick, without ulceration.
      Two-panel drawing of stage IIB melanoma; the panel on the left shows a tumor that is more than 2 but not more than 4 millimeters thick, with ulceration (a break in the skin). There is also an inset that shows 2 millimeters is about the size of a new crayon point and 5 millimeters is about the size of a pencil-top eraser. The panel on the right shows a tumor that is more than 4 millimeters thick, without ulceration. There is also an inset that shows 5 millimeters is about the size of a pencil-top eraser. Also shown are the epidermis (outer layer of the skin), the dermis (inner layer of the skin), and the subcutaneous tissue below the dermis.

      Stage IIB melanoma. The tumor is more than 2 but not more than 4 millimeters thick, with ulceration (a break in the skin); OR it is more than 4 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.

  • Stage IIC: The tumor is more than 4 millimeters thick, with ulceration.
    Stage IIC melanoma; drawing shows a tumor that is more than 4 millimeters thick, with ulceration (a break in the skin). Also shown are the epidermis (outer layer of the skin), the dermis (inner layer of the skin), and the subcutaneous tissue below the dermis.

    Stage IIC melanoma. The tumor is more than 4 millimeters thick, with ulceration (a break in the skin). Skin thickness is different on different parts of the body.

Stage III (also called stage 3) melanoma

Stage III is divided into stages IIIA, IIIB, IIIC, and IIID.

  • Stage IIIA: The tumor is not more than 1 millimeter thick, with ulceration, or not more than 2 millimeters thick, without ulceration. Cancer is found in 1 to 3 lymph nodes by sentinel lymph node biopsy.
  • Estadio IIIB:
    • (2) The tumor is not more than 1 millimeter thick, with ulceration, or not more than 2 millimeters thick, without ulceration, and one of the following is true:
      • cancer is found in 1 to 3 lymph nodes by physical exam or imaging tests; or
      • there are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin.

        o

    • (3) The tumor is more than 1 but not more than 2 millimeters thick, with ulceration, or more than 2 but not more than 4 millimeters thick, without ulceration, and one of the following is true:
      • cancer is found in 1 to 3 lymph nodes; or
      • there are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin.
  • Estadio IIIC:
    • (1) It is not known where the cancer began, or the tumor primario can no longer be seen. Cancer is found:
      • in 2 or 3 lymph nodes; or
      • in 1 lymph node and there are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin; or
      • in 4 or more lymph nodes, or in any lymph nodes that are matted together; or
      • in 2 or more lymph nodes and/or in any lymph nodes that are matted together. There are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin.

        o

    • (2) The tumor is not more than 2 millimeters thick, with or without ulceration, or not more than 4 millimeters thick, without ulceration. Cancer is found:
      • in 1 lymph node and there are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin; or
      • in 4 or more lymph nodes, or in any lymph nodes that are matted together; or
      • in 2 or more lymph nodes and/or in any lymph nodes that are matted together. There are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin.

        o

    • (3) The tumor is more than 2 but not more than 4 millimeters thick, with ulceration, or more than 4 millimeters thick, without ulceration. Cancer is found in 1 or more lymph nodes and/or in any lymph nodes that are matted together. There may be microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin.

      o

    • (4) The tumor is more than 4 millimeters thick, with ulceration. Cancer is found in 1 or more lymph nodes and/or there are microsatellite tumors, satellite tumors, and/or in-transit metastases on or under the skin.
  • Stage IIID: The tumor is more than 4 millimeters thick, with ulceration. Cancer is found:

Stage IV (also called stage 4) melanoma

In stage IV, the cancer has spread to other parts of the body, such as the lung, liver, brain, spinal cord, bone, soft tissue (including muscle), digestive tract, and/or distant lymph nodes. Cancer may have spread to places in the skin far away from where it first started.

Stage IV melanoma is also called metastatic melanoma. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if melanoma spreads to the lung, the cancer cells in the lung are actually melanoma cells. The disease is called metastatic melanoma, not lung cancer. Learn more in Metastatic Cancer: When Cancer Spreads.

