Is IFN right for you? Here are some of the pros and cons of interferon treatment to discuss with your doctor:
1. IFN is the only medicine that has been approved for use in melanoma patients after surgery. Outside of clinical trials, it's all we've got!
2. Some people tolerate interferon well and do receive a significant benefit from it in terms of preventing a relapse for a longer period of time. Also, many people feel that they need to do everything possible to fight their disease and that they would regret not taking IFN if the cancer came back.
3. Unfortunately, IFN is not very effective in the majority of patients. A year’s worth of IFN treatment can delay the time to recurrence, although half the time this delay will be less than one year. However, it is now known that the overall chance of recurrence and the overall survival time is not improved (contrary to some early studies that showed an increased survival time of about one year).
4. IFN is associated with significant side effects in virtually all patients. The most frequently reported are flu-like symptoms, fatigue, muscle pain, depression and liver problems, some of which may worsen over the year of treatment.
5. The schedule for taking interferon is challenging. Injections are usually done three times per week, at your home by yourself or a loved one. You'll also need to come into the doctor's office frequently for blood tests. This represents both a financial cost to you and the healthcare system.
6. While you are taking IFN, it is impossible to know if it's working, since after surgery there are no tumors to measure. So during the year of IFN treatment, all you are aware of are the side effects -- and that can be psychologically difficult.
Ultimately, you need to ask yourself this question: How much is living without melanoma for less than a year more worth, knowing that there will be little or no effect on your overall long-term survival? Your doctor can give you advice, but only you know your need for physical and mental well-being, your desire to do everything possible, and thus what risk–benefit ratio is acceptable.
Sources:
Hurley KE, Chapman PB. Helping melanoma patients decide whether to choose adjuvant high-dose interferon-alpha2b. Oncologist. 2005 Oct;10(9):739-42.
Hauschild A. Adjuvant interferon alfa for melanoma: new evidence-based treatment recommendations? Curr Oncol. 2009 May; 16(3): 3–6.
