• Head & Neck Mucosal Melanoma: Treatment

Head & Neck Mucosal Melanoma: Treatment

How is head and neck mucosal melanoma treated?

The first line of treatment for a mucosal melanoma is surgery, which should be done by a surgeon who is very experienced in complex head and neck surgery and is based in a centre where there is support from an experienced skin cancer team.

If the cancer hasn’t spread beyond the primary site, it is likely that the tumour will be removed by surgery. If the tumour is in your nose or throat it is more difficult to access than a mouth cancer, and the operation should, if possible, be done endoscopically (‘key-hole surgery’) to minimise any problems. If possible, the surgeon will biopsy the lymph nodes near the tumour. In any case, the aim of surgery is also to remove a little of the surrounding healthy tissue to ensure that all of the cancer is removed. This is called having ‘clear margins’. In planning the operation, the consultant should discuss your current health and how the surgery may affect your quality of life. If it is likely to have an impact, the consultant should discuss other treatment options with you to agree what is best for you.

If the cancer hasn’t spread and the margins are clear, this may be the end of your treatment or, depending on the stage and tumour, you may be offered adjuvant therapy

Adjuvent treatment for mucosal melanoma

You are likely to be offered adjuvant (extra) therapy to reduce the likelihood that the cancer comes back after it has been removed entirely by surgery. (A ‘belt and braces’ approach!). Recently there have been advances in the treatment of skin melanomas with immunotherapy. Immunotherapy stimulates your body to fight the cancer. Immunotherapy doesn’t work for everyone and there can be potentially severe, but manageable, side effects.

However, because mucosal melanomas are so rare, scientists are still uncertain whether these treatments work in the same way as with skin melanomas. You may be asked if you would like to enter a clinical trial to help doctors answer this question. As doctors learn more, you may be offered immunotherapy or other targeted therapies.

Similarly, you may be offered adjuvant radiotherapy if there is a very high risk of local recurrence in your case but there is no evidence to show that it benefits everyone.

Rehabilitation

If the surgery has affected your teeth or eyes or your appearance, you should be referred to the appropriate services. You should be offered a referral to special psychological services before and after surgery to talk through your condition and your emotions, should you wish.

Next: What happens after treatment for mucosal melanoma?

Back: How is mucosal melanoma diagnosed?

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