Childhood Melanoma Treatment
The experts at MD Anderson's Children's Cancer Hospital take a personalized approach to your child's treatment. Drawing upon a range of the most-advanced treatment options, your child's care team works together closely and with you to determine the best course of action. This helps increase your child's opportunity for successful treatment.
Each child's case is managed by an interdisciplinary team that may include oncologists, surgical oncologists and radiation oncologists. They are supported by a highly trained team of nurses, physician's assistants, therapists and social workers.
Melanoma is not a ¡°one-size-fits-all¡± type of cancer. The molecular and cellular changes are different for each person. If pediatric melanoma is caught early, it is highly treatable.
Leading-edge options
Surgery is almost always part of the treatment for pediatric melanoma. Because Children's Cancer Hospital leads one of the most active pediatric melanoma treatment programs in the nation, our surgeons have extraordinary expertise and experience that can help increase your child's chances for successful treatment.
Several innovative treatments for pediatric melanoma are offered at Children's Cancer Hospital. We offer a range of clinical trials, some of them available only here.
If your child has been diagnosed with melanoma or your child¡¯s doctor suspects your child may have melanoma, we can help. Call 877-632-6789 to make an appointment or request an appointment online.
Our childhood melanoma treatments
If your child is diagnosed with pediatric melanoma, the doctor will discuss the best ways to treat it. This depends on several factors, including if the cancer has spread. Your child¡¯s treatment for melanoma will be customized to your child¡¯s particular needs. One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.
Surgery
The main treatment for pediatric melanoma is surgery to remove the tumor. The type and extent of surgery depends on the size and location of the melanoma and if it has spread.
Early pediatric melanomas usually don¡¯t need further treatment after surgical removal. After surgery, your child will need to have check-ups to be sure the cancer has not returned.
If the melanoma is more advanced, a sentinel node biopsy may be done during surgery. Lymph nodes are olive-sized glands that are part of the lymphatic system that circulates lymph fluid throughout the body. The lymphatic system also can carry cancer cells from the tumor site to other areas of the body. In a sentinel lymph node biopsy, a radioactive blue dye is injected into the area before surgery. The dye shows up in cancerous lymph nodes. The node with the highest amount of blue dye is the ¡°sentinel¡± node. The surgeon removes all nodes with blue dye.
Chemotherapy
Chemotherapy may be used after surgery for some advanced pediatric melanomas. Children¡¯s Cancer Hospital offers the most up-to-date and advanced chemotherapy options.
Targeted Therapies
Treatment with these innovative agents may be needed in advanced pediatric melanomas. They are specially designed to treat each child¡¯s specific cancer and its genetic/molecular profile to help the patient¡¯s body fight the disease. Many of the doctors at Children¡¯s Cancer Hospital are dedicated researchers who have pioneered and actively lead national and international clinical trials with novel targeted agents.
Learn more about childhood melanoma:
Childhood melanoma patient returns to the rodeo after surgery
Rebekah Thibodeaux didn¡¯t expect to see her daughter 13-year-old daughter, Lane, back in the saddle so soon. When Lane was diagnosed with melanoma, she was scared and unsure of what to expect. Lane was, too. She was anxious about her future and upcoming rodeo competitions.
For the Thibodeauxes, rodeos are a family affair. Since they were toddlers, Lane and her sisters have been competing in events like barrel racing, pole bending, and flags. Breakaway Roping has become their favorite.
Fortunately, her care team was able to help Lane overcome melanoma and get back to riding and roping without missing a single competition. Not only did she get to compete in the Texas Junior High Rodeo State Finals, she walked away the All-Around Champion Cowgirl. She also qualified for the national competition in breakaway roping.?
Spotting childhood melanoma
Rebekah wasn¡¯t sure when the mole first appeared on Lane¡¯s neck. She was certain it had been there for years. But suddenly, it seemed to be growing in size. Lane¡¯s sisters noticed it, too. When Rebekah looked closer and ran her fingers over it, a bit of it flaked off. She knew something wasn¡¯t right and scheduled Lane a doctor¡¯s appointment in Lafayette, Louisiana.
Lane had never had a skin screening before. The doctor examined her, noting the ABCDEs of melanoma. Indeed, the one on her neck was an outlier. It just didn¡¯t match the others. The dermatologist conducted a shave biopsy.
A few days later, the dermatologist called Rebekah with the results: Lane had melanoma.
Coming to MD Anderson for childhood melanoma treatment
Melanoma is rare in children and teens. Between 300 and 400 childhood melanoma cases are diagnosed in the U.S. each year. And because it¡¯s so rare, the disease is often found in the later stages, when it¡¯s more difficult to treat.
The dermatologist recommended they travel to Baton Rouge, New Orleans or Houston for treatment. Rebekah had always heard that MD Anderson was the best, so they decided to make the four-hour trip to Houston for Lane¡¯s first appointment a month later.
At MD Anderson, Lane and Rebekah met with pediatric oncologist and her care team. Right away, Lane and Rebekah felt comfortable.
¡°Their optimism was very encouraging,¡± Rebekah says.
Herzog explained that Lane would need surgery and introduced them to pediatric surgeon , and head and neck cancer surgeon They explained that they would need to remove the cancer, as well as the surrounding lymph nodes, to determine how far the cancer had spread and if Lane would need additional treatment. Both Lane and Rebekah were nervous. Goepfert assured them, that as a parent himself, he knew the surgery would be far tougher on Rebekah.
