To treat melanoma, a doctor must remove the visible tumor along with 1 to 2.5 centimeters of healthy skin around the tumor, depending on the size of the tumor. (Nearby skin can contain microscopic bits of the cancer.) In some cases, the doctor may perform a specialized procedure during which the tumor is shaved away one thin layer at a time. Each layer is examined under the microscope as it is removed. This technique helps the doctor remove as little healthy skin as possible.
If the melanoma is more than 1 millimeter deep, your doctor will want to know if the melanoma has spread to nearby lymph nodes. To do this, he or she may inject a radioactive liquid into the tumor. The liquid flows through the natural drainage pathway that connects the tumor to nearby lymph nodes. The drainage path can be tracked, and the first lymph node along the path is called the sentinel node. This node is removed and examined for cancer cells. If the sentinel node has no cancer, the other nodes are most often cancer-free. If cancer is found, your doctor may recommend additional treatment.
If cancer has spread to one or more lymph nodes, some experts recommend that all lymph nodes in the area be removed, but this is controversial. Although spreading cancer cells might be removed, cells that are fighting the cancer also are removed. It has not been proven that removing lymph nodes makes melanoma patients more likely to survive.
Additional therapies can often help people with:
A melanoma that is deep in the skin
Cancer cells that have spread to the lymph nodes
Cancer that has spread to other organs.
Treatment may include chemotherapy, radiation therapy, and/or medicines that boost your immune system's ability to fight the cancer. Examples of immune boosters and other types of therapy for melanoma include: