Subungual Melanoma Treatment: Surgical and Non-Surgical Options

What is Subungual Melanoma?

Subungual melanoma is a type of melanoma that develops in the nail bed, typically under the patient’s fingernails and toenails. These often appeared as dark, irregularly shaped spots mistaken for a bruise or fungal infection in the nails. In most cases, people will ignore or overlook these signs as subtle appearances, making early detection often crucial for improving the treatment outcomes. 

The real cause of subungual melanoma is not fully understood, but like any other types of melanoma, it is thought to be related to DNA damage often caused by genetic mutations, family history of subungual melanoma, people above the age of 50. Additionally, there are some risk factors that cause these cancers which may include race, ethnicity, trauma, and weakened immune system.

Treatment options for Subungual Melanoma?

Treatments for subungual melanoma generally involve a combination of surgical and non-surgical treatment approaches, mainly depending on the stage of the melanoma and the patient’s overall health.

Surgical procedures:

Surgery is the first line of treatment for these types of melanoma, especially used for the early stages of cancer. The main goal of this treatment is to remove the melanoma and prevent the spread of the cancer from spreading to the other parts of the body. Performing surgery on patients mainly depends on the stage and location of the melanoma. 

Nail excision

In early-stage subungual melanoma, the most common treatment involves the removal of the affected nail and the tissue underneath it. 

The surgical procedure might involve:

• First of all, a local anesthetic will be given.
• Excision of the nail along with the surrounding tissue, which includes the nail bed as well, to ensure that the melanoma will be completely removed. 
• In case the melanoma is localized and has not spread to surrounding tissues or lymph nodes, this procedure is often considered curative. While in some cases, your medical team suggests getting a skin graft might be required to cover the exposed nail bed. 

Wide local excision (WLE)

If the melanoma has spread beyond the nail bed to the surrounding tissues, then a more extensive procedure such as wide local excision is performed on patients. These procedures require removing a large area of tissue around the melanoma to make sure that all the cancer cells are excised. The margin of healthy tissue surrounding the tumor is essential to reduce the risk of recurrence.

Lymph node dissection

If your healthcare provider suspects that you have a melanoma that has spread to nearby lymph nodes, tissues, and procedures often known as a lymph node biopsy might be performed. Lymph node dissection often involves the removal of the affected lymph nodes for further medical examination. This treatment typically involves when the melanoma has reached an advanced stage of cancer. 

Non-surgical treatment outcomes

While surgery is the main cornerstone for this type of cancer treatment, there are some other non-surgical treatment options available for patients who may not be suitable for surgery or for those taking additional cancer treatments.

Some of these treatments may include:

Immunotherapy

Immunotherapy is an effective treatment that works by stimulating the body’s immune system to fight against cancer cells. It is primarily used for advanced cancer cases, where the cancer has spread to other parts of the body, such as metastatic melanoma. 

There are drugs such as checkpoint inhibitors (e.g., pembrolizumab and nivolumab) that can be effective in treating melanoma by blocking the proteins that prevent the immune system from attacking cancer cells.

Targeted therapy

For people with specific genetic mutations, targeted therapy is often used as an effective treatment option. Targeted drugs, such as BRAF inhibitors (e.g., vemurafenib, debrafenib), target and block the mutations responsible for the growth of melanoma cells. These treatments are typically used for patients when melanoma tests positive for the BRAF gene mutation, which is quite possible in all melanoma cases.

Radiation therapy

Radiation therapy is often used with a combination of surgery, especially for patients with larger or more invasive subungual melanoma tumors. In some patients, radiation may be used to shrink tumors before surgery. These treatments are often used after surgery to target any remaining cancerous cells in the surrounding tissues.

Radiation therapy is often used for palliative care in patients with metastatic melanoma to relieve pain and other symptoms caused by the spread of the cancer.

Chemotherapy

Chemotherapy is less commonly used for melanoma than in other cancers; chemotherapy is a last treatment option for patients with advanced melanoma when immunotherapy and targeted therapies may not have been effective. While chemotherapy drugs are designed to kill and destroy, a range of potential side effects exist. These treatments are typically used when other therapies may not have been effective in subungual melanoma cases.

Consult Today

Subungual melanoma is a rare and complex form of melanoma that requires an immediate diagnosis and treatment. While other surgical options might include nail excision and wide local excision, which remain the most common and effective treatments, there might also be non-surgical treatments such as immunotherapy, targeted therapy, and radiation therapy, which play a key role in managing the advanced or metastatic cancer disease.

At Oncare, we offer premium- quality cancer treatments, including advanced cancer surgeries at an affordable price range with an experienced cancer specialist consultation.

If you or any loved ones of yours are diagnosed with cancer, then visit Oncare Cancer Center and book an appointment with our experienced cancer specialist today! Get an estimated cost of your cancer treatments today!