"What and where are the latest treatemnts for Desmoplastic melanoma?"

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Request for Question Clarification by librariankt-ga on 26 Aug 2004 05:56 PDT

Hi there -
I'm having some wording problems here - the tumor that you are
concerned with, is it a bone tumor (desmoplastic fibroma) or a brain
tumor (medulloblastoma)? Thanks -
Librariankt

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Clarification of Question by suga41-ga on 01 Sep 2004 01:54 PDT

Desmoplastic Melanoma - in this case it affects the face - cheek and
jaw to be exact. Urgent - hope you can help!

Hi suga41,

Thank you for your question. 

Please read the *Important Disclaimer* at the bottom of this page. 
Google Answers Researchers can only provide general information and a
physician or health care provider should always be contacted for more
specific advice and treatment.


Desmoplastic melanoma 

"Wider excision than is normal for other histological types of
melanoma is recommended for desmoplastic melanoma. Postoperative
radiotherapy, in consultation with a melanoma centre should be
considered after surgical excision of a recurrent desmoplastic or
neurotropic melanoma."
http://www.mascri.com.au/guidelines.html

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Desmoplastic Melanoma (cached page - please copy and paste URL)
http://66.102.7.104/search?q=cache:i05vfTEd1qwJ:www.utmb.edu/otoref/Grnds/Melanoma-2004-0310/Melanoma-2004-0310.doc+treatment+Desmoplastic+Melanoma+&hl=en

Or click here for the information in a Word Document
http://www.utmb.edu/otoref/Grnds/Melanoma-2004-0310/Melanoma-2004-0310.doc

"This type of melanoma may lack pigment.  They are characterized by a
"school of fish" appearance of spindle cells in a fibrous stroma.  A
hallmark of this lesion is its tendency for perineural invasion."

Treatment

Stage I

"Surgery is the only recommended treatment.  For these thin lesions,
margins of 1 cm are acceptable.  Minimal workup, including chest x-ray
and LDH, is generally performed to rule out metastasis.  No neck
dissection or lymph node biopsy is recommended due the low incidence
of metastasis."
 
Stage II

"Workup for stage II lesions includes CXR and LDH as with stage I
lesions.  Some authors recommend lymph node mapping and a CT
metastatic workup in cases such as ulcerative lesions or recurrent
disease.  The treatment of stage II lesions is probably the most
complicated.  This difficulty stems from the significant percentage of
occult metastasis present with these lesions.  While higher stage
lesions require more complex and invasive therapies due to their
obvious clinical findings, treatment of stage II lesions involves
controversial therapies with inherent morbidity to treat a low yet
statistically significant percentage of metastasis.  The primary
therapy for stage II lesions is surgical, with a wide local excision
and 2 cm margins."


Radiotherapy

"Although melanoma was once considered to be a radioresistent tumor,
several studies have recently shown that treatment of the lymphatic
basins can result in a significant decrease in local and regional
control.  This improvement in local control is not confined to early
stage lesions, and has been found to equally effect stage II-IV
lesions, as well as patients with recurrent melanoma of the head and
neck, making local recurrence rates almost 88% at five years.  It must
be noted though, that even with improved local control, there was no
statistical significance in survival in any of the groups.  However,
since local recurrence can be debilitating and cosmetically deforming,
this treatment should be considered more therapeutic rather than
palliative."


Chemotherapy

"Chemotherapy is reserved for proven systemic spread beyond regional
lymphatics. According to Braud et al., there is no role for
chemotherapy or immunotherapy in stage III disease, and no studies yet
have shown any benefit.  Although several common regimens exist for
stage IV melanoma, including interferon, interleukin, and several
multi-drug regimens, none have shown any significant improvement in
outcome.  Systemic therapy for these lesions are generally considered
experimental, and many authors recommend that if patients who elect
for chemotherapy be referred to an appropriate oncologist for
enlistment in a current clinical trial."
 
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Clinical Trials listed for desmoplastic melanoma

http://www.clinicaltrials.gov/ct/show/NCT00060333


http://www.clinicaltrials.gov/ct/gui/show/NCT00060333;jsessionid=09A96D44113D09E3BA5CBFD12FCAAA66?order=40


http://cancer.gov/clinicaltrials/NCCTG-N0275


http://health.yahoo.com/search/ctrials?p=skin+cancer&b=21


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desmoplastic melanoma
http://upcmd.com/?Size=100&Count=52&First=Melanoma&Term=desmoplastic%20melanoma

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keyword search:

desmoplastic melanoma latest treatments
desmoplastic melanoma face
desmoplastic melanoma clinical trials

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Best regards,
tlspiegel

Surgery should be the first consideration.
There is no successful chimio or radiotherapy.
However, intense nutriutional therapies, that improve the immune
system are very important. One of the most intensive is the so called
Gerson Therapy.
You can see more details in www.gerson.org 
There is a hospital in Mexico that provides it (BajaNutricare
Hospital) and a clinic in Spain, check
www.mundofree.com/chroniclinic/main.html