Stage IV melanoma; drawing shows other parts of the body where melanoma may spread, including the brain, spinal cord, lung, liver, gastrointestinal (GI) tract, bone, muscle, and distant lymph nodes. An inset shows cancer cells spreading through the blood and lymph system to another part of the body where a metastatic tumor has formed.

Stage IV melanoma. Cancer has spread to other parts of the body, such as the brain, spinal cord, lung, liver, gastrointestinal (GI) tract, bone, muscle, and/or distant lymph nodes. Cancer may have spread to places in the skin far away from where it first started.

Melanoma can recur (come back) after it has been treated.

Recurrent melanoma is melanoma that has come back after it has been treated. If melanoma comes back, it may come back in the area where it first started or in other parts of the body, such as the lungs or liver. Tests will help determine where in the body the cancer has returned. The type of treatment that you have for recurrent melanoma will depend on where it has come back.

Para obtener más información, consulte Cáncer recurrente: cáncer que regresa.

Descripción general de las opciones de tratamiento

Puntos clave

  • There are different types of treatment for people with melanoma.
  • Se utilizan los siguientes tipos de tratamiento:
    • Cirugía
    • Quimioterapia
    • Radioterapia
    • Inmunoterapia
    • Terapia dirigida
  • Se están probando nuevos tipos de tratamiento en ensayos clínicos.
    • Terapia de vacunas
  • Treatment for melanoma may cause side effects.
  • Es posible que se necesiten cuidados de seguimiento.

There are different types of treatment for people with melanoma.

Different types of treatment are available for people with melanoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for people with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. People may want to think about taking part in a clinical trial. Some clinical trials are open only to people who have not started treatment.

Se utilizan los siguientes tipos de tratamiento:

Cirugía

Surgery to remove the tumor is the primary treatment for all stages of melanoma. A wide local excision is used to remove the melanoma and some of the normal tissue around it. Skin grafting (taking skin from another part of the body to replace the skin that is removed) may be done to cover the wound caused by surgery.

Sometimes, it is important to know whether cancer has spread to the lymph nodes. Lymph node mapping and sentinel lymph node biopsy are done to check for cancer in the sentinel lymph node, which is the first lymph node the cancer is likely to spread to from the primary tumor.

If only a small amount of cancer cells are found during a sentinel lymph node biopsy, active surveillance with ultrasound may be recommended instead of more surgery.

After the doctor removes all the melanoma that can be seen at the time of the surgery, some people may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after the surgery to lower the risk that the cancer will come back is called adjuvant therapy.

Surgery to remove cancer that has spread to the lymph nodes, lung, digestive tract, bone, or brain may be done to improve quality of life by controlling symptoms.

Quimioterapia

Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

One type of regional chemotherapy is hyperthermic isolated limb perfusion. With this method, anticancer drugs go directly to the arm or leg the cancer is in. The flow of blood to and from the limb is temporarily stopped with a tourniquet. A warm solution with the anticancer drug is put directly into the blood of the limb. This gives a high dose of drugs to the area where the cancer is.

La forma en que se administra la quimioterapia depende del tipo y estadio del cáncer que se esté tratando.

Para obtener más información sobre cómo funciona la quimioterapia, cómo se administra, los efectos secundarios comunes y mucho más, visite Quimioterapia para tratar el cáncer y Quimioterapia y usted: Apoyo para personas con cáncer .

Radioterapia

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. External radiation therapy is used to treat melanoma and may also be used as palliative therapy to relieve symptoms and improve quality of life.

Para obtener más información, consulte Radioterapia de haz externo para el cáncer y Efectos secundarios de la radioterapia.

Inmunoterapia

La inmunoterapia ayuda al sistema inmunitario a combatir el cáncer. Su médico podría sugerirle pruebas de biomarcadores para predecir su respuesta a ciertos medicamentos de inmunoterapia. Obtenga más información sobre las pruebas de biomarcadores para el tratamiento del cáncer.

