Four months ago, Mr. Ji noticed an ulceration on the heel of his right foot, which was eventually diagnosed as melanoma.
On June 4th, Mr. Ji underwent "radical melanoma surgery with intraoperative radiotherapy" at Hainan Cancer Hospital.
On October 8th, he returned for a follow-up visit. All indicators had normalized, and the treatment had achieved its intended goals.
This marks the first case of melanoma treated with intraoperative radiotherapy in Hainan.
Expert Team Visits the Patient
I. Be Especially Vigilant of Plantar Nevi
Mr. Ji, a resident of Dongfang City, Hainan, recalled that the mole on the heel of his right foot had been there "for quite some time." It was originally the size of a soybean but had gradually grown larger in recent years. He didn’t pay much attention to it.
Earlier this year, the mole suddenly ulcerated. He tried various herbal remedies and folk treatments, both topical and oral, but none were effective. Upon visiting the hospital, the pathology report confirmed it was melanoma.
Despite being in his 60s, Mr. Ji was in excellent health. "I never thought such a small mole could turn out to be so dangerous," he said. After extensive research, his family promptly accompanied him to the Bone and Soft Tissue Surgery Department at Hainan Cancer Hospital for treatment.
Hainan Cancer Hospital has been designated by the Melanoma Professional Committee of the China Anti-Cancer Association as a "Clinical Research Sub-Center for Melanoma," the first such center in Hainan to receive national industry recognition.
Professor Chen Yu, Director of the Bone and Soft Tissue Surgery Department, explained that moles located on the soles of the feet, collar areas, or other sun-exposed areas are relatively more prone to malignant transformation. If a pre-existing mole changes in size, shape, color, or texture and is accompanied by symptoms such as bleeding, itching, or pain, it may indicate melanoma. These symptoms should not be ignored.
Experts also emphasized the importance of avoiding reckless “mole removal”. Unregulated procedures and infections may increase the risk of malignancy.
II. Benefits of Intraoperative Radiotherapy
Melanoma is a malignant tumor that originates from melanocytes in the skin and mucous membranes. Although the incidence rate in China is relatively low, it is highly malignant, with a high mortality rate, and is prone to recurrence and metastasis, making it extremely dangerous.
Intraoperative radiotherapy, as the name suggests, is a new technology that involves using specialized equipment during surgery to irradiate the tumor bed after tumor excision. Dr. Ran Haonan, leader of the hospital’s intraoperative radiotherapy team, outlined three key advantages of intraoperative radiotherapy compared to conventional treatments: (1) high radiation doses with greater treatment efficacy; (2) direct and precise application to the tumor bed, with minimal side effects, ensuring high safety; (3) immediate elimination of any residual cancer cells during surgery, greatly reducing the risk of recurrence and metastasis.
Fortunately, Mr. Ji’s plantar melanoma had not metastasized, as it was detected early. After a multidisciplinary expert consultation, Professor Chen and the intraoperative radiotherapy team devised a comprehensive surgical treatment plan for him, incorporating intraoperative radiotherapy.
Professor Chen performed the surgery, ensuring the complete removal of the malignant tumor, while Dr. Ran’s team simultaneously carried out intraoperative radiotherapy.
Post-surgery, the condition of the affected area improved significantly. Regular follow-ups showed no signs of tumor metastasis or recurrence.
Research from the Mayo Clinic shows that the local recurrence rate for melanoma treated with intraoperative radiotherapy is 15%, compared to 30% in patients who receive conventional postoperative radiotherapy. The five-year overall survival rate for intraoperative radiotherapy is 60%, while the rate for traditional postoperative radiotherapy is 50%.
From a statistical perspective, the use of intraoperative radiotherapy for melanoma improves both local recurrence control and the five-year survival rate.
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Text and Images | Liang Shan
Editor | Chen Lin