Melanoma

It is crucial to seek treatment for melanoma as soon as possible. Treatment options often depend on the size of the melanoma mole, the cancer stage, your health, and your personal comfort levels.

Melanoma is traditionally treated with surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy.

Cosmetically Sensitive Melanoma Surgery

Thin, early-stage melanomas maybe be removable in a doctor’s office. If the melanoma is thicker, our surgeons can make flaps from the skin near the tumor, or with skin grafts taken from another part of your body. This will achieve the same survival benefits with a much smaller scar.

For later-stage melanoma, surgery may be required to remove lymph nodes or other affected areas.

Chemotherapy

Chemotherapy uses powerful drugs to attack and kill cancerous cells. It can be administered through pill form or an IV drip.

For melanoma in an arm or leg, chemotherapy may be administered by an isolated limb perfusion (ILP). A surgeon will temporarily cut off blood flow through the affected limb, so that the chemotherapy can travel directly to the melanoma and surrounding area, sparing the rest of your body from exposure to the drugs.

Radiation therapy

Radiation treatments utilize high-powered beams to destroy cancer cells. Radiation therapy may be used in areas where melanoma wasn’t completely removed, or on any affected lymph nodes.

Immunotherapy for melanoma

NewYork-Presbyterian's cancer specialists have participated in pivotal studies evaluating novel immunotherapies for advanced melanoma—treatments that boost the power of the immune system to find and kill cancer cells.

Recently approved immunotherapies for metastatic melanoma include:

• Tumor-Infiltrating Lymphocyte (TIL) therapy is an innovative form of immunotherapy that uses a patient’s own immune cells to fight cancer. TILs are a type of white blood cell found inside tumors—evidence that the immune system is already trying to attack the cancer. In TIL therapy, these cells are collected from the tumor,  a sample of which has been removed from the patient’s body, multiplied in a lab to create billions of cancer-fighting cells, and then infused back into the patient. Although TILs is only FDA approved for use in melanoma, this personalized approach has shown promise in treatment-resistant cancers by helping the immune system mount a stronger and more targeted response. NewYork-Presbyterian is one of only a few hospitals in New York City to offer this novel therapy.
• Nivolumab or pembrolizumab. These drugs bind to and block a molecule called PD-1, which shuts down the immune response. By inhibiting PD-1, nivolumab and pembrolizumab enhance the body's ability to detect and destroy cancer cells.
• Ipilimumab. Similar to nivolumab, ipilimumab works by blocking a protein that shuts down the immune response—in this case, a protein called CTLA-4—thereby provoking an immune attack against melanoma cells.
• Talimogene laherparepvec. Also called T-Vec, this is a genetically engineered herpes virus that is injected into tumors and specifically kills cancer cells.

Targeted melanoma therapies

Approximately 50% of cutaneous melanomas contain mutated versions of a gene called BRAF. If your melanoma has this mutation, you may be able to receive drugs that block a pathway activated by this mutation, such as vemurafenib, cobimetinib, dabrafenib, or trametinib. Since these drugs are taken orally (by mouth), you can take them at home. Your doctor will see you periodically to monitor your care.

Melanoma clinical trials

NewYork-Presbyterian has a robust portfolio of cancer clinical trials, including many studies evaluating promising new therapies and treatment combinations for advanced melanoma. Your doctor will let you know if you are eligible to participate in a clinical trial of an innovative therapy.