Melanoma

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Treatments for metastatic melanoma skin cancer

The following are treatment options for metastatic melanoma skin cancer. Metastatic melanoma skin cancer means that the cancer has spread to or come back in other parts of the body farther from where it started. This includes stage 4 and distant recurrences. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Find out more about metastatic cancer.

Surgery

You may be offered surgery for metastatic melanoma skin cancer. Surgery is not used in most cases, but may be done when only one area or a few areas of cancer are found on the skin or just under it, in lymph nodes, or in the lung, liver, brain or small intestine. The type of surgery done will depend on where the cancer has spread.

Chemotherapy

Chemotherapy may be offered for metastatic melanoma skin cancer. Most often it is used as palliative therapy to control symptoms such as pain. Dacarbazine (DTIC) is the most common chemotherapy drug used. It is given through a needle into a vein (intravenously). How often and how long dacarbazine is given depends on factors such as the dose and if other treatments are used.

Radiation therapy

You may be offered radiation therapy for metastatic melanoma skin cancer. Most often it is used as palliative therapy to control symptoms from widespread metastases. External beam radiation therapy to the bone, brain, lung, liver or pelvis may be used.

A type of external beam radiation therapy, called stereotactic radiation therapy, may be used when there is only one small area of cancer in the brain. It delivers a high dose of radiation to a very specific area of the brain.

Radiation therapy can be given before or after other treatments. It is usually given once a day. How long it is used depends on the number and size of metastases, the type and dose of radiation therapy used, how severe symptoms are and other factors.

Immunotherapy

You may be offered immunotherapy for metastatic melanoma skin cancer. It is used to help shrink and control the growth of the melanoma skin cancer. The immunotherapy drugs used include:

  • ipilimumab (Yervoy)
  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)

These drugs are given through a needle into a vein by infusion. How often and how long immunotherapy is given depends on the type of drug used. Immunotherapy may be given along with chemotherapy.

Targeted therapy

Targeted therapy is usually offered for metastatic melanoma skin cancer in people who have certain gene changes (mutations), including mutations in the BRAF gene. Targeted therapy is used to help shrink and control the growth of the melanoma skin cancer.

The targeted therapy drugs used to treat metastatic melanoma skin cancer include:

  • vemurafenib (Zelboraf)
  • cobimetinib (Cotellic)
  • dabrafenib (Tafinlar)
  • trametinib (Mekinist)

Targeted therapy drugs are taken as a pill by mouth (orally) daily. They are usually given in combination. How long treatment is given depends on the type of drug used and how well the cancer responds to the treatment.

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.

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.

infusion

A procedure in which a fluid, other than blood, is introduced into the body through a vein.

For example, infusion can be used to give saline (salt) solution or deliver drugs.

When infusion is used over an extended period of time, it is called continuous infusion.

Also called intravenous infusion.

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