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
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
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.
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.
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.
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
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.