Treatment for advanced melanoma
Chemotherapy uses anti cancer drugs to destroy cancer cells. Sometimes doctors use the word cytotoxic to describe the way chemotherapy works. Cytotoxic means toxic to cells.
Chemotherapy doesn’t work as well against melanoma skin cancer as it does for some other types of cancer. So, doctors are more likely to use targeted cancer drugs or immunotherapy first. Or you might have chemotherapy if you are not able to have the other treatments.
The aim of chemotherapy for advanced melanoma skin cancer is to control the cancer and relieve symptoms. This can help improve your quality of life.
Find out more about advanced melanoma skin cancer
There are different ways to have chemotherapy for melanoma skin cancer.
You normally have chemotherapy for melanoma into your bloodstream (intravenously). This is called systemic treatment. It means the chemotherapy reaches your whole body. The most common systemic chemotherapy drug for melanoma is dacarbazine.
You have dacarbazine as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover. Each cycle of treatment lasts 21 days (3 weeks).
Your doctor will tell you how often you have dacarbazine in each cycle, and how many cycles you will have.
To have chemotherapy, a nurse puts a small tube (cannula) into one of your veins. They connect a drip containing the chemotherapy to it. Or you may have it into a larger vein through a:
central line
portacath
PICC line
Read more about having chemotherapy into your bloodstream
If the melanoma comes back in your skin, you might have chemotherapy combined with electric pulses. You have this under a or a .
Your doctor injects the chemotherapy into your bloodstream or straight into the melanoma. And then puts a probe in or near the melanoma. The probe gives out electric pulses. These help the chemotherapy go into the cancer cells.
Read more about electrochemotherapy
If the melanoma has come back in your arm or leg very near to where it started (local recurrence) you might have regional chemotherapy. This is called isolated limb infusion or isolated limb perfusion. It is a way of having chemotherapy just into one arm or leg. The chemotherapy doesn’t go around the rest of your body so there are usually fewer side effects.
Read more about isolated limb infusion and perfusion
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.
Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.
Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.
You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.
Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.
Common chemotherapy side effects include:
feeling sick
loss of appetite
losing weight
feeling very tired
increased risk of getting an infection
bleeding and bruising easily
diarrhoea or constipation
hair loss
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.
Let your doctors know if you:
take any supplements
have been prescribed anything by alternative or complementary therapy practitioners
It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.
Read about the safety of complementary and alternative therapies
Chemotherapy for melanoma skin cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. Your nurse will give you telephone numbers to call if you have any problems at home.
Last reviewed: 20 Jan 2025
Next review due: 20 Jan 2028
Advanced melanoma skin cancer means the cancer has spread to another part of the body such as the liver, lungs or bone. Or it has come back after treatment.
You might have general symptoms of advanced melanoma skin cancer. But other symptoms can depend on where the cancer has spread to. And some people may not get any symptoms at all.
Treatments include targeted cancer drugs, immunotherapy and chemotherapy. They aim to control the cancer, any symptoms you have and improve your quality of life.
Chemotherapy into the arm or leg is a form of regional chemotherapy. You may have a procedure called an isolated limb infusion or a different procedure called isolated limb perfusion.
Get support to cope with emotional, practical and physical issues when you have advanced melanoma skin cancer.
Melanoma develops in cells called melanocytes. You have these in your skin and other parts of your body. Melanoma that starts in the skin is called melanoma skin cancer.
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