Melanoma Treatment: Options, Care, and Follow-up

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.

What is melanoma and how is it diagnosed?

Diagnosis begins with a clinical exam and assessment of any suspicious mole or pigmented lesion. Dermatologists use the ABCDE criteria (Asymmetry, Border, Color, Diameter, Evolving) to screen for concerning features, and dermoscopy can improve visual assessment. A biopsy — excisional when possible — is required to confirm melanoma and determine depth (Breslow thickness) and other histologic features that guide staging and treatment decisions. Imaging or sentinel lymph node evaluation may be recommended for more advanced tumors.

Surgical pathology from the biopsy provides critical information: tumor thickness, ulceration, and mitotic rate. These pathological details help determine whether additional surgery, such as a wider local excision or lymph node assessment, is necessary. Accurate diagnosis and staging establish the appropriate treatment pathway and follow-up intensity.

Surgical treatment for melanoma on the skin

Surgery is the mainstay of treatment for most localized melanoma. The primary tumor is typically removed with a margin of normal skin around it (wide local excision). Margin size depends on tumor thickness and established guidelines to reduce the risk of local recurrence while preserving function and appearance.

For tumors at risk of spreading to nearby lymph nodes, a sentinel lymph node biopsy may be offered to stage disease more accurately. If nodes contain melanoma, further nodal surgery or additional treatments may be considered. Reconstructive techniques, such as skin grafts or local flaps, are often used after excision when needed to optimize healing and cosmetic outcome.

Systemic cancer treatments and targeted therapies

For melanoma that has spread beyond the original site, systemic therapies play a central role. Immunotherapies, including checkpoint inhibitors, harness the immune system to target cancer cells and have improved outcomes for many patients. Targeted therapies are available for tumors with specific genetic alterations, such as BRAF mutations; these drugs block molecular pathways that drive tumor growth.

Chemotherapy is now less commonly used but may still be an option in certain situations. Radiation therapy can be useful for control of localized metastatic lesions or for symptom relief. Because treatments can have significant side effects, multidisciplinary care teams — including medical oncologists, dermatologists, and surgical specialists — tailor therapy to each patient’s stage, tumor characteristics, and overall health.

When should a changing mole prompt evaluation?

A mole that changes in size, color, shape, or sensation warrants prompt medical evaluation. New or evolving lesions, a mole that bleeds or does not heal, or the appearance of satellite spots near an existing mole are reasons to see a clinician. Regular skin checks by a dermatologist are recommended for people with many moles, a personal or family history of melanoma, fair skin, or significant sun exposure.

Self-exams every month help people notice changes early. Photographic records or mole-mapping services can assist clinicians in tracking lesion evolution over time. Early detection often allows for less extensive treatment and better outcomes.

How sunburn and UV exposure affect treatment and prevention

Ultraviolet (UV) radiation from sun exposure and sunburn is a major modifiable risk factor for melanoma. Recurrent sunburns, especially during childhood, increase lifetime melanoma risk. Prevention strategies — protective clothing, broad-spectrum sunscreen, seeking shade, and avoiding tanning beds — reduce future risk and are important after treatment to lower the chance of new skin cancers.

After treatment for melanoma, clinicians emphasize strict sun-protection measures and routine skin surveillance. Counseling on UV avoidance, education about recognizing suspicious lesions, and coordination with primary care and dermatology for periodic full-body exams form part of comprehensive survivorship care.

Conclusion

Melanoma treatment is individualized based on tumor stage, pathology, and patient factors. Early surgical removal remains the cornerstone for localized disease, while sentinel node assessment, immunotherapy, targeted therapy, and radiation are important for advanced or high-risk cases. Ongoing skin surveillance and UV protection are key components of post-treatment care. Consultation with a qualified clinical team will provide the most appropriate plan for diagnosis, treatment, and follow-up.