Dermatology Associates of the Bay Area

Melanoma

Melanoma Treatment Options by Stage

Stage 0 (Melanoma in Situ)

Treatment of stage 0 is usually surgery to remove the area of abnormal cells and a small amount of normal tissue around it.

Stage I Melanoma

Treatment of stage I melanoma may include the following:

  • Surgery to remove the tumor and some of the normal tissue around it. Sometimes lymph node mapping and removal of lymph nodes is also done.
  • A clinical trial of new ways to find cancer cells in the lymph nodes.

Stage II Melanoma

Treatment of stage II melanoma may include the following:

  • Surgery to remove the tumor and some of the normal tissue around it. Sometimes lymph node mapping and sentinel lymph node biopsy are done to check for cancer in the lymph nodes at the same time as the surgery to remove the tumor. If cancer is found in the sentinel lymph node, more lymph nodes may be removed.
  • Surgery followed by biologic therapy with interferon if there is a high risk that the cancer will come back.
  • A clinical trial of new types of treatment to be used after surgery.

Stage III Melanoma That Can Be Removed By Surgery

Treatment of stage III melanoma that can be removed by surgery may include the following:

  • Surgery to remove the tumor and some of the normal tissue around it. Skin grafting may be done to cover the wound caused by surgery. Sometimes lymph node mapping and sentinel lymph node biopsy are done to check for cancer in the lymph nodes at the same time as the surgery to remove the tumor. If cancer is found in the sentinel lymph node, more lymph nodes may be removed.
  • Surgery followed by biologic therapy with interferon if there is a high risk that the cancer will come back.
  • A clinical trial of new kinds of treatments to be used after surgery.
  • A clinical trial of injections into the tumor, such as oncolytic virus therapy.

Stage III Melanoma That Cannot Be Removed By Surgery, Stage IV Melanoma, and Recurrent Melanoma

Treatment of stage III melanoma that cannot be removed by surgery, stage IV melanoma, and recurrent melanoma may include the following:

  • Targeted therapy with vemurafenib or dabrafenib.
  • Biologic therapy with interleukin-2 (IL-2), ipilimumab, or pembrolizumab.
  • Chemotherapy.
  • Palliative therapy to relieve symptoms and improve the quality of life. This may include:
  • Surgery to remove lymph nodes or tumors in the lung, gastrointestinal (GI) tract, bone, or brain.
  • Radiation therapy to the brain, spinal cord, or bone.

Treatments that are being studied in clinical trials for stage III melanoma that cannot be removed by surgery, stage IV melanoma, and recurrent melanoma include the following:

  • Biologic therapy agents alone or in combination.
  • Targeted therapy with other signal transduction inhibitors.
  • Angiogenesis inhibitors.
  • Targeted therapy for melanoma with gene mutations.
  • Treatment with injections into the tumor, such as oncolytic virus therapy.
  • Surgery to remove all known cancer.
  • Regional chemotherapy (hyperthermic isolated limb perfusion). Some patients may also have biologic therapy with tumor necrosis factor.
  • Systemic chemotherapy.

Reference: National Cancer Institute

Last updated: February 12, 2016