Surgery is the most common treatment for all stages of melanoma. It’s often combined with other approaches, like chemotherapy or radiation therapy, to kill any remaining cancer cells.

Melanoma often has a positive outlook when treatment starts before the cancer spreads to distant body parts. Researchers continue to examine the potential benefit of treatments like immunotherapy and targeted therapy to help treat cancers that may not respond to surgery alone.

For cancers that aren’t considered curable, healthcare professionals often administer palliative treatments, such as radiation therapy or chemotherapy, to reduce symptoms and prolong life.

You can learn more about how melanoma looks here.

Here’s a look at the most common treatment options for melanoma.

Surgery

Surgery is the primary treatment for melanoma in all stages. Depending on the tumor and its location, surgery may be a minor intervention or a more complex procedure.

The standard surgical technique for melanoma is a wide local excision. This involves removing the tumor in addition to some surrounding tissue. You may need a skin graft to cover large wounds.

Your medical professional may use a technique called Mohs surgery if you have early stage melanoma on your face or other sensitive areas. This procedure involves removing a series of thin slices and checking each layer under a microscope for signs of cancer before taking another slice.

You may also need to have lymph nodes removed if there’s evidence your cancer has spread.

Extremely rarely, amputation may be needed if you have melanoma that’s grown deeply into a finger or toe.

Surgery to remove lymph nodes or tumors in other parts of your body may be administered as a palliative therapy for cancers that have metastasized and aren’t considered treatable.

Immunotherapy

Immunotherapy involves medications that help your immune system recognize and destroy cancer cells.

For some stage 2 and 3 melanomas, the immune checkpoint inhibitor pembrolizumab (Keytruda) is administered after surgery to reduce the chance of the cancer returning. The drug is typically administered every 2–6 weeks as an intravenous (IV) infusion.

Stage 3 melanoma may be treated with surgery followed by immunotherapy for melanoma with:

These medications, as well as interleukin-2 (Proleukin), are sometimes administered for stage 3 melanoma that can’t be removed with surgery, stage 4 melanoma, and recurrent melanoma.

Your medical professional might recommend an immunotherapy cream called imiquimod (Aldara or Zyclara) after surgery for early stage melanoma. It’s usually applied to the skin 2–5 times a week for about 3 months.

Chemotherapy

Chemotherapy may be administered after surgery to help destroy any cancer cells that might not have been removed. It’s typically used to treat advanced melanoma if the cancer has not responded to other treatments.

Chemotherapy is not generally the first treatment because newer immunotherapy and targeted therapy drugs tend to be more effective.

Chemotherapy might be administered alone for stage 3 melanoma that can’t be removed with surgery, stage 4 melanoma, or recurrent melanoma.

Chemotherapy is often administered through an IV if the cancer has spread to other body parts. This is called metastasis. Some medications, such as temozolomide (Temodar), can be taken orally.

Hyperthermic isolated limb perfusion can sometimes treat melanoma contained in an arm or leg. This technique involves administering the drugs directly to the limb and stopping the blood flow with a tourniquet.

Radiation therapy

Radiation therapy uses high energy X-rays or other types of radiation to kill cancer cells. Uses include:

  • early stage melanoma that can’t be removed with surgery
  • melanoma with a high risk of recurrence, even after surgery
  • melanoma that has returned after surgery or has spread to distant organs
  • melanoma that’s not considered curable but may respond to palliative care to lessen symptoms

Targeted therapy

Targeted therapy drugs target melanoma cells instead of broadly destroying rapidly dividing cells like chemotherapy does.

For stage 3 cancers with a high chance of returning, you may undergo surgery followed by treatment with a targeted therapy drug like dabrafenib (Tafinlar) or trametinib (Mekinist).

For stage 3 melanoma that can’t be removed with surgery, stage 4 melanoma, or recurrent melanoma, you may receive dabrafenib, trametinib, or:

  • vemurafenib (Zelboraf)
  • cobimetinib (Cotellic)
  • encorafenib (Braftovi)
  • binimetinib (Mektovi)

New treatments and clinical trials

Researchers are continuing to examine new treatments and combinations of treatment for melanoma.

One type of treatment under investigation for stage 3 melanoma is vaccine therapy. This treatment involves injecting a substance that stimulates your body to destroy cancer cells.

You can find current clinical trials from the National Cancer Institute here.

You can read more about melanoma staging here.

Different types of doctors may participate in melanoma treatment, including:

  • dermatologists who specialize in skin disease
  • surgeons who specialize in cancer (surgical oncologist)
  • medical oncologists who specialize in administering medications such as chemotherapy and immunotherapy
  • radiation oncologists who treat cancer with radiation

You may only need one treatment session if melanoma responds to surgery, although you’ll also have regular follow-ups.

Follow-ups are often scheduled every 3–12 months but may be more frequent if you have an aggressive or advanced type of melanoma cancer.

If you receive chemotherapy, each cycle may last a few weeks. The number of cycles of chemotherapy you need depends on how well melanoma responds to the treatment.

Melanoma is often curable if you receive a diagnosis during its early stages. This is when the cancer is localized and contained to your skin.

Healthcare professionals often consider cancer cured if you have no signs or symptoms for at least 5 years. This may vary from person to person, and it doesn’t include all melanoma cases. Most melanomas may recur within 5 years.

Experts often use the 5-year relative survival rate to report cancer survival statistics. This statistic reflects the chances a person will survive a cancer for at least 5 years from the time of diagnosis compared with a person without the cancer.

Here’s a look at the 5-year relative survival rates of melanoma by stage, according to the Surveillance, Epidemiology, and End Results (SEER) database:

SEER stage5-year relative survival rate
Localizedmore than 99%
Regional74%
Distant35%
All stages94%

Melanoma can reappear if it’s not entirely removed with surgery and other treatments. Most melanomas that return come back within the first 5 years. Melanoma isn’t likely to return if you’ve been melanoma-free for more than 10 years.

People who had melanoma once also have an elevated chance of developing a second melanoma in the exact or other location.

In a 2019 study using data from Australia, researchers found that 13.4% of people in a group of 700 with high risk melanoma saw the cancer return within 2 years.

Surgery most often treats all stages of melanoma. You may receive other treatments after surgery, such as radiation therapy or chemotherapy, to destroy remaining cancer cells. Immunotherapy and targeted therapy are commonly used in advanced melanoma stages.

Palliative treatment with radiation therapy or chemotherapy may be administered if your cancer has spread to distant areas and isn’t considered curable. You may also be offered clinical trials of newer treatments or new combinations.