Melanoma treatment overview
About treatment for melanoma
Your treatment plan for melanoma depends on:
- where the melanoma is
- how deep the melanoma is
- whether it has broken the skin (ulcerated)
- if it has spread
- your general health and your preferences.
Your doctor or specialist nurse will talk to you about the different treatment options and things to think about when making treatment decisions. You can then decide together what treatment is best for you. You may be offered some treatments as part of a clinical trial.
Related pages
We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:
- Call the Macmillan Support Line for free on 0808 808 00 00.
- Chat to our specialists online.
- Visit our melanoma forum to talk with people who have been affected by melanoma, share your experience, and ask an expert your questions.
Stage 0 (melanoma in situ) treatment
You have surgery to treat stage 0 melanoma. The surgeon removes more tissue from the area where the melanoma was removed.
The aim is to remove all the cancer cells and an area of healthy tissue around it. This reduces the risk of cancer cells being left behind. Sometimes you may need a second operation to make sure all the melanoma has been removed.
Some areas of the body are difficult to treat with surgery. Or there may be a health reason that means you cannot have surgery.
Your doctor may talk to you about having a different treatment for stage 0 melanoma such as imiquimod cream. Imiquimod uses your body’s immune system to get rid of the cancer cells. You spread the cream on the area of melanoma. Your doctor or nurse will explain when and how often you should do this.
After your treatment, you may have a biopsy to check the area for cancer cells.
Melanoma stage 1 and 2 treatment
Surgery may be the only treatment you need for stage 1 and 2 melanoma. The surgeon removes more tissue from the area where the melanoma was removed. The aim is to remove all the cancer cells and an area of healthy tissue around it. This reduces the risk of cancer cells being left behind.
Some people may have a test called a sentinel lymph node biopsy to see if any melanoma cells have spread to the lymph nodes. If the cancer has spread to the lymph nodes it is a stage 3 melanoma.
If you have stage 2 melanoma your doctor may talk to you about having immunotherapy treatment to reduce the risk of it coming back. This is called adjuvant treatment.
Melanoma stage 3 treatment
The main treatments for stage 3 melanoma are:
-
Surgery
You will usually have surgery to remove more tissue from the area where the melanoma was removed. If tests show cancer in the lymph nodes, sometimes you may have surgery to remove these lymph nodes.
If the melanoma has spread to nearby skin, you may also have surgery.
-
Immunotherapy and targeted therapy
Immunotherapy drugs use the body’s immune system to recognise and kill cancer cells. Targeted therapy drugs ‘target’ something in or around the cancer cell that is helping it grow and survive. You may have immunotherapy or targeted therapy drugs:
- as your main treatment
- after surgery to help reduce the risk of cancer coming back.
The following treatments may also be used if surgery is not possible. Some of these treatments are specialised and may only be available at certain hospitals. Some are not available on the NHS in every area of the UK. Your doctor or nurse can give you more information.
-
Radiotherapy
Radiotherapy uses high-energy rays to destroy the cancer cells. Sometimes, this treatment is used to treat cancer in the lymph nodes or nearby skin if it is not possible to remove them with surgery.
-
Chemotherapy into a limb
Chemotherapy can be given directly into a limb to treat clusters of melanoma in the same limb where the melanoma started. Chemotherapy into a limb is also called isolated limb perfusion (ILP) or isolated limb infusion (ILI).
-
Laser therapy
Laser therapy can be used to destroy small areas of melanoma on the skin.
-
Electrochemotherapy
Electrochemotherapy uses chemotherapy and a small electrical current to treat small areas of melanoma on the skin.
-
T-VEC
This is a type of immunotherapy given as an injection into an area of melanoma on the skin or in the lymph nodes.
-
Imiquimod
Imiquimod is a cream that uses your body’s immune system to get rid of the cancer cells. It is sometimes used to treat small areas of melanoma on the skin.
Melanoma stage 4 treatment
Stage 4 or advanced melanoma means the cancer has spread to other parts of the body. The aim of treatment is usually to control the cancer and help you live longer. It may also help improve your symptoms and quality of life. Newer treatments mean many people are living a long time with advanced melanoma.
We have more information about advanced melanoma and treatments.
About our information
-
References
Below is a sample of the sources used in our melanoma information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Michielin O, van Akkooi ACJ, Ascierto PA, et al. Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2019; 30, 12, 1884-1901 [accessed May 2022].
Michielin O, van Akkooi ACJ, Ascierto PA, et al. ESMO consensus conference recommendations on the management of locoregional melanoma: under the auspices of the ESMO Guidelines Committee. Annals of Oncology. 2020; 31, 11, 1449-1461 [accessed May 2022].
Peach H, Board R, Cook M, et al. Current role of sentinel lymph node biopsy in the management of cutaneous melanoma: A UK consensus statement. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2020; 73, 1, 36-42 [accessed May 2022].
-
Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Samra Turajlic, Consultant Medical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.