Is Immunotherapy The Right Treatment For Anal Melanoma?

Posted on Tue, 25 Nov 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 25 Nov 2014 Answered on

Fri, 19 Dec 2014 Last reviewed on

Question : I am a 75 year old white male. I had triple heart bypass surgery 10 years ago. I am not diabetic. Blood pressure runs 140/78 untreated. I have high cholesterol and triglycerides. I do not take statins. I had a XXXXXXX stroke 10 years ago right before I had the bypass surgery. I am physically active. A recent colonoscopy discovered a growth the size of a little finger fingernail that was removed. Biopsy revealed Anal Melanoma. Subsequent PET and CAT scans showed no other tumors. Proposed treatment is excision to clear margins and removal of the lymph node on each side of the groin. I am not sure I can survive what I understand will be very painful surgery with several weeks of recovery time in light of my age and previous health problems. My research revealed that immunotherapy appears to be very effective in treating Melanoma. Does it make more sense to try immunotherapy first before the proposed invasive surgery?

Answered by Dr. Monish De (57 minutes later)

Brief Answer:
Surgery followed by immunotherapy

Detailed Answer:
Hi

I have gone through your history.

Anal melanoma is a devastating malignancy.

Average survival time is around 15.2 months even with treatment.

The standard treatment option is surgery followed by immunotherapy.

Immunotherapy for anal melanoma is still under trial and its use first before surgery will not provide any benefit.

Regards

DR DE

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Monish De (34 hours later)

DR.DE: Thanks for your prompt response. My first follow-up question is if the excision cannot achieve clear margins, would total removal of the anal area and a colostomy increase the average survival time?

Answered by Dr. Monish De (4 minutes later)

Brief Answer:
It should increase the average survival time by at least 6 months

Detailed Answer:
Hi

If the excision cannot achieve clear margins total removal of the anal area and a colostomy will increase the average survival time by at least 6 months.

Regards

DR DE

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj