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How is melanoma treated?

Treatment options for melanoma depends on several factors, including the stage of the cancer and the age of the person affected. The most common treatment for melanoma is surgical removal of the cancer and some of the surrounding tissue. If the area is large, skin grafting may be used to repair the area. Surgery is almost always successful if the melanoma is caught early. If the melanoma is deep and appears on an appendage (like a finger or toe), removal of the appendage may be needed. Lymph nodes may be surgically removed as well if it is thought that the cancer could have spread to them. Chemotherapy uses chemicals given orally or intravenously to kill cancer cells, but is not usually used for melanoma unless it has spread significantly. Radiation therapy, which involves killing cancer cells with radiation such as X-rays, may also be used to treat melanoma. Targeted therapy uses drugs that are designed to stop or kill melanoma by attacking these cancer cells directly. Immunotherapy uses the body's own immune system to attack cancer. One type immunotherapy blocks a protein on the cancer cell that protects it from the immune system, thus allowing the immune system to attack the cancer cell. Talk to your doctor to determine the best treatment for you.

Dr. Jill Onesti, MD
Surgical Oncologist

The majority of melanomas are diagnosed at an early stage and can be treated safely with surgery. Treatment usually involves removing a large portion of the skin and soft tissue at the site of the lesion and may involve checking the lymph nodes. For more advanced cancers, a combination of chemotherapy and radiation may also be necessary.

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To treat melanoma, the mole and a margin of healthy tissue are removed. A procedure called sentinel node biopsy may determine if the lymph node nearest the tumor contains any cancer cells. If it does, additional lymph nodes will be removed in the same procedure. In addition to surgery, standard treatments for melanoma include chemotherapy, radiation, and biological therapy, which strengthen the immune system against the cancer. For reasons still not understood, chemotherapy generally helps only a small number of people with melanoma, and there is no standard treatment regimen. Melanoma survival rates are 95% or higher if the tumor is less than 1 mm thick. But beyond 4 mm in thickness, the cure rate drops to 45%. As with most other forms of cancer, if the tumor has spread to distant organs, overall survival is lower, about 18%.
Once melanoma has been found and staged, your cancer care team will discuss treatment options with you. Depending on your own case, you may have different types of doctors on your treatment team. These doctors may include:
  • A dermatologist: a doctor who treats diseases of the skin
  • A surgical oncologist: a doctor who uses surgery to treat cancer
  • A medical oncologist: a doctor who treats cancer with medicines
  • A radiation oncologist: a doctor who treats cancer with radiation
Many other experts may be involved in your care as well, such as nurses, dietitians, social workers and others.

It’s important to discuss all your treatment options and their side effects with your treatment team to help decide what’s best for you. If there’s anything that’s not clear, ask to have it explained. 

Based on the stage of the cancer and other factors, your treatment options may include:
  • Surgery
  • Immunotherapy
  • Targeted therapy
  • Chemotherapy
  • Radiation therapy
Early-stage melanomas can often be treated with surgery alone, but more advanced cancers often need other treatments. Sometimes more than one type of treatment is used.

When time allows, getting a second opinion is often a good idea. It can give you more information and help you feel good about the treatment plan you choose. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.