Treatment for Melanoma

Depending on the stage of your melanoma, you have several treatment options. Here's what you should know about treatment for melanoma and what you should expect.

There are various treatment choices for melanoma. Which one may work best for you depends on several factors. They include the size, location, and stage of your melanoma. Factors also include your age, overall health, and what side effects you’ll find acceptable.

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Learning about your melanoma treatment options

Your medical team will be able to explain your choices, their chances of success, and their risks and side effects. Your doctor may advise a specific treatment. He or she may offer more than one treatment method from which you can choose. It is important to take the time you need to make the best decision.

Types of treatment

Treatments for melanoma are local or systemic:

• Local treatments. These remove, destroy, or control the cancer cells in one area. Surgery and radiation therapy are local treatments.
• Systemic treatments. These are used to destroy or control cancer cells in your entire body. Chemotherapy, targeted therapy, and biological therapy are systemic treatments.

You may have just one treatment or a combination of treatments.

Goals of different treatments

Each type of treatments has its own goal. Below is a list of treatments and their goals:

• Surgery. The goal of surgery is to remove the melanoma, while leaving as much of the nearby skin as intact as possible. That is the main option for most melanomas and usually cures early-stage melanomas.
• Radiation therapy. The goal of radiation is to destroy cancer cells. It may be used if a melanoma returns after surgery or has spread to other parts of your body. It can sometimes relieve your symptoms. Radiation therapy uses high energy x-rays or other types of radiation.
• Chemotherapy. The goal of chemotherapy is to destroy cancer cells directly to shrink tumors that can’t be removed by surgery. It may be used to kill cells that have spread to other areas of your body (metastatic melanoma). It might be used for advanced melanoma after other treatments. Chemotherapy involves taking medications.
• Immunotherapy. Tumors turn off proteins called checkpoints on immune cells to protect themselves against your immune system. Immunotherapy overcomes those defenses, generally boosting your immune system response to the melanoma. Drugs called pembrolizumab (Keytruda) and nivolumab (Opdivo) can help treat melanomas that can’t be surgically removed or that have spread to other parts of your body. They can also lower your risk of a recurrence. Other possible immunotherapy drugs for melanomas have different mechanisms. 
• Targeted therapy. Medicines can target specific parts of melanoma cells. For example, medicines called BRAF inhibitors target cells with a change in the BRAF gene. This gene is found in about half of all melanomas. BRAF inhibitors include vemurafenib (Zelboraf) and dabrafenib (Tafinlar). 

Clinical trials for new treatments

Researchers are always finding new ways to treat cancer. New methods are tested in clinical trials. Talk with your doctor to find out if there are any clinical trials you should consider.

Talking with your doctor

At first, thinking about treatment options may seem overwhelming. Talk with your doctors, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your doctor before making a decision.

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