Other treatments such as isolated limb infusion (ILI) and isolated limb perfusion (ILP) can sometimes be recommended if the melanoma is in one place e.g. an arm or leg. This treatment involves giving chemotherapy through the bloodstream of the affected limb, and does not circulate the treatment through the rest of your body. This treatment is performed by a surgeon and