Melanoma

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Treatments for melanoma skin cancer

If you have melanoma skin cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for melanoma skin cancer, your healthcare team will consider:

  • the stage of the cancer – whether it is early stage, locoregional or metastatic
  • the risk that the cancer will come back (recur)
  • where the cancer is located
  • how treatments will affect how you look
  • your personal preferences (what you want)

You may be offered one or more of the following treatments for melanoma skin cancer.

Surgery

Surgery is the main treatment for most melanoma skin cancers. Depending on the stage and risk of the cancer coming back, you may have one or more of the following types of surgery.

Wide local excision removes the cancer along with some normal tissue around it (called the surgical margin). It is the first treatment for early stage, locoregional and locally recurrent melanoma skin cancers.

Sentinel lymph node biopsy (SLNB) finds and removes the first lymph node (or first few lymph nodes) in a group of lymph nodes to see if it contains cancer cells. It may be done for early stage melanoma skin cancers when the tumour is thick.

Complete lymph node dissection removes a group of lymph nodes from the body. It is done for locoregional or locally recurrent melanoma skin cancer that has spread to nearby lymph nodes.

Reconstructive surgery repairs the skin and nearby area after the tumour is removed. When a large area of skin has been removed to make sure the cancer is completely gone, the doctor rebuilds the area using a piece of skin from another part of the body, called a skin graft or skin flap.

Surgery for metastases may be done to remove metastatic melanoma skin cancer that has spread to only one area or a few areas on or just under the skin, or in the lung, liver, brain or small intestine.

Immunotherapy

Immunotherapy uses drugs to help the body’s immune system fight cancer cells. It is sometimes used after surgery to lower the risk of the cancer coming back, or shrink and control the growth of melanoma skin cancer when surgery can’t be done.

Radiation therapy

External beam radiation therapy uses a machine to direct a beam of radiation to the area of skin and a small amount of nearby tissue. It is sometimes used after surgery to lower the risk of the cancer coming back, or as palliative therapy to control symptoms from advanced melanoma skin cancer.

Chemotherapy

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It can be given throughout the body (called systemic chemotherapy) for metastatic melanoma skin cancer. It may be given directly into an arm or leg (called regional chemotherapy) for locally recurrent melanoma skin cancer that is only in one limb.

Targeted therapy

Targeted therapy uses drugs to target specific molecules (such as proteins) on or inside cancer cells to stop the growth and spread of cancer and limit harm to normal cells. It is usually used in people with metastatic melanoma skin cancer who have certain gene changes (mutations) in the BRAF gene.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Follow-up care

Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 5 years after treatment has finished. These visits allow your healthcare team to follow your progress and recovery from treatment.

Clinical trials

Some clinical trials in Canada are open to people with melanoma skin cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Questions to ask about treatment

To make the decisions that are right for you, ask your healthcare team questions about treatment.

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Making progress in the cancer fight

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