There are various treatment choices for melanoma. Which one may work best for you? It depends on a number of factors. These include the size, location, and stage of your melanoma. Factors also include your age, overall health, and what side effects you’ll find acceptable.
Learning about your treatment options
You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.
The doctor is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your doctor may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. 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 the 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.
Radiation therapy. The goal of radiation is to destroy cancer cells. It may be used after surgery to try to kill any cancer cells that are left. It may also be used to help treat melanoma that has come back after initial treatment or has spread to other parts of the body. 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. Or, it may be used to kill cells that have spread to other areas of the body (metastatic melanoma). Chemotherapy is done with medications.
Biological therapy. The goal of biological therapy is to shrink advanced melanoma tumors. This type of therapy is done with medicines. The medicines use chemicals that affect the immune system. It is also called immunotherapy, antibody therapy, or vaccine therapy. The medicine uses your body’s immune defense to attack the cancer cells. Common medicines for this include interferon and interleukin-2. These may also be given along with chemotherapy for stage IV melanomas. Medicines called immune checkpoint inhibitors can also boost the body's immune response. These include pembrolizumab and ipilimumab.
Targeted therapy. The goal of targeted therapy is to shrink advanced melanoma tumors. This type of therapy is done with medicines. The medicines 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 and dabrafenib.
Clinical trials for new treatments
Researchers are always finding new ways to treat cancer. These 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.
March 30, 2020
Alteri, Rick, MD, Foster, Sara, RN, MPH