Adjuvant Systemic Therapy

Systemic therapy is treatment with medications that can help combat melanoma throughout your whole system or body. Most patient who are diagnosed with melanoma will never need systemic therapy, since they are diagnosed when the melanoma is at an early stage. Early stage melanomas are often cured by surgery alone.

Sometimes after surgery, though, your medical oncologist may be concerned that microscopic melanoma cells could have spread systemically in your body. They may be too small to detect on any exams, blood tests or scans, but your oncologist may know that there would still be a chance that the microscopic cells are out there, and that they might grow to be large tumors over time. Melanoma can spread to almost any part of the body, including the brain, the lungs, the liver, and the bones, among others. Patients generally considered to have a moderate or high chance of the cancer having spread microscopically are those who have deep melanomas in the skin or those who have been found to have it in the lymph nodes.

If your oncologist is concerned that the melanoma has a moderate or high chance of recurrence (coming back and spreading), he or she may recommend that you received adjuvant systemic therapy. This is treatment designed to eliminate microscopic melanoma cells that could have spread – before they grow back as detectable tumors (when they are very difficult to treat). This adjuvant therapy is really a strong form of preventive medicine.

The most common form of adjuvant systemic therapy is a medication called interferon alfa-2b. Your body normally makes interferon, which is part of the immune system and helps your body fight cancers and infections. Interferon alfa-2b is similar, and is given at high doses by injection (intravenously and sometimes into the skin). The goal is to stimulate your own immune system to fight any microscopic melanoma cells that may have spread. Interferon also has additional cancer-killing properties. Interferon reduces the chance that your melanoma will return and spread, and some studies show that it improves the odds that you will be cured.

Although interferon alfa-2b is an immune booster, it does have significant side effects. It is often given daily intravenously in the medical oncologist’s office, 5 days a week, for a month. Sometimes it is also given by skin injection for a longer period of time, but how long to give it is still controversial. Most patients experience significant fatigue and flu-like symptoms while they receive it. Patients can also experience other serious side effects.

The North Bay Melanoma Program medical oncologists and treatment team are experienced at giving adjuvant systemic treatments such as interferon. They may also talk to you about potential promising new adjuvant systemic treatments that may be available to you as part of a clinical trial.