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Treatments and drugs
By Mayo Clinic staffThe best treatment for you depends on your stage of cancer and your age, overall health and personal preferences.
Ask your doctor and other members of your melanoma treatment team any questions you have so that you can fully understand the different treatments and the potential risks and side effects of each treatment. Consider seeking a second opinion, especially from a doctor who specializes in treating melanoma. In some cases, after weighing your options you may choose not to treat the melanoma itself but rather to try to relieve any symptoms the cancer may cause.
Treating early-stage melanomas
The best treatment for early-stage melanomas is surgical removal (simple excision). Very thin melanomas may have been entirely removed during the biopsy and require no further treatment. Otherwise, your surgeon will excise the cancer as well as a small border of normal skin and a layer of tissue beneath the skin. In almost every case this eliminates the cancer.
At one time, surgery for more invasive early-stage tumors involved cutting out the cancer along with a large border of normal skin (wide local excision). This usually meant having a skin graft — a procedure in which skin from another part of the body is used to replace the skin that's removed. But taking smaller amounts of normal skin in some cases of invasive melanomas may be just as effective in treating cancer and may eliminate the need for skin grafts.
Treating melanomas that have spread beyond the skin
If melanoma has spread beyond the skin, treatment options may include:
- Surgical removal. It's very difficult to cure melanomas that have spread beyond the skin. But surgically removing a melanoma that has spread (metastatic melanoma) can often provide relief of symptoms — sometimes for years. Whether this is an option for you will depend on where the cancer is located and how severe it is, as well as on your own wishes and overall health.
- Chemotherapy. This form of treatment uses drugs to destroy cancer cells. Two or more drugs are often given in combination and may be administered intravenously, in pill form or both — usually for four to six months. Melanoma has long been thought to be resistant to most forms of chemotherapy, but new chemotherapy regimens are being studied and developed. In the meantime, chemotherapy is sometimes used to relieve symptoms in people with advanced metastatic melanoma.
- Radiation therapy. This treatment uses high-energy X-rays to kill cancer cells. It's sometimes used to help relieve symptoms of melanoma that has spread to another organ. Fatigue is a common side effect of radiation therapy, but your energy usually returns once the treatment is completed.
- Biological therapy (immunotherapy). Biological therapy boosts your immune system to help your body fight cancer. These treatments are made of substances produced by the body or similar substances produced in a laboratory. Biological therapies used to treat melanoma include interferon and interleukin-2. Side effects of these treatments are similar to those of the flu, including chills, fatigue, fever, headache and muscle aches.
Clinical trials
Clinical trials are studies of new therapies that aren't yet approved for treatment of melanoma. Doctors use clinical trails to determine whether a treatment is safe and effective. People who enroll in clinical trials have a chance to try evolving therapies, but a cure isn't guaranteed. And sometimes the potential side effects aren't known.
Some melanoma treatments being studied in clinical trials include:
- Chemoimmunotherapy. Combining chemotherapy and biological therapy drugs may increase the success of both of these treatments. However, combining treatments can make severe side effects more likely.
- Gene therapy. Researchers hope replacing faulty genes that allow cancer cells to proliferate might cause the cancer cells to die. Another approach to gene therapy involves placing genes into cancer cells to make them sensitive to normally harmless drugs. That way only the cancer cells would die when the drug is released into the body.
- Targeted therapy. Targeted therapies interrupt a specific process in cancer cells in order to control cancer. For instance, the process by which cancers develop blood vessels to draw nutrients from your body could be stopped so that tumors remain small and localized. In another approach, specific chemicals that stimulate cancer cells to grow rapidly could be inactivated.
- Vaccine treatment. Vaccines for treating cancer are different from vaccines used to prevent diseases. Vaccine treatment for melanoma might involve injecting altered cancer cells into the body in order to draw the attention of the immune system.
