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From MayoClinic.com


The best treatment for you depends on the stage of cancer you have and your age, overall health and personal preferences. But in most cases, the standard treatment for melanomas that haven't spread beyond the skin is surgery to remove the cancer.

When melanoma has spread to another part of your body, options may include surgery, chemotherapy, radiation therapy, biological therapy, experimental therapy or a combination. It's important to understand the different treatments and their potential risks and side effects. Don't be afraid to discuss any questions you may have with your treatment team. You may also want to consider seeking a second opinion, especially from doctors who specialize in treating melanoma. In some cases, after weighing your options you may choose not to treat the melanoma itself but rather to try to relieve any symptoms the cancer may cause.

Treating early-stage melanomas

The best treatment for early-stage melanomas is surgical removal (simple excision). Very thin melanomas may have been entirely removed during the biopsy and require no further treatment. Otherwise, surgery involves your doctor excising the cancer as well as a small border of normal skin and a layer of tissue beneath the skin. In almost every case this eliminates the cancer.

At one time, surgery for more invasive early-stage tumors involved cutting out the cancer along with a large border of normal skin (wide local excision). This usually meant having a skin graft — a procedure in which skin from another part of the body is used to replace the skin that's removed. But taking smaller amounts of normal skin in some cases of invasive melanomas may be just as effective in treating cancer and may eliminate the need for skin grafts.

Even so, you may be concerned about scarring. It may help to know that in many cases, the scar is a small line about 1 to 2 inches long that fades with time. If you need a skin graft, however, the scar will be larger and more noticeable.

Treating melanomas that have spread beyond the skin

  • Surgical removal. Unfortunately, it's usually not possible to cure melanomas that have spread beyond the skin. But surgically removing a metastatic melanoma can often provide relief of symptoms — sometimes for years. Whether this is an option for you depends on where the cancer is located and how severe it is, as well as on your own wishes and overall health. 

  • Chemotherapy. This form of treatment uses drugs to destroy cancer cells. Two or more drugs are often given in combination and may be administered intravenously, in pill form or both — usually for 4 to 6 months. Although not as effective in treating melanoma as some other types of cancer, chemotherapy can help relieve symptoms in people with advanced metastatic melanoma.

  • Chemotherapy is generally a systemic therapy, which means that it can affect cancer cells throughout your body. But chemotherapy also affects healthy cells — especially fast-growing cells in your digestive tract, hair and bone marrow. This can cause side effects such as nausea, vomiting and fatigue. Not everyone has these side effects, however, and there are now better ways to manage them if you do.

  • Researchers are studying different ways to administer chemotherapy medications in an attempt to reduce their effect on healthy cells. One method under investigation is limb perfusion. It's used for melanomas on the arm or leg. In this procedure, the blood flow to the limb being treated is temporarily stopped with a tourniquet. High doses of chemotherapy drugs are then injected directly into the melanoma. Because most of the drugs stay in the limb, they're less likely to affect other parts of the body.

  • Radiation therapy. This treatment uses high-energy X-rays to kill cancer cells. It's sometimes used to help relieve symptoms of melanoma that has spread to another organ. Fatigue is a common side effect of radiation therapy, but your energy usually returns once the treatment is completed.

  • Biological therapy (immunotherapy). This form of treatment is designed to help your immune system fight disease. It involves the use of biologic response modifiers (BRMs) — substances your body normally produces in response to infection. BRMs such as interleukin-2 and interferon are now produced in laboratories for use in treating cancer and other diseases. Side effects include symptoms similar to those of the flu, such as chills, fever, nausea, vomiting and diarrhea. Often, these symptoms are so severe you need to be hospitalized. For that reason, researchers are searching for forms of immunotherapy that not only are more effective but also cause fewer side effects.

Melanoma > 1 > 2 > 3 > 4

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