On April 7, Lane returned to MD Anderson for surgery. While Lane was under anesthesia, Geopfert, Austin and their team removed the cancerous spot on Lane¡¯s neck. Next, they injected a blue dye called a radiotracer around the site of the cancer. The radiotracer flowed through the lymphatic system, a network of lymph channels and nodes. This allows surgeons to see how the lymph nodes drain from the tumor. If the cancer had spread, this is the way it would have advanced. From there, Lane¡¯s surgical team identified and removed what¡¯s called a sentinel lymph node, the first lymph node the cancer would spread to. The lymph node would later be studied in a lab by a pathology team. If the lymph node showed signs of cancer, Lane would need additional treatment, such as immunotherapy.
Lane was discharged from the hospital that same day. Right away, she started to heal from the surgery. It never impacted her mobility, and she didn¡¯t have much pain.
On April 14, Rebekah received good news. The cancer hadn¡¯t spread, and Lane was cancer-free. Less than a week later, they returned to Houston for a follow-up appointment. Lane was healing quickly and could compete in rodeos. Two weeks later, she did just that. She even won a prize in breakaway roping later that month.
Through it all, the Thibodeaux family remained grateful to the friends and family who prayed for them. One group in particular called themselves ¡°Team Lane.¡± Knowing friends and family were thinking of them brought the Thibodeauxs peace, no matter what they faced.
Life after melanoma surgery
Lane returns to MD Anderson for her follow-up appointments and skin exams every three months. Rebekah promises that her other daughters will also start undergoing skin screenings as well. Bottles of sunscreen can be found in just about every corner of the house.
Rebekah wants other parents to know the importance of skin cancer prevention. And to the parents of kids facing a diagnosis, she wants them to know that MD Anderson offers treatment options that will help their kids get back to living their lives.
¡°There¡¯s hope in all of it," she says. "And MD Anderson gives you just that!¡±
or by calling 1-877-632-6789.
Melanoma 101: Answers to five common questions
Melanoma is a type of skin cancer that occurs in melanocytes, the cells that carry pigment.
But are there different types? How is it usually treated? And are there any new therapies available?
We checked in with melanoma specialist ., for answers to these questions and more. Here¡¯s what she had to say.
What are the different types of melanoma?
The vast majority of cases occur in the skin and are called cutaneous melanomas. These can be further subdivided into four major types. The most common one is superficial spreading, followed by nodular melanoma. Other cutaneous melanomas include lentigo maligna and acral lentiginous.
But melanomas can also develop in melanocytes located in other areas, including the eye (uveal and conjunctival melanomas) and mucosal surfaces throughout the body (mucosal melanoma), such as the gastrointestinal tract.
Desmoplastic melanoma is another distinct subtype that occurs in skin regions with chronic sun exposure. Other very rare subtypes include primary central nervous system melanoma, which occurs in the leptomeninges (the lining of the brain and spinal cord) and melanoma of soft parts (also known as clear cell sarcoma), which arises in the dermal layer of the skin and other soft tissues.
How is melanoma usually diagnosed?
Some melanomas are diagnosed during regular skin screenings. Others are found after patients notice a swollen lymph node in their neck, armpit, or groin. And in a few patients, melanoma is discovered entirely by chance, during a scan that was ordered for another medical reason.
But in a good number of cases, either the patient or somebody close to them notices a change in a pre-existing mole. That spurs them to see a dermatologist, who then orders a biopsy.
How is melanoma staged?
Staging for melanoma is usually based on the three-tiered ¡°T-N-M¡± model.
- T stands for ¡°tumor.¡± It considers both the thickness of the primary tumor, and whether a pathologist can see ulcerations under a microscope.
- N stands for ¡°lymph nodes.¡± A surgeon may remove these to determine if the cancer has spread.
- M stands for ¡°metastases.¡± These are secondary locations where the cancer has spread. In this tier, doctors will note either the presence (M1) or absence (M0) of metastases.
All of these taken together are what doctors use to determine how advanced a particular melanoma is.
How is melanoma typically treated?
That all depends on the stage. Surgery is the initial treatment in most cases, especially if the cancer has not spread. Some patients may require radiation therapy, too. But melanoma can also be treated with a variety of other systemic therapies, such as targeted therapy and immunotherapy.
At MD Anderson, treatment is tailored to the specific needs of each patient. So, we take into consideration the type of melanoma, its stage and any other medical issues a patient might have.
What are the latest advances in melanoma diagnosis and treatment?
Over the past decade, the Food and Drug Administration (FDA) has approved a number new drugs for the treatment of melanoma.
In the immunotherapy category alone, there are ipilumumab, pembrolizumab, and nivolumab, plus the combination of ipilumumab and nivolumab taken together. These are given through an IV.
There are also three FDA-approved oral targeted therapy drug combinations for melanoma patients with a BRAF mutation: vemurafenib and cobimetinib, dabrafenib and trametinib, and encorafenib and binimetinib.
Other approaches for treating advanced melanoma include injecting an oncolytic virus called talimogene laherparepvec (T-VEC) directly into the tumor.
Not all of these therapies will work for everybody, of course, but it¡¯s still really exciting to have them. Because now, patients have many great FDA-approved medications available, and numerous clinical trials they can join, should they exhaust all current treatment options.
We¡¯re seeing some really amazing results, too. Patients who would¡¯ve lived maybe 4 to 6 months after being diagnosed with a melanoma brain metastasis before, for example, have a chance of living for years. And some are seeing complete responses. So, while we still have a lot more work to do to help our patients, having melanoma today is very different from having melanoma a decade ago.
or by calling 1-877-632-6789.