Melanoma Treatment Options and What to Expect
Melanoma is a form of skin cancer that develops from pigment-producing cells called melanocytes. Treatment depends on the stage at diagnosis, the location of the tumor, and specific tumor features such as genetic mutations. Early melanoma is often curable with surgery; more advanced cases may need systemic therapies, targeted drugs, or radiation. Decisions are typically made by a multidisciplinary team that includes dermatologists, surgical oncologists, medical oncologists, and radiation specialists. This article summarizes common treatments, how they work, and what patients can expect during diagnosis, surgery, and follow-up care.
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.
How is melanoma treated?
Early-stage melanoma is most commonly treated with surgical excision. A dermatologist or surgical oncologist removes the mole or tumor with a margin of normal-looking skin; the width of the margin is based on tumor thickness. For some intermediate or thicker lesions, a sentinel lymph node biopsy may be performed at the same time to check for microscopic spread. If lymph nodes contain cancer, additional surgery or systemic treatment may be recommended. Surgical treatment aims for complete removal with clear margins to reduce the risk of local recurrence.
Treatments for skin involvement
When melanoma affects or is close to critical skin structures, surgeons may coordinate reconstructive approaches to preserve function and appearance. Options include local flap closure, skin grafts, or staged reconstruction, depending on defect size and location. Dermatologic techniques like Mohs surgery are not routinely used for melanoma but may be considered in selected superficial or lentigo maligna cases by experienced teams. Postoperative wound care and regular skin checks are essential because patients remain at higher lifetime risk for new melanomas or other skin cancers.
Systemic therapies for advanced cancer
Advanced or metastatic melanoma is often managed with systemic therapies. Immunotherapy with immune checkpoint inhibitors (for example, PD-1 inhibitors) can boost the immune response against tumor cells. Targeted therapies are available for tumors with specific genetic changes, such as BRAF V600 mutations; these drugs aim at molecular pathways that drive cancer growth. Radiation therapy may be used for palliative control of symptoms or for certain brain metastases. Chemotherapy is less commonly used now but can be an option in specific situations or after other treatments.
When is a mole removed or biopsied?
Any new, changing, or suspicious mole should be evaluated by a clinician. Common guidelines use the ABCDEs: Asymmetry, Border irregularity, Color variation, Diameter over 6 mm, and Evolving lesions. If a mole looks suspicious on clinical exam or dermoscopy, a biopsy—typically an excisional biopsy with narrow margins—is performed to establish diagnosis and measure tumor thickness (Breslow depth). Biopsy results guide staging and treatment planning. Even benign-appearing moles that change after a sunburn or trauma warrant medical review to rule out early melanoma.
Can sunburn affect treatment or risk?
Severe or repeated sunburns, especially in childhood, increase the long-term risk of melanoma by causing DNA damage in skin cells. A history of sunburn does not directly change a specific melanoma treatment plan, but it contributes to overall risk profile and prompts more intensive surveillance. Patients recovering from melanoma should be counseled on sun protection: regular use of broad-spectrum sunscreen, protective clothing, and avoiding peak UV hours. Preventive steps reduce the chance of new skin cancers and support long-term skin health during and after treatment.
Conclusion
Melanoma treatment varies from straightforward surgical excision for early disease to combinations of surgery, immunotherapy, targeted therapy, and radiation for advanced stages. Treatment choice depends on tumor depth, stage, molecular features, and patient health. Long-term follow-up includes skin checks, education on sun safety, and monitoring for recurrence or new lesions. Accurate staging and care by a specialized team improve the chances of effective management and better outcomes.
