Medications

Medicines for melanoma include chemotherapy with a single medicine or several medicines. Medicines for treatment may include immunotherapy or even a combination of chemotherapy and immunotherapy.

Medication Choices

Medicine for melanoma that has metastasized may include:

• Chemotherapy with medicines such as dacarbazine or temozolomide.
• Immunotherapy with interferon or interleukin-2.

What To Think About

Chemotherapy used to treat melanoma may be given as an outpatient treatment, but sometimes people need a short hospital stay.

Medicines used for chemotherapy may be taken by mouth or injected into your bloodstream so they can travel throughout your body. If the melanoma is on an arm or leg, chemotherapy medicines may added to a warm solution that is injected into the bloodstream of that limb. The flow of blood to and from that limb is stopped for a short time so the medicine can go right to the tumor. This is called hyperthermic isolated limb perfusion.

Medicines being studied in clinical trials include combinations of chemotherapy, vaccines, and immunotherapies. Clinical trials are also looking at targeted therapy with the monoclonal antibody ipilimumab and a medicine called PLX4032.

Surgery

Surgery is the most common treatment for melanoma and is done to remove the primary melanoma. Sometimes lymph nodes may be removed at the same time to check them for cancer. Surgery also may be done to remove lymph nodes that have cancer or to remove tumors that may have spread to other parts of the body.

Surgery Choices

The most common types of surgery used to treat melanoma include:

• Local excision. This surgery takes out the melanoma and a little of the tissue around it.
• Wide local excision. This surgery removes more of the tissue around the melanoma. Lymph nodes may also be removed during this surgery.
• Lymph node dissection (lymphadenectomy). This is surgery to remove lymph nodes to see if they have cancer cells. Or this may be done to remove lymph nodes that are cancerous.
• Sentinel lymph node biopsy. This surgery removes the first lymph node that the cancer may have spread to from the tumor. If this lymph node does not have any cancer cells, then you may not need to have more lymph nodes removed.

What To Think About

After removal of a primary melanoma, you may need a skin graft or other reconstructive surgery for cosmetic reasons or to restore function. This is most likely if the melanoma was large or was a late-stage tumor.