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There are four approaches to treating melanoma skin cancer:

Surgery | Chemotherapy | Radiation | Immunotherapy

Surgery for Melanoma Skin Cancer

There are several types of surgery used to treat melanoma.

Simple excision
The tumour is cut out, along with a small amount of normal (non-cancerous) marginal skin around the edge of the tumour. The remaining skin is then stitched back together. Before the incision, a local anesthetic is injected into the area to numb it.

This procedure is done after melanoma is diagnosed from an excisional biopsy. The doctor cuts away more skin from the melanoma site and examines it to make sure that no cancer cells remain in the skin.

Sentinel node dissection (lymphadenectomy)
If a sentinel node biopsy shows that melanoma cells are present in the lymph nodes, the lymph nodes closest to the melanoma are surgically removed. If the lymph nodes feel very hard or large, or if a fine needle aspiration indicates melanoma cells, a dissection is also usually performed. After the lymph nodes are removed, they are examined under a microscope to see how many of them are cancerous. Be sure to discuss the potential risks and side effects of this procedure with your doctor.

Amputation may occasionally be necessary for melanomas found on a finger or toe. The affected digit or part of the digit may be amputated.

Surgery for Metastatic Melanoma
Once melanoma has spread from the skin to distant organs, the cancer is rarely curable by surgery. If it appears that the cancer has metastasized to just one other place in the body, the cancer is surgically removed and patients are sometimes cured successfully. However, even when imaging studies (CT or MRI scans) show just one or two metastases, there may be many others too small to be detected by these scans. Nevertheless, surgery is sometimes performed to help some patients live longer or to relieve symptoms and improve their quality of life.


Chemotherapy is the use of a combination of drugs to kill cancer cells. Systemic chemotherapy, where the drugs are administered by injection or pill, is used to fight cancer cells that have spread beyond the skin to the lymph nodes and other organs.

Chemotherapy is not usually used for melanomas. It is rarely as effective at treating melanoma as it is at treating other types of cancer. Surgery and immunotherapy are more common approaches. However, chemotherapy can sometimes relieve symptoms or extend a patient’s life.

Radiation Therapy

Radiation therapy is only used to treat melanoma if it has spread or reoccurred. Radiation therapy is not expected to cure the cancer; its main role is to relieve the symptoms of melanoma that has spread to the brain or bones. When a melanoma has entered the brain, it can cause partial paralysis, severe dizziness or other symptoms, which can be temporarily relieved by radiation therapy.


Immunotherapy aims to enhance a patient’s immune system, to recognize and destroy cancer cells more effectively.

There are several types of immunotherapy used to treat patients with advanced melanoma. These include:

  • Cytokine therapy
    Cytokines are proteins that help activate the immune system. Two cytokines, used to help boost immunity in patients with melanoma are interferon-alpha and interleukin-2. Both drugs can help shrink about 10 to 20 percent of metastatic (Stage III and IV) melanomas. This therapy may also help prevent the growth of melanoma cells in other organs.
  • Vaccine therapy
    Just as a flu vaccine stimulates our body to fight the flu, weakened melanoma cells or certain chemical substances found in melanoma cells can be injected into a patient in an attempt to stimulate the immune system, to selectively destroy melanoma cells. Clinical trials are in progress to test the value of treating patients with Stage III and Stage IV melanoma with vaccines.




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Melanoma Skin Cancer

  • A publication of:
  • Women's College Hospital