If you are diagnosed with melanoma, you
should begin treatment soon after diagnosis. This cancer is very
curable when caught early and treated. Waiting gives the cancer a
chance to grow deep or spread. Treatment then becomes more
difficult, and the cure rate drops.
The following describes treatment that may be recommended. Your
doctor carefully considers many factors before recommending
treatment. Sometimes more than one treatment is recommended.
Be sure to ask your doctor to explain your personal risks and
benefits for the treatment that is recommended.
Surgical Excision: This is the most common treatment. It is
used to treat patients who have early melanoma. It is used to treat
patients who have advanced melanoma. Surgical excision is similar to
the biopsy. During surgical excision, though, the doctor removes a
wider and deeper amount of skin.
When a patient has an early melanoma, the dermatologist can perform
surgical excision during an office visit. To perform this surgery,
the dermatologist will:
Numb the area
Cut out any remaining melanoma not
removed during the biopsy
Remove surrounding normal-looking
Close the area with stitches
Send the removed skin to a lab
At the lab, the skin will be examined
under a microscope for cancer cells. Your dermatologist will receive
a report from the lab. It will tell your dermatologist whether a
portion of the normal-looking skin is free of cancer cells. This is
the goal for this type of treatment.
Sentinel Lymph Node Biopsy (SLNB): This is not a treatment.
It is a type of surgery used to find out whether the melanoma has
spread to a patient’s lymph nodes (what many people call lymph
Here are key facts about a SLNB:
Usually recommended when melanoma
at least 1 millimeter deep. At this depth, there is a greater
risk that the melanoma cells have spread to the lymph nodes
closest to the melanoma.
When melanoma spreads, it often
first travels to the lymph nodes closest to the melanoma. The
first node to get melanoma cells is called the “sentinel lymph
To find the sentinel lymph node,
the surgeon injects a blue dye or radioactive material.
About 30 minutes after injecting
the dye, or other material, the surgeon sees where the sentinel
The surgeon makes a small incision
and removes the sentinel lymph node.
Like the original biopsy, the node
is sent to a lab.
The node will be examined under a
microscope for cancer cells.
If the lymph node contains cancer
cells, the patient has stage III melanoma. Treatment becomes more
complex, but it can sometimes still cure the disease.
Lymph Node Dissection: This surgery is often recommended
During this surgery, the surgeon
removes the lymph nodes that lie closest to the melanoma on the
“Adjuvant” means supplemental. When there is a risk that the
melanoma has spread, adjuvant therapy is often recommended. It is
called adjuvant because it is given after the first treatment.
Adjuvant therapy helps kill melanoma cells.
Patients are typically referred to a medical oncologist to discuss
adjuvant therapy. An oncologist is a doctor who specializes in
cancer. The oncologist may recommend one or more of the following
types of adjuvant therapy:
Immunotherapy: This treatment strengthens the patient’s
immune system so that the patient’s body can better fight the
cancer. Interferon, melanoma vaccines, and biologic medicines are
types of immunotherapy given to treat melanoma.
Clinical trial: The purpose of a clinical trial is to
evaluate a medicine or other treatment. A doctor may recommend a
clinical trial when the medicine or other treatment could help a
Chemotherapy: This treatment
works by either killing cells or preventing cells from dividing.
When receiving chemotherapy for melanoma, the patient may take an
anti-cancer medicine or a combination of medicines. To receive
chemotherapy, a patient may take pills or receive infusions. Both
methods send the medicine throughout the body. Chemotherapy kills
cancer cells. It also kills some healthy cells, which may cause side
Radiation therapy: Radiation therapy uses x-rays to kill
cancer cells. It is not as effective for melanoma as it is for some
types of cancer. For select patients with melanoma, radiation
therapy may be recommended. Radiation kills the cancer cells. It
also kills some healthy cells. The goal is to kill as few healthy
cells as possible.
This care can relieve symptoms and improve a patient’s quality of
life. It does not cure the cancer. Many patients receive palliative
care, not just patients with late-stage cancer.
When melanoma spreads, palliative care can help control the pain and
other symptoms. Radiation therapy is a type of palliative care for
stage IV (spread beyond the lymph nodes) melanoma. It can ease pain
and other symptoms.
Melanoma can return. If you have had melanoma, you have a higher
risk for developing another melanoma. This makes follow-up
appointments with your dermatologist or oncologist essential. During
these appointments, your doctor will look for signs of melanoma. The
cure rate for new melanoma is very high. Be sure to keep every
Melanoma: How it Returns, Where it Spreads
Halpern AC, Johnson TM et al. “Guidelines of Care for the
Management of Primary Cutaneous Melanoma,” American Academy of
Dermatology, published spring 2011.
content solely developed by the American Academy of Dermatology
Melanoma can run in
families. If you have been diagnosed with melanoma, your
close blood relatives (parents, sisters, brothers, and
children) should have a skin cancer screening.
Free skin cancer screenings