How to Treat Acral Melanoma

Acral melanoma (ALM) is a rare form of skin skin cancer that occurs on the palms, soles, and nail beds.

Unlike most skin cancers, it has nothing to do with sun exposure. ALM accounts for 70% of melanomas in blacks, 46% in Asians, and less than 10% in whites.

If caught early, ALM can be cured with surgical excision. This procedure, called wide local excision, is performed by surgical oncologists (doctors who specialize in cancer diagnosis and treatment) and is the mainstay of treatment for most ALM lesions.

If the cancer has spread, additional treatment, such as chemotherapy, may be needed. In this article, we will review treatment options.

Surgery and expert-driven procedures

A team of dermatologists (doctors who specialize in diagnosing and treating skin, hair and nail disorders), oncologists, nurses and support staff may help you manage your care. If you are seeing a healthcare professional with suspicion of AML, these are the surgeries and specialist-driven procedures you can expect.


AML lesions can be difficult to distinguish from noncancerous moles (benign mole).Therefore, your dermatologist may use Dermoscopy Confirm the diagnosis and better understand the depth and other characteristics of the associated tumor before surgery.

Dermoscopy is a special test that uses a microscope and incandescent light to examine the details of the tiny structures of melanocyte skin lesions (abnormal changes in the skin that produce melanin or pigment). Dermoscopy reveals hard-to-see skin changes that are not visible to the naked eye.

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If you are diagnosed with ALM, you will be referred to a surgical oncologist to remove the tumor. Physicians in the field of surgical oncology specialize in the safe removal of acral melanoma.

The most common surgery is wide local excision. It is the mainstay of treatment for ALM and works well for early-stage melanoma. During this procedure, the entire tumor and a small amount of healthy surrounding tissue will be removed.

Recommendations for determining surgical margins (the amount of nearby healthy skin removed) are based on tumor thickness at biopsy. If the surgery creates a large defect, the surgeon may use other techniques, such as skin grafting (using skin from other parts of the body to close the wound) or flap reconstruction (closing the wound with nearby healthy skin tissue), to maintain the appearance of the skin.

Sentinel lymph node biopsy and other procedures

Later in the disease, your healthcare provider may palpate (feel with your body) nearby swollen lymph nodes. If they are larger than normal, the surgeon will remove them.

If the lymph nodes are not enlarged, a sentinel lymph node biopsy can be used to detect the presence of metastases (spread of cancer). During this procedure, surgeons take a small sample from the nearest lymph node and send it to a lab where it can be tested for cancer cells.

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If metastases are found, other forms of treatment may be required.


Systemic (whole body) therapy can be used to kill cancer cells that have metastasized. Potential treatments include:

  • Chemotherapy drugs: Chemotherapy drugs are prescription drugs used to kill cancer cells throughout the body. They can be given by mouth or intravenously as a pill.
  • Targeted mutation therapy: These new drugs in development work by attacking certain mutations or targets in cancer cells that cause them to change, grow and divide.
  • Immune checkpoint inhibitors: These drugs use the body’s own immune system to kill cancer cells. Recent clinical trials have shown that immune checkpoint inhibitors can significantly improve overall survival in patients with metastatic AML.

ALM tumors are insensitive to radiation (meaning that radiation is not effective at killing cancer cells).But in rare cases, radiation therapy (a beam of high-energy X-rays designed to kill cancer cells) can be used to adjuvant treatment (supportive care versus other treatments such as chemotherapy), ease (for reducing symptoms and improving quality of life), or if there is evidence of recurrent disease.

Home Remedies and Lifestyle

There are no home remedies or lifestyle factors approved for the treatment of ALM.

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However, it’s important to be aware of some lifestyle factors, including avoiding or quitting smoking, maintaining a healthy, nutrient-dense diet, reducing stress levels, and finding an exercise program that works for you, may help you feel better and improve your results while you’re During cancer treatment and recovery.


Wide local excision is the mainstay of treatment for acral melanoma. Early detection of ALM is highly curable, underscoring the importance of early diagnosis and treatment. Chemotherapy is mainly used if the cancer has spread to tissues beyond the primary site, while radiation therapy can be used as a palliative treatment measure in the case of end-stage metastases.

VigorTip words

Early diagnosis can be difficult because early ALM skin changes can be subtle and symptoms can be nonspecific or absent at all. Still, this type of skin cancer is aggressive and prevalent in dark-skinned people, so it’s important to do regular self-exams and maintain regular screenings to catch skin changes early.

Early treatment costs are lower and the cure rate is higher. If you have a family history of melanoma, don’t see skin changes in the sun, or have a mole that doesn’t look the same as usual, if you suspect melanoma, get it checked and addressed right away.