Immunotherapy drugs used to treat melanoma include:

Obtenga más información sobre la inmunoterapia para el tratamiento del cáncer .

Terapia dirigida

La terapia dirigida utiliza medicamentos u otras sustancias para identificar y atacar células cancerosas específicas. Su médico puede sugerirle pruebas de biomarcadores para ayudar a predecir su respuesta a ciertos medicamentos de terapia dirigida. Para obtener más información, consulte Pruebas de biomarcadores para el tratamiento de cáncer.

Targeted therapies used to treat melanoma include:

Obtenga más información en Terapia dirigida para tratar el cáncer.

Se están probando nuevos tipos de tratamiento en ensayos clínicos.

Terapia de vacunas

Vaccine therapy is a cancer treatment that uses a substance or group of substances to stimulate the immune system to find the tumor and kill it. Vaccine therapy is being studied in the treatment of stage III melanoma that can be removed by surgery.

Treatment for melanoma may cause side effects.

Para obtener información sobre los efectos secundarios causados por el tratamiento para el cáncer, visite la página de efectos secundarios.

Es posible que se necesiten cuidados de seguimiento.

A medida que avanza el tratamiento, se le realizarán pruebas o controles de seguimiento. Es posible que se repitan algunas pruebas para diagnosticar o estadificar el cáncer con el fin de evaluar cómo está funcionando el tratamiento. Las decisiones sobre si continuar, modificar o suspender el tratamiento pueden basarse en los resultados de estas pruebas.

Algunas pruebas seguirán realizándose de manera periódica después de terminar el tratamiento. Los resultados pueden indicar si su afección ha cambiado o si el cáncer ha redicivado (regresado).

Treatment of Stage 0 (Melanoma in Situ)

Treatment of stage 0 is usually surgery to remove the area of abnormal cells and a small amount of normal tissue around it.

Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Treatment of Stage I Melanoma

Treatment of stage I melanoma is usually surgery to remove the tumor and some of the normal tissue around it, with or without lymph node mapping and sentinel lymph node biopsy.

Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Treatment of Stage II Melanoma

Treatment of stage II melanoma may include:

Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Treatment of Stage III Melanoma That Can Be Removed By Surgery

Treatment of stage III melanoma that can be removed by surgery may include:

Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

Treatment of Stage III Melanoma That Cannot Be Removed By Surgery, Stage IV Melanoma, and Recurrent Melanoma

Treatment of stage III melanoma that cannot be removed by surgery, stage IV melanoma, and recurrent melanoma may include:

Obtenga más información sobre estos tratamientos en la sección Descripción general de las opciones de tratamiento .

Puede utilizar la búsqueda de ensayos clínicos y encontrar ensayos clínicos sobre cáncer patrocinados por el NCI que acepten participantes. La búsqueda le permite filtrar los ensayos según el tipo de cáncer, la edad y el lugar donde se realizan los ensayos. También encontrará información general sobre los ensayos clínicos.

To Learn More About Melanoma

Sobre este resumen del PDQ

Acerca del PDQ

El Physician Data Query (PDQ) es la base de datos integral sobre el cáncer del National Cancer Institute (NCI). La base de datos del PDQ contiene resúmenes con la última información publicada sobre prevención, detección, genética, tratamiento, atención médica de apoyo y medicina complementaria y alternativa relacionada con el cáncer. La mayoría de los resúmenes se presentan en dos versiones. Las versiones para profesionales de la salud contienen información detallada escrita en lenguaje técnico. Las versiones para pacientes están escritas en un lenguaje fácil de entender y no tan técnico. Ambas versiones contienen información precisa y actualizada sobre el cáncer. La mayoría de las versiones también están disponibles en español.

El PDQ es un servicio del NCI. El NCI es parte de los Institutos Nacionales de Salud (NIH), que son el centro de investigación biomédica del Gobierno federal. Los resúmenes del PDQ se basan en una revisión independiente de la literatura médica. No son declaraciones de políticas del NCI ni de los NIH.

