The goal of treating melanoma skin cancer is to destroy or remove the cancer completely with minimal scarring of the patient’s skin. The treatment options for melanoma depend on a number of factors, including the location of the melanoma and the type and stage of the cancer. Generally, the treatment for melanoma will depend on the following:

• The thickness of the melanoma
  
  
• Whether or not it has spread to deeper levels of the skin or other areas of the body
  
  
• The mitotic index (an indication of how quickly the cancer cells are growing and reproducing)
  
  
• The number of regional lymph nodes involved
  
  
• Ulceration or bleeding at the primary site
  
  
• Microscopic satellites
  
  
• Age and general health of the patient

When caught early, melanoma may be treated by simple excision. This is a minor surgical procedure in which the tumor is cut out along with a small margin of healthy skin around the edges of the melanoma, usually less than an inch (2 centimeters). It may be removed as treatment or as part of a biopsy to confirm a diagnosis of melanoma. A wide excision (re-excision) may be performed to ensure that the cancer has not spread to nearby cells.

If the melanoma has spread, additional surgery and other options may be necessary, including:

• Chemotherapy. Chemotherapy is a method of treating various cancers that involves the use of powerful anti-cancer drugs.  It works by destroying cancer cells and keeping them from growing, dividing and spreading. Chemotherapy with a single drug is only effective for a small percentage of melanoma patients with advanced disease. However, high-dose chemotherapy followed by bone marrow or stem cell replacements is considered to be more successful in treating advanced melanoma.
  
  
• Radiation therapy. Radiation therapy uses precise x-ray beams to kill or shrink cancer cells. Radiation targets dividing cancer cells and disrupts or destroys their genetic material, preventing the cells from continuing to grow and spread throughout the body. Often, radiation is often used to treat melanoma that has spread to nearby lymph nodes or to areas that cannot be treated surgically. Radiation may be used to shrink large melanomas and also to relieve pain. However, due to melanoma’s level of resistance to radiation, high individual doses are normally required in order to be effective.
  
  
• Biological therapy. Also called immunotherapy, this form of therapy stimulates the body’s immune system to recognize and fight cancer cells. Immunotherapy uses certain proteins to trigger the body’s immune system to produce more white blood cells, which attack and kill cancer cells. In some forms, biological therapy directly attacks the cancer cells. It also can help reduce the side effects associated with cancer treatments such as chemotherapy. With this type of treatment, the side effects are normally minor tenderness at the injection site or, at times, lumps that are painful. However, these usually arise only after a long series of treatments. A limited response has been seen with this type of treatment.
  
  
• Surgery. Surgical options may be limited once melanoma has spread to other areas of the body. Even if melanoma invades just one or two sites, surgical removal may not provide a cure. However, removing metastases in some areas, such as the brain, may be considered if it will enhance the patient’s quality of life.
  
  
• To determine whether or not the cancer has spread, many surgeons will also perform a lymph node dissection. This procedure removes some or all of the lymph nodes that are closest to the lesion for inspection by the pathologist for evidence of cancer. An alternative to a complete lymph node dissection is a sentinel node biopsy, a relatively new treatment that requires removal of only one lymph node to determine if the cancer has spread.