If you receive a diagnosis of stage 4 melanoma, it means the cancer has spread from your skin to other parts of your body.
It can be stressful to learn that cancer has advanced. Keep in mind that treatment is available. Advancements in research mean there are more options than ever before for treating stage 4 melanoma.
Your doctor can help you learn which treatment options may provide the best outcomes for you. Read on to learn more about managing this condition.
Melanoma is a type of skin cancer that develops in the pigment cells of skin. It often starts out as a dark spot or mole.
In stage 4 melanoma, the cancer has spread from skin to other organs, such as the liver, lungs, brain, or gastrointestinal tract. It may also mean that the cancer has spread from the spot where it started to distant parts of your skin.
Stage 4 melanoma is harder to treat than less advanced stages of the cancer. However, treatment may still help improve your quality of life, your chances of survival, or both.
Treatment options for melanoma include:
- targeted therapy
Your doctor’s recommended treatment plan will depend on several factors, such as your overall health and where the cancer has spread in your body.
Immunotherapy involves the use of medications to stimulate your immune system. This may help it attack cancer cells.
Several types of immunotherapy are used to treat stage 4 melanoma, including:
- Checkpoint inhibitors. These medications include the PD-1 blockers nivolumab (Opdivo) and pembrolizumab (Keytruda) and the CTL4-blocker ipilimumab (Yervoy). These drugs may help T cells in your immune system recognize and kill melanoma cancer cells.
- Oncolytic virus therapy. In this treatment, a modified virus known as talimogene laherparepvec (T-VEC, Imylgic) is injected into melanoma tumors. This virus kills cancer cells and may trigger your immune system to attack cancer cells as well.
- Cytokine therapy. Cytokines are a type of protein that help immune cells communicate with each other. Treatment with the cytokine interleukin-2 (aldesleukin, Proleukin) may boost your immune system’s response against cancer.
Your doctor might prescribe one type of immunotherapy or a combination of immunotherapy drugs. For example, they might prescribe Yervoy and Opdivo together.
Immunotherapy has helped improve survival rates for people with stage 4 melanoma. However, this treatment can cause potentially serious side effects.
If you think you might be experiencing side effects, contact your doctor right away.
Targeted therapy medications affect specific molecules within cancer cells. They stop those molecules from working. In doing so, they may help stop cancer from spreading or growing.
BRAF inhibitors and MEK inhibitors are two types of targeted therapy medications used to treat melanoma. Your doctor might prescribe one type or a combination of both.
BRAF inhibitors include:
- vemurafenib (Zelboraf)
- dabrafenib (Tafinlar)
- encorafenib (Braftovi)
MEK inhibitors include:
- trametinib (Mekinist)
- cobimetinib (Cotellic)
- binimetinib (Mektovi)
Your doctor may recommend surgery to remove melanoma cancer cells from your skin or enlarged lymph nodes that are causing symptoms.
If melanoma tumors have spread to other organs in your body, your doctor may also recommend surgery to remove cancer from those organs.
Sometimes it’s not safe or possible to remove melanoma cancer with surgery.
Radiation isn’t typically used to treat early stages of melanoma.
But if you have stage 4 melanoma, your doctor might recommend radiation therapy to treat tumors that have spread to other organs.
In some cases, your doctor may recommend radiation therapy before surgery. This may help shrink melanoma tumors and make them easier to remove.
In other cases, your doctor may recommend radiation therapy after surgery. This may help kill any cancer cells that remain.
If surgery isn’t an option, your doctor may still recommend radiation to help relieve symptoms.
Chemotherapy drugs attack quickly dividing cells in your body, including cancer cells.
Chemotherapy isn’t the first-line treatment for stage 4 melanoma. That means that in most cases, your doctors will encourage you to try other treatments instead.
Palliative therapy aims to improve quality of life in people with serious medical conditions. It may involve the use of medications, counseling, or other treatments.
Although many people associate palliative therapy with end-of-life care, it’s also used to treat people who have a chance of surviving cancer. Your doctor might recommend palliative therapy at any point in your treatment process.
For example, they may prescribe palliative medications to help manage symptoms of melanoma or side effects of other treatments, such as pain, insomnia, or loss of appetite.
They may also refer you to a psychologist, social worker, or other sources of support for coping with the emotional, social, or financial challenges of stage 4 melanoma.
Researchers are continually looking into new treatment options for stage 4 melanoma. They’re also working to improve existing treatment options.
If your doctor thinks you might benefit from trying an experimental treatment for melanoma, they may talk to you about joining a clinical trial.
Stage 4 melanoma is harder to treat than earlier stages of melanoma, but you still have options.
Newer advancements in treatment, such as immunotherapy and targeted therapy, may improve your chances of survival. Treatment may also help relieve symptoms and improve your quality of life with melanoma.
It’s important to discuss your treatment options with your doctor, including the potential benefits and risks of different treatments. Your doctor can help you make an informed decision about how you want to treat your condition.