Melanoma varies considerably in type, stage, genetic mutations, and location. Treatment selection depends on all these factors. The main treatment options are summarized here.
How is melanoma treated?
Excision
The first choice of treatment for local melanoma is wide excision.1,2 Margin width depends on the thickness of the tumor.
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.
Topical medication
Topical imiquimod may be used to treat certain forms of early stage melanoma or melanoma that is only found in the skin.2
Systemic medications
Systemic medications may be used for primary or adjuvant treatment if the cancer has spread. Several different types of medication are available. Immunotherapy turns your immune system against the cancer. Targeted therapy aims at the mutations that lead to uncontrolled cell growth or focuses on specific features that are unique to cancer cells. Chemotherapy is often less effective than newer medications, but remains an option in some circumstances.
Intralesional medication
Talimogene laherparepvec is a medication injected into the tumor. It is an oncolytic virus that makes copies of itself in cancer cells.3 It is used to treat certain forms of melanoma in the skin and lymph nodes. Another intralesional therapy, the Bacillus Calmette-Guerin vaccine, is used less often.
Radiation therapy
Radiation therapy is sometimes used to treat the lymph node region after the lymph nodes are removed. Radiation therapy kills cancer cells that remain. In some circumstances, radiation therapy is a primary treatment for melanoma. It is also used to relieve symptoms of cancer metastasis (spread).