Propósito de este resumen

This PDQ cancer information summary has current information about the treatment of melanoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Revisores y actualizaciones

Los comités editoriales escriben los resúmenes de información sobre el cáncer del PDQ y los mantienen actualizados. Estos comités están formados por equipos de especialistas en el tratamiento del cáncer y otras especialidades relacionadas con esta enfermedad. Los resúmenes se revisan periódicamente y se modifican cuando hay información nueva. La fecha de actualización al pie de cada resumen indica cuándo se realizó el cambio más reciente.

La información de este resumen para pacientes procede de la versión para profesionales de la salud, la cual es revisada y actualizada por el comité editorial del PDQ sobre el tratamiento para adultos.

Información sobre ensayos clínicos

Un ensayo clínico es un estudio para responder a una pregunta científica como, por ejemplo, si un tratamiento es mejor que otro. Los ensayos se basan en estudios anteriores y en lo aprendido en el laboratorio. Cada ensayo responde a determinadas preguntas científicas que permiten encontrar nuevas y mejores formas de ayudar a los pacientes con cáncer. Durante los ensayos clínicos de tratamiento, se recopila información sobre los efectos de un nuevo tratamiento y su eficacia. Si un ensayo clínico demuestra que un nuevo tratamiento es mejor que uno que se utiliza actualmente, el nuevo tratamiento puede convertirse en “estándar”. Los pacientes pueden valorar la posibilidad de participar en un ensayo clínico. Algunos ensayos clínicos solo están abiertos a pacientes que no hayan iniciado el tratamiento.

Los ensayos clínicos se pueden encontrar en línea en el sitio web del NCI. Para obtener más información, llame al Servicio de Información sobre el Cáncer (CIS, por sus siglas en inglés), el centro de contacto del NCI, al 1-800-4-CANCER (1-800-422-6237).

Permiso de uso de este resumen

Physician Data Query (PDQ) es una marca registrada. Se autoriza el libre uso del contenido de los documentos del PDQ como texto. Sin embargo, no se podrá identificar como un resumen de información sobre cáncer del PDQ del NCI, salvo que se reproduzca en su totalidad y se actualice con regularidad. Por otra parte, se permite que los autores incluyan una oración como “en el resumen del PDQ del NCI sobre la prevención del cáncer de mama se describen, de manera concisa, los siguientes riesgos: [incluir fragmento del resumen]”.

La forma recomendada para citar este resumen del PDQ es:

PDQ® Adult Treatment Editorial Board. PDQ Melanoma Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389388]

Las imágenes de este resumen se utilizan con el permiso del autor, artista y/o editorial para uso exclusivo en los resúmenes del PDQ. Si desea usar una imagen de un resumen del PDQ sin incluir el resumen completo, debe obtener autorización del propietario. El National Cancer Institute no puede otorgar dicho permiso. Para obtener más información sobre el uso de las imágenes de este resumen o de otras ilustraciones relacionadas con el cáncer, consulte Visuals Online, una colección de más de 3,000 imágenes científicas.

Descargo de responsabilidad

La información de estos resúmenes no debe utilizarse para tomar decisiones sobre reembolsos de seguros. Puede encontrar más información sobre la cobertura de seguros en Cancer.gov en el sitio Manejo de la atención del cáncer.

Contáctenos

Puede encontrar más información sobre cómo contactarnos o recibir ayuda en el sitio web Cancer.gov en la página Comuníquese con el NCI. También puede enviar sus preguntas a Cancer.gov en el apartado Escríbanos del sitio web.

Actualizado:

Este contenido ha sido facilitado por el National Cancer Institute (www.cancer.gov)
Información sobre artículos sindicados:
Source URL: https://www.cancer.gov/node/1148/syndication
Agencia de origen: National Cancer Institute (NCI)
Captured Date: 2013-09-14 09:00:14.0