Melanoma treatment overview

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 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.

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 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 can be used to destroy small areas of melanoma on the skin.

Electrochemotherapy uses chemotherapy and a small electrical current to treat small areas of melanoma on the skin.

This is a type of immunotherapy given as an injection into an area of melanoma on the skin or in the lymph nodes.

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.

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].

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, Professor Samra Turajlic, Consultant Medical Oncologist.

With thanks to: Dr Stephanie Arnold, Consultant; Kerry Jane Bate, Advanced Nurse Practitioner; Dr Philippa Closier, Clinical Oncologist; Sharon Cowell-Smith, Macmillan Advanced Nurse Practitioner Skin Cancers; and Dr Benjamin Shum, Medical Oncologist.

Thanks also to the other professionals and people affected by cancer who reviewed this edition, and to those who shared their stories.

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.