Chemotherapy for advanced melanoma

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You sometimes have it as a treatment for advanced melanoma. 

Advanced melanoma means the melanoma has spread from where it started to another part of the body.

Aim of chemotherapy

Chemotherapy for advanced melanoma might help control the cancer and improve your quality of life for a time.

Doctors usually use chemotherapy after other treatments for melanoma or if you are unable to have those other treatments.

Chemotherapy doesn’t work as well against melanoma as it does for some other types of cancer. Doctors are more likely to use newer drugs called targeted cancer drugs or immunotherapy first to treat melanoma.

Types of chemotherapy

The most common chemotherapy drug for melanoma is dacarbazine (DTIC).

If your melanoma has come back in an arm of leg very near to where it started (a local recurrence) you might have regional chemotherapy. Regional chemotherapy is a way of having chemotherapy just into one arm or leg, without the drugs circulating through the rest of your body.

How you have chemotherapy

You have dacarbazine into your bloodstream through a drip into your arm. A nurse puts a small tube into one of your veins and connects the drip to it.

You usually have dacarbazine every few weeks. The time between one round of treatment and the start of the next is called a cycle. You usually have chemotherapy as a course of several cycles of treatment. Your doctor can tell you about your treatment plan.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have signs of infection. These include a temperature above 37.5C or below 36C, or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

When you're at home

Chemotherapy for melanoma can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

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