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Treatments and drugs

By Mayo Clinic staff

Living With Cancer

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The best treatment for you depends on your stage of cancer and your age, overall health and personal preferences.

Treating early-stage melanomas
Treatment for early-stage melanomas usually includes surgery to remove the melanoma. A very thin melanoma may be removed entirely during the biopsy and require no further treatment. Otherwise, your surgeon will remove the cancer as well as a small border of normal skin and a layer of tissue beneath the skin. For people with early-stage melanomas, this may be the only treatment needed.

Treating melanomas that have spread beyond the skin
If melanoma has spread beyond the skin, treatment options may include:

  • Surgery to remove affected lymph nodes. If melanoma has spread to nearby lymph nodes, your surgeon may remove the affected nodes. Additional treatments before or after surgery may also be recommended.
  • Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can be given intravenously, in pill form or both so that it travels throughout your body. Or chemotherapy can be given in a vein in your arm or leg in a procedure called isolated limb perfusion. During this procedure, blood in your arm or leg isn't allowed to travel to other areas of your body for a short time so that the chemotherapy drugs travel directly to the area around the melanoma and don't affect other parts of your body.
  • Radiation therapy. This treatment uses high-powered energy beams, such as X-rays, to kill cancer cells. It's sometimes used to help relieve symptoms of melanoma that has spread to another organ. Fatigue is a common side effect of radiation therapy, but your energy usually returns once the treatment is complete.
  • Biological therapy. Biological therapy boosts your immune system to help your body fight cancer. These treatments are made of substances produced by the body or similar substances produced in a laboratory. Biological therapies used to treat melanoma include interferon and interleukin-2. Side effects of these treatments are similar to those of the flu, including chills, fatigue, fever, headache and muscle aches. Ipilimumab (Yervoy) is another drug that uses your immune system to fight melanoma. Ipilimumab is used to treat advanced melanoma that has spread beyond its original location.
  • Targeted therapy. Targeted therapy uses medications designed to target specific vulnerabilities in cancer cells. Vemurafenib (Zelboraf) is a targeted therapy approved to treat advanced melanoma that can't be treated with surgery or melanoma that has spread through the body. Vemurafenib only treats melanoma that has a certain genetic mutation. Cells from your melanoma can be tested to see whether this treatment may be an option for you.

Experimental melanoma treatments
Clinical trials are studies of new treatments for melanoma. Doctors use clinical trials to determine whether a treatment is safe and effective. People who enroll in clinical trials have a chance to try evolving therapies, but a cure isn't guaranteed. And sometimes the potential side effects aren't known.

Some melanoma treatments being studied in clinical trials include:

  • New combinations of treatments. Researchers are testing whether combining treatments may increase the effectiveness of melanoma treatment. For instance, different combinations of chemotherapy, biological therapy, targeted therapy and radiation have been proposed. However, combining treatments can make severe side effects more likely.
  • New targeted therapies. Researchers are testing new targeted medications in people with advanced melanoma. For instance, targeted drugs designed to stop melanoma from attracting blood vessels have shown some success. Blood vessels carry nutrients to the melanoma, and blood vessels help spread cancer cells throughout the body. A drug that stops this process could cause a melanoma to remain small and localized.
  • Vaccine treatment. Vaccines for treating cancer are different from vaccines used to prevent diseases. Vaccine treatment for melanoma might involve injecting altered cancer cells into the body to draw the attention of the immune system.
Prevention Tests and diagnosis
References
  1. What you need to know about melanoma and other skin cancers. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/skin. Accessed May 10, 2012.
  2. Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-4/0/1709/0.html. Accessed May 10, 2012.
  3. Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed May 7, 2012.
  4. Sureda N, et al. Conservative surgical management of subungual (matrix derived) melanoma: Report of seven cases and literature review. British Journal of Dermatology. 2011;165:852.
  5. Seetharamu N, et al. Mucosal melanomas: A case-based review of the literature. The Oncologist. 2010;15:772.
  6. Intraocular (eye) melanoma treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/intraocularmelanoma/patient/. Accessed May 15, 2012.
  7. Smith RA, et al. Cancer screening in the United States, 2012: A review of current American Cancer Society guidelines and current issues in cancer screening. CA A Cancer Journal for Clinicians. 2012;62:129.
  8. Skin examinations. SkinCancerNet. http://www.skincarephysicians.com/skincancernet/skin_examinations.html. Accessed May 10, 2012.
  9. Preventive services for adults. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/guidelines_and_more/gl_os_prot/preventive_health_maintenance/preventive_services_for_adults/preventive_services_for_adults__11.html. Accessed May 15, 2012.
  10. Zelboraf (prescribing information). South San Francisco, Calif.: Genentech Inc.; 2011. http://www.zelboraf.com/dermatology/index.html. Accessed May 11, 2012.
  11. U.S. Preventive Services Task Force. Screening for skin cancer: U.S. Preventive Services Task Force Recommendation statement. Annals of Internal Medicine. 2009;150:188.
  12. Melanoma. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 10, 2012.
  13. Melanoma treatment. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/healthprofessional/. Accessed May 10, 2012.
  14. Finn L, et al. Therapy for metastatic melanoma: The past, present and future. BMC Medicine. 2012;10:23.
  15. Reed KB, et al. Increasing incidence of melanoma among young adults: An epidemiological study in Olmsted County, Minnesota. Mayo Clinic Proceedings. 2012;87:328.
  16. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. May 17, 2012.
DS00439 June 12, 2012

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