Once you have been diagnosed and your melanoma has been staged, your medical team will begin planning a course of treatment for you. You can take as active or passive a role in creating your treatment plan as you would like. Your treatment plan defines the roles that will be played by you and your medical team during your treatment, and adheres to your specific needs and wishes as much as possible.
As you progress through treatment, your treatment plan will change to reflect your condition. Your treatment plan will consider factors such as your overall health, the location and stage of your cancer, side effects of treatment, treatment costs, and whether you have to travel for a given treatment. While much of your treatment plan will be determined by your medical team, the patient has the final say on all decisions. When you begin collaborating on your treatment plan with your medical team, be sure to communicate whether you want to take an active or passive role in your treatment planning, or somewhere in between. Regardless of the role you decide to take in your treatment planning, the NCCN suggests having an idea of your treatment goals (cancer elimination or symptom relief), having an understanding of your test results, writing down questions before medical appointments to get the most out of your time, and being willing to accept the help and advice of others (NCCN 87). The last of these include asking another doctor for a second opinion, which is a completely normal part of cancer care and should not offend your regular doctor.
Below are outlined some of the basic treatment options for melanoma:
- Surgery is the most common treatment for melanoma, and is often successful in removing early stage, (usually) non metastasized melanomas. Wide excision surgery (removal of the melanoma and a margin of skin around it) may be used to remove an entire melanoma, and occasionally amputation is used to remove a melanoma on a finger or a toe. Lymph nodes may be removed to inhibit the spread of melanoma, and if the melanoma has metastasized to the organs, surgery may be used to remove it.
- Chemotherapy is often used to treat advanced or metastasized melanoma. Chemotherapy is often given in cycles that last two to four weeks. While chemotherapy attempts to eliminate cancer cells, it may eliminate healthy cells, which will cause side effects. These might include a decrease in red blood cells, making you feel tired, white blood cells, which weaken your immune system, and platelets, which help your blood to clot. Chemotherapy may also damage cells in the hair roots, causing temporary hair loss during the chemotherapy cycle.
- Radiation therapy is also often used to treat advanced melanoma, or if it is not possible to remove all cancerous cells with surgery. Radiation therapy utilizes lasers or x-rays in an attempt to kill cancer cells. In this process, both cancerous and regular cells may be killed. Side effects depend on the area of the body receiving the radiation treatment.
- Targeted therapy is used to treat recurrent or metastatic melanoma. Targeted therapy requires a specific genetic mutation in a patient’s melanoma, such as a BRAF mutation. Side effects are varied. Targeted therapy is a relatively new treatment method to Canada, and new drugs are always in the process of being tested via clinical trials.
- Immunotherapy or biological therapy is used to treat advanced melanoma, or as an adjuvant (additional therapy). Biological therapy generally damages fewer normal cells than chemotherapy or radiation therapy. Side effects are generally less severe than with other forms of treatment, though this depends on the medication used and the person receiving it. New forms of immunotherapy are currently undergoing clinical trials.
We hope that this helps answer some of your questions about the different methods of treatment for melanoma in Canada. If you require further information, we recommend looking at our sources. Please remember that while we keep the information we post as accurate for Canadians as possible, not all of the websites we source content from are Canadian.
“About Melanoma: Signs and Symptoms of Melanoma”. NCCN Guidelines for Patients: Melanoma. 2014: National Comprehensive Cancer Network Foundation.
“Targeted Therapy”. Melanoma Network of Canada.
“Treating Melanoma- Chemotherapy”. Melanoma Network of Canada.
“Treating Melanoma- Radiation”. Melanoma Network of Canada.
“Treating Melanoma- Surgery”. Melanoma Network of Canada.
“Treatment of Melanoma”. Canadian Cancer Society.
“Treatment Options for Malignant Melanoma”. Canadian Skin Cancer Foundation.