Melanoma Treatment

Melanoma is a type of skin cancer. It begins in cells called melanocytes. Melanoma often looks like a mole that has changed or a new growth on the skin. These moles or growths might be larger or have irregular borders. They may change color. They may bleed or itch. Sun exposure is a major risk factor. People with fair skin are more likely to develop melanoma. Genetics also play a role. Some people inherit genes that increase their risk. Other potential factors can also increase melanoma risk.¹

Melanoma varies considerably in type, stage, genetic mutations, and location. What type of treatment you need depends on all these factors. This is why early detection is so important.¹

Treatment for early-stage melanoma

Early-stage melanoma is often treated with surgery. Treatment options for early-stage melanoma include:

Excision

The first choice of treatment for local melanoma is wide excision. Doctors remove the melanoma and a small area of healthy skin around it. This helps to ensure all cancer cells are removed.^2,3

Lymph node dissection

If the cancer has spread to the lymph nodes close to the tumor, your doctor may recommend additional surgery to remove these nearby lymph nodes.^2,3

Topical medicine

Topical imiquimod cream (Zyclara®) may be used to treat certain forms of early-stage melanoma or melanoma that is only found in the top layer of the skin.^2,3

Treatment for advanced melanoma

For more advanced melanoma – when the cancer has spread (metastasized) – other, more systemic treatments are often needed. These treatments may include:^2,3

Immunotherapy

This helps the body's immune system fight cancer. One example includes drugs called immune checkpoint inhibitors. These drugs help the immune system recognize and attack cancer cells.^2,3

Targeted therapy

This uses drugs that target specific genes or proteins that help cancer grow or that are unique to cancer cells. About half of all melanomas have mutations in the BRAF gene. One example includes targeted therapy drugs that can block the activity of this gene.^2,3

Chemotherapy

This uses drugs to kill cancer cells. Chemotherapy is becoming less commonly used to treat melanoma, as targeted therapy and immunotherapy are generally more effective. However, it may be used for certain forms of advanced melanoma.^2,3

Radiation therapy

This uses high-energy beams to kill cancer cells. Radiation therapy can be used for certain melanomas that are considered early-stage when surgery is not possible. It can also be used to treat melanoma that has spread to other parts of the body and can help relieve symptoms related to cancer metastasis (spread). Radiation therapy is sometimes used to treat the lymph node region after lymph nodes are removed. Radiation therapy kills cancer cells that remain.^2,3

Intralesional medicine

Talimogene laherparepvec is a drug injected into the tumor. It is an oncolytic virus that makes copies of itself in cancer cells. It is used to treat certain forms of melanoma in the lymph nodes and skin that has returned following initial surgery, and cannot be treated with additional surgery.³

What to expect from treatment

Melanoma treatment is different for each person. Surgery is often done as an outpatient procedure. This means you go home the same day. Immunotherapy for melanoma is often given as an infusion or injection. These infusions or injections are given in a clinic, infusion center, or hospital. Chemotherapy and radiation therapy are also given in a clinic, infusion center, or hospital. Targeted therapy for melanoma is typically given in pill form, taken by mouth.^2,3

Doctors monitor patients closely during and after treatment. They check for signs of cancer returning. They also manage any side effects. Regular skin checks are vital. This helps to find any new melanomas early.^2,3

Treatment side effects

All treatments can have side effects. Surgery can cause pain and scarring. Immunotherapy can cause flu-like symptoms. It can also cause skin rashes and other immune-related side effects. Targeted therapy can cause skin problems, fatigue, and other side effects. Chemotherapy can cause nausea, vomiting, and hair loss. Radiation therapy can cause skin irritation and fatigue.^2,3

Talk to your doctor about your specific treatment, any potential side effects, and your concerns. They can help manage them. They can also adjust treatment if needed.

When to seek medical treatment

You should see a doctor if you notice any changes in your skin. This includes changes in a mole. You should also see a doctor if you have a new growth on your skin. Early detection is key. If melanoma is found early, it is easier to treat.^1-3

Here are some signs to watch for:^1-3

• A mole that changes in size, shape, or color
• A mole that bleeds or itches
• A new dark spot on your skin
• A sore that does not heal

If you have any of these signs, see a doctor right away. Early treatment can save lives.