Treatment

An individual treatment plan is developed for each patient, using the most advanced treatment approaches available.

Treatment has several stages. Your dermatologic oncologist will discuss your treatment plan with you, and determine the best course of treatment for the stage of your cancer.  You will probably need one of more of the following treatments:

• Staging
• Surgery, including removal of the lesion
• Plastic and reconstructive surgery
• Adjuvant melanoma treatments
• Infusion/ Perfusion
• Interferon
• Immunotherapy
• Radiation therapy
• Systemic treatment of advanced melanoma

Staging
Treatment begins with a biopsy.  Once the biopsy is found to be malignant, the lesion is assigned a stage.  Treatment plans are based on the stage.  Learn more about staging. 

Surgery:  Removal of the Lesion (Excision)
The lesion itself is removed, as are adequate margins (additional tissue around melanoma lesions).  This is done to prevent recurrence.  Surgical options include:

• Wide local excision, which removes the tumor and up to two centimeters of surrounding tissue.
• Sentinel lymph node biopsy, depending on the depth of the tumor.  This type of biopsy measures the closest lymph node to the lesion.  If the biopsy is positive, this tells your physicians that the cancer may have spread to nearby lymph nodes, changing the diagnosis and treatment plan.
• Elective lymph node dissection, removes both the tumor and the surrounding lymph nodes, if the sentinel lymph node biopsy is positive.
• Lymphoscintigraphy and sentinel lymph node dissection. These procedures help to identify whether the melanoma has spread to lymph nodes near the area of the tumor.  The nearest lymph nodes to the original lesion are biopsied and examined for potential spread. Additional lymph nodes may be removed.  Plastic and reconstructive surgery may also be performed at this time.

Plastic and Reconstructive Surgery
When lesions are located in cosmetically-sensitive areas, a plastic surgeon can repair the scars created by the original excision surgery.  Reconstructive surgery may also be needed if a large amount of tissue was removed along with the original lesion.

Adjuvant Melanoma Treatments
Adjuvant treatments refer to protocols of therapy to prevent the melanoma from coming back. In this setting, there is no obvious melanoma in your system.

Infusion/ Perfusion
Learn more about infusion/ perfusion.

Interferon
This is a synthetic version of a naturally occurring protein in your body that can fight cancer cells. It is considered in patients with melanoma at Stage IIB, IIC, IIIA, IIIB and IIIC.

Radiation Therapy
Radiation of the melanoma site is sometimes recommended to decrease the chances of the melanoma coming back. Learn more about Radiation Oncology.

Systemic Treatment of Advanced Melanoma

• Chemotherapy
  Melanoma is notoriously chemo-resistant. A minority of patients respond and are cured with traditional single and multi-drug chemotherapy regimens.

• Immunotherapy
  This class of therapy involves drugs that manipulate your immune system. Medications include interferon, interleukin-2 and others.

• Biochemotherapy
  This multi-drug approach combines traditional chemotherapy with immunotherapy.