Surgical removal (excision) of the affected skin is the most effective treatment for melanoma. Excision involves removing the entire melanoma along with a border (margin) of normal-appearing skin. Additional treatment may be needed based on the stage of the melanoma.

Staging for treatment of melanoma

Staging is a method of describing how far a cancer has progressed. It is done after excision of the melanoma and assessment of lymph nodes and other parts of the body to determine whether the cancer has spread. Staging helps doctors determine the best possible treatment. Staging evaluates:²

Tumor thickness and depth.
Ulceration of skin over the melanoma.

Initial treatment

Melanoma may be cured if caught and treated in its early stages when it affects only the skin. If melanoma is confined to the skin (primary melanoma), you will have surgery to remove the affected skin. If the melanoma is thin and has not invaded surrounding tissues, excision may cure the melanoma. In more advanced stages, melanoma may spread, or metastasize, to other organs and bones, making cure less likely.

Initial treatment will depend on the stage of the melanoma.^5,⁶

Stage 0 melanoma or melanoma in situ invades only the outer layer of skin. Surgery to remove the lesion or mole is usually all that is needed.
Stage I melanoma is generally less than 1mm thick. Surgery to remove the cancer is usually all that is needed. Some advanced stage I melanomas may be treated like stage II.
Stage II melanoma is more than 1mm thick, but does not spread to the lymph nodes. Surgery to remove the cancer is most common. Other treatments your doctor may consider are a lymph node biopsy, a medicine called interferon, observation, or enrolling you in a clinical trial. Reconstructive surgery may be needed to repair the scar left by surgery, especially if it is on the face or hands. Some advanced stage II melanomas may be treated like stage III.
Stage III melanoma has spread to the lymph nodes. Treatment includes surgery to remove the primary melanoma and all of the lymph nodes near the primary melanoma. This is usually followed by immunotherapy with interferon. Interferon is a protein similar to proteins made by the white blood cells. These proteins act in two ways-by weakening or killing cancer cells and also by boosting the body's immune system to fight the cancer. Your doctor may also talk to you about enrollment in a clinical trial.
Stage IV melanoma is cancer that has spread far from the initial cancer site, perhaps to the liver, brain, or bones. Treatment may include surgery, radiation, chemotherapy, or immunotherapy with drugs such as interferon. Most treatment in stage IV is to treat the symptoms caused when the cancer spreads to other areas, such as bone pain if the cancer spreads to the bone.

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WebMD Medical Reference from Healthwise

Last Updated: December 05, 2008

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.