Melanoma in situ is a common tumor, and often affects the elderly. In some cases, surgery can be extremely extensive and/or patients are not good surgical candidates. For years, Dermatogists have been offering topical imiquimod (Aldara) to these patients as an alternative to surgery, with the full understanding that it is not as good as surgery, but better than nothing.
A recent study published in Dermatologic Surgery looked at long-term recurrence rates for patients who were treated with Aldara. They found that 17% of patients had a recurrence of their tumor, which is far higher than surgical recurrence rates.
In short, some publications talk about a “new” “alternative” to surgery. This is simply not the case. Surgery is the best option and topical treatment with imiquimod, as it has been, should only be considered for those who are not surgical candidates or those who are not expected to outlive their disease.