Understanding Treatment > Treatment Overview

Treatment Overview

There are several types of treatment for melanoma. Some are given in a healthcare setting through infusions. Others are taken orally. Which treatment your doctor chooses depends on several factors, including¹:

• The stage of your cancer
• Where the cancer is
• Your overall health
• Your prognosis (how your condition is most likely to change)

Traditional chemotherapy is no longer the most effective treatment for most cases of melanoma.² Now there are newer options that are more effective, like these:³

Targeted therapies

Targeted therapies are drugs that target cancer cells to prevent them from growing and spreading.¹

Targeted therapies can shrink tumors in people with Stage 3 or Stage 4 melanoma. They can also delay the time that the tumors start growing again.¹²

About half of all melanomas have changes (mutations) in the BRAF gene. The most common types of BRAF mutations are called BRAF V600E and V600K. Melanoma cells with these changes make an altered BRAF protein that helps them grow. Some drugs target this and related proteins, such as the MEK proteins.

Drugs that target the BRAF protein (BRAF inhibitors) or the MEK proteins (MEK inhibitors) aren’t likely to work on melanomas that have a normal BRAF gene.

Most often, if a person has a BRAF mutation and needs targeted therapy, they will get both a BRAF inhibitor and a MEK inhibitor, as combining these drugs often works better than either one alone.²¹ This is called targeted combination therapy.¹³ 

Immunotherapy

The immune system detects and destroys abnormal cells as part of its normal function. Cancer cells have a way of avoiding this destruction.⁴ That’s where immunotherapy comes in. Immunotherapy uses the body’s immune system to recognize and destroy cancer cells.⁴ The drugs are usually given as an intravenous infusion (injection of medication into a vein). They can be used to treat patients with melanoma that can’t be removed by surgery or that has spread to other parts of the body (Stage 4).⁴ Immunotherapy drugs can also be used after surgery to treat melanoma that has reached the lymph nodes (Stage 3). The goal is to reduce the chance of the cancer coming back.⁴

Your healthcare team may recommend immunotherapy as a single treatment. Or it may be given in combination with other types of treatment.⁵

Radiation therapy

External beam radiation therapy is sometimes used for treating melanoma.⁶ It is a local treatment, meaning the radiation only affects the area where the cancer is located.⁷ External beam radiation therapy uses a machine to aim radiation at the cancer.⁸ Radiation may be recommended after surgery to reduce the chance that the cancer will come back.⁶ It can also be used to treat melanoma that has spread to the skin or lymph nodes.⁹ Radiation may help relieve symptoms caused by the spread of melanoma.¹⁰ The goal is to deliver the highest prescribed dose of radiation to the tumor while not affecting the normal tissue around it.⁷

Some people may receive radiation in combination with immunotherapy or other therapies.⁶

The type of treatment that’s appropriate for you also depends on the treatment goals for the stage of your melanoma.¹¹

Adjuvant treatment (for treatment after surgery)

The goal of surgery to treat melanoma is to remove as many melanoma cells as possible. But even after surgery, you may still have some melanoma cells left in your body.¹⁵

Medicine after surgery targets the melanoma cells that the surgery did not remove. This is called adjuvant treatment (or adjuvant treatment).¹⁶ Adjuvant treatment is often recommended for Stage 3 melanoma.¹⁵

Melanoma has a high cure rate when diagnosed and treated at an early stage. But people with more advanced melanoma have a lower chance of survival and a higher risk of the cancer coming back.^17,18

The goal of adjuvant treatment is to reduce the chance that the cancer will recur (come back) and help you stay cancer free longer.¹⁴

Metastatic Melanoma Treatment (for Stage 4 melanoma)

The goals of treatment for metastatic melanoma are to^19,20:

• Help you live longer
• Keep your cancer from spreading
• Slow the growth of cancer cells, or totally stop cancer cells from growing

Treatment for metastatic melanoma may also reduce your cancer symptoms.²¹

Following your treatment plan correctly can give you the best chance of feeling better and living well longer with metastatic melanoma.

What treatment makes the most sense for me?

Knowing your specific type of melanoma can help your doctor determine the best treatment plan.²² If you haven't received biomarker testing, like BRAF testing, bring this topic up at your next appointment. Biomarker testing can help your doctor tailor treatment to your specific type of melanoma.

Biomarkers can also help predict how a cancer may respond to treatment, determine how well treatment is working, and signal that cancer is returning.^22,23

Talk with your healthcare team

Your healthcare team may include a dermatologist, a radiation oncologist, a medical oncologist, and a surgeon.²⁴ All of them work with one another—and with you—to help you get the best results you can. Talk with them about your treatment goals, what you may expect, and any questions you have. And remember that sticking to your treatment plan can give you the best chance of staying cancer free.

Where to next? Learn about monitoring treatment >