The Skin
Last updated (19 November 2003)
Good Stuff
Spot Diagnosis
Skin
Padding space 'Pigmented lesion'
Padding space Q1
Padding space Q2
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Pigmented Click on the image to download a larger version
What adjuvant therapy should be considered?
Tamoxifen
BCG
LAK cells with IL-2
Recombinant Interferon alpha
Radiation to the draining lymph nodes.

The answer

Recombinant Interferon alpha has been shown to have some benefit.

What the student might say

Thats a difficult question, I would ask the opinion of an oncologist. I have heard some encouraging news about the user of Interferon, but I think that it is only useful in patients who are node positive.

Small Print

Tamoxifen has its main role as an adjuvant treatment in breast cancer. It is particularly useful in post-menopausal estrogen receptor positive patients.

Melanoma and renal cell cancer are two somewhat peculiar tumors in that the main things that have been shown to be of benefit are immuno-therapy. However BCG is not particularly useful.

There was initial enthusiasm for the use of LAK, or lymphokine activated killer cells in combination with interleukin 2 (IL-2). However while there were some amazing responses the overall benefit was poor with the toxicity of IL-2 being a limiting factor, (the vascular leak syndrome).

Interferon has been shown in clinical triail to offer some benefit in node positive patients. The benefit is small and the cost of therapy high.

Elective radiation of the regional lymph node basins has not been shown to be beneficial.

Adrian P. Ireland