11 FAQs About Melanoma Treatment


Denise Mann, MS

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Mohs surgery

Melanoma, the potentially fatal form of skin cancer, is on the rise. And rates have been rising for more than 30 years, according to the American Cancer Society. But the good news is there have been a slew of new treatments approved in recent years that can help people with advanced melanoma live longer and better lives.

Learn more about treatment options with these 11 frequently asked questions.

1. Is melanoma curable?

Yes. When found early and treated, the cure rate for melanoma is nearly 100%.

2. How do you catch melanoma early?

Perform monthly skin self-exams and know what to look out for–asymmetrical moles with irregular borders, many colors and diameters of ¼ inch or greater. Check your scalp, feet, nails, and genital area as well. See your dermatologist yearly for a skin check, and always let him or her know if you spot any suspicious moles. It’s always better to be safe than sorry.

3. What are the current treatment options for melanoma?

Surgery to remove the melanoma is typically the first step. This can be followed by additional treatments based on the cancer’s stage. Other treatments include chemotherapy, which kills all fast-growing cells in the body as a means to remove all traces of the cancer and/or radiation, which use energy rays to kill cancer. Immunotherapy is a newer melanoma treatment that stimulates your immune system to recognize and destroy cancer cells.

Targeted therapies are also new. These are essentially heat-seeking missiles designed to disable very specific genetic mutations in some melanomas.

4. How will my doctor decide on my melanoma treatment?

Your doctor will make melanoma treatment decisions based on the stage of the skin cancer, which includes how deeply it has grown into your skin, whether or not it has started to spread to other parts of the body, as well as your overall health. Treating early-stage melanomas may involve surgery alone, while more advanced melanomas often require other treatments, such as chemotherapy, radiation, immunotherapy or targeted therapy.

5. What is Mohs surgery?

Mohs micrographic surgery is a specific form of skin cancer surgery. During Mohs surgery, your surgeon first removes the visible melanoma. Then he or she goes back to remove more layers of skin, one by one. Each layer is examined under the microscope to make sure that there are clear margins (no cancer cells left). This type of surgery has a high cure rate.

6. What is targeted therapy?

Targeted therapies are among the newest and most exciting developments in melanoma treatment. These drugs target genetic mutations that play a role in certain melanoma’s spread. They only work in individuals who have the specific mutation. For example, about half of all melanomas have changes in the BRAF gene. The following drugs are U.S. Food and Drug Administration (FDA) approved to treat melanoma driven by BRAF mutations:

  • Vemurafenib (Zelboraf®)
  • Dabrafenib (Tafinlar®)
  • Trametinib (Mekinist®)
  • Cobimetinib (Cotellic®)

MEK inhibitors, such as Trametinib, blocks the BRAF pathway at a different step. BRAF inhibitors are taken as pills.

7. What is immunotherapy?

Immunotherapy is another recently developed melanoma treatment. Immunotherapy agents help your immune system recognize and fight cancer. They include Ipilimumab (Yervoy®), given by IV, and Pegylated interferon, which is an injection. The FDA also approved the immunotherapy agents nivolumab (Opdivo®) and pembrolizumab (Keytruda®) for individuals who have tried the drug ipilimumab and have a BRAF gene mutation. Both of these drugs are given as infusions.

8. Can targeted therapies be used together?

Yes, sometimes they can. For example, BRAF inhibitors and MEK inhibitors are used in combination to provide more effective, longer-lasting treatment for advanced melanoma. These drugs are not used at the same time as immunotherapy agents.

9. Are immunotherapy and targeted therapy cures for advanced melanoma?

People with advanced melanoma are living longer because of these treatments, but they do tend to stop working in time. When this happens, melanoma can progress. Clinical researchers have shown that alternating various biologic drugs can induce remission.

10. What side effects are associated with melanoma therapies?

Common side effects of melanoma treatment may include pain, scarring, infection, fatigue, nausea/vomiting, diarrhea, and/or constipation. Each therapy has its own list of potential side effects. For example, BRAF inhibitors may cause fatigue, hair loss, rash, itching, sensitivity to the sun, nausea, and vomiting. Some people treated with these drugs develop new skin cancers. Ask your doctor about the specific risks associated with your chosen treatment.

11. What’s next in melanoma treatment?

The melanoma treatment pipeline is robust, and scientists are currently working many angles including developing a vaccine to treat melanoma. There are also clinical trials underway assessing other types of immunotherapy treatments. Stay tuned.

Patient speaking with doctors

Treatments for Advanced Melanoma

When melanoma reaches an advanced stage and begins to spread, getting the right treatment becomes very important.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: May 11, 2017

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Medical References

  1. Melanoma Key Statistics. American Cancer Society. https://www.cancer.org/cancer/melanoma-skin-cancer/about/key-statistics.html
  2. Treatment of Melanoma Skin Cancer, by Stage. American Cancer Society. https://www.cancer.org/cancer/melanoma-skin-cancer/treating/by-stage.html
  3. Treating Melanoma Skin Cancer. American Cancer Society. https://www.cancer.org/cancer/melanoma-skin-cancer/treating.html
  4. Moh’s Surgery. Mayo Clinic. http://www.mayoclinic.org/tests-procedures/mohs-surgery/basics/definition/PRC-20014261
  5. ABCDES of Melanoma. Melanoma Research Foundation. https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/detection-screening/abcdes-melanoma
  6. Melanoma. American Academy of Dermatology (AAD). https://www.aad.org/public/diseases/skin-cancer/melanoma

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