Learning about your treatment choices

You may have questions and concerns about your treatment choices. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. They can tell you what your treatment choices are, how successful they are expected to be, and what the risks and side effects are. Your provider may advise a specific treatment. Or they may offer several different choices and ask you to decide which one you’d like to use. It may be hard to make this decision so it is important to gather the information and take the time you need to make the best decision.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your choices. You may want to get another opinion before deciding on your treatment plan. In addition, you may want to involve your family and friends in this process.

Types of treatment

Treatments for melanoma are local or systemic:

• Local treatments. These remove, destroy, or control the cancer cells in one specific area. Surgery and radiation therapy are local treatments.

• Systemic treatments. These are used to destroy or control cancer cells in the entire body. Chemotherapy, targeted therapy, and immunotherapy are systemic treatments.

You may have just one type of treatment, or a combination of treatments.

Goals of different treatments

Each type of treatment has its own goal. Below is a list of treatments and their goals:

• Surgery. The goal of surgery is to remove the melanoma but leave as much of the nearby skin as intact as possible. Surgery can also be used to help treat melanoma that has reached the lymph nodes.

• Radiation therapy. The goal of radiation is to destroy cancer cells. It may be used after surgery to try to kill any cancer cells that are left. It may also be used to help treat melanoma that has come back after a first treatment or has spread to other parts of the body. Radiation therapy uses high energy X-rays or other types of radiation.

• Chemotherapy (chemo). The goal of chemo is to destroy cancer cells directly to shrink tumors that can’t be removed by surgery or it may be used to kill cells that have spread to other areas of the body (metastatic melanoma). Chemo is done with medicines.

• Immunotherapy. The goal of immunotherapy is to boost your body's immune system to shrink advanced melanoma tumors. This therapy is also called biologic therapy. It might also be used after surgery for some earlier stage melanomas. This is to lower the risk that the cancer will come back. This type of therapy is done with medicines that help your body’s immune defense attack the cancer cells.   

• Targeted therapy. The goal of targeted therapy is to shrink advanced melanoma tumors. This type of therapy is done with medicines. The medicines target certain parts of melanoma cells. For example, medicines called BRAF inhibitors target cells with a change in the BRAF gene. This gene is found in about half of all melanomas.  

Clinical trials for new treatments

Researchers are always finding new ways to treat cancer. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.

Talking with your healthcare provider

At first, thinking about treatment choices may seem overwhelming. Talk with your healthcare providers, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each choice. Discuss your questions and concerns with your provider before making a decision.