Treatment for stage 3 melanoma
This page tells you about treatment for stage 3 melanoma skin cancer. There is information about
If you haven't already had surgery, your surgeon will remove the melanoma and the tissue around it. This is called a wide local excision.
You may have surgery to remove the lymph nodes in the area near to the melanoma.
After surgery, doctors may offer radiotherapy to some people with stage 3B or 3C melanoma to reduce the chance of it coming back in the original area.
Biological therapy after surgery
Biological therapy after surgery to try to prevent melanoma coming back is called adjuvant treatment. Doctors don’t know whether adjuvant treatment is helpful for people with stage 3 melanoma. Your doctor may ask you to join a clinical trial looking into this.
Melanoma in nearby skin (in-transit metastases)
Sometimes melanoma develops on or just under the skin, between the melanoma and the nearby lymph nodes. These are called in-transit metastases. There are many possible treatments for in-transit metastases including surgery, laser therapy, or chemotherapy delivered directly to the metastases. Your doctor will discuss these treatment options with you.
What happens after treatment
If melanoma comes back
If melanoma comes back in the nearby area this is called a local recurrence. You usually have surgery to remove it. Your doctor may suggest other types of treatment as part of a clinical trial.
You will have surgery to remove the melanoma. You then have further surgery called a wide local excision. This operation removes more tissue in the area where the melanoma was. You may have already had this surgery when the doctors first diagnosed your melanoma.
If the melanoma has spread to the lymph nodes, you may need surgery to remove all of the lymph nodes in the area near the melanoma. So if for example your melanoma is on your arm, the surgeon removes the lymph nodes under your arm on that side of the body. This is where the melanoma cells are most likely to spread.
Read more about surgery for melanoma.
Radiotherapy uses high energy rays to destroy cancer cells. It can sometimes reduce the chance of cancer coming back in the area where the surgeon has removed the lymph nodes. But it can cause side effects. And it doesn't change the risk of the melanoma spreading to other parts of the body such as the organs.
So doctors carefully weigh up the benefits of giving radiotherapy against the side effects. If you have stage 3A melanoma the doctor will not usually offer you radiotherapy. This is because the disadvantages are likely to outweigh the advantages.
The doctor might offer radiotherapy to some people with stage 3B or 3C melanoma, if they think that the advantages outweigh the disadvantages. They will discuss all the possible risks and benefits with you.
Read more about the stages of melanoma. And read more about radiotherapy for melanoma.
Treatment after surgery for cancer to try to prevent it coming back is called adjuvant treatment. There is no strong research evidence at the moment to show that any adjuvant treatment helps to stop melanoma from coming back or spreading. For this reason, you should only be offered adjuvant treatment within a clinical trial.
Your doctor may ask you to join a trial looking at biological therapy if your lymph nodes contained cancer cells.
Clinical trials are going on all the time to try to find out the best treatment approach. Find out more on our clinical trials database.
Read more about biological therapy for melanoma.
Some people develop small melanomas on or just under the skin, between the main melanoma and the nearby lymph nodes. These are called in-transit metastases.
Your doctor may offer you surgery to remove the small secondary melanoma. If surgery is not suitable, you may have
• Chemotherapy directly into the leg or arm where the melanoma is (known as isolated limb infusion or isolated limb perfusion)
• Chemotherapy combined with an electric current (electrochemotherapy)
• Laser treatment using a carbon dioxide laser
• Cream to put on the skin (such as imiquimod cream)
After surgery to remove stage 3 melanoma some people are cured and have no further problem. But in some people the melanoma comes back in the nearby area. This is called a local recurrence. If the melanoma comes back somewhere else in the body, this becomes a stage 4 melanoma.
For a local recurrence the usual treatment is surgery to remove the new area of melanoma.
If surgery is not possible, or it does not get rid of the melanoma, then your doctor may recommend you have chemotherapy. Or they may recommend radiotherapy to the area of melanoma.
The doctor may offer you a clinical trial looking at a new treatment. Find out more about clinical trials for melanoma on our clinical trials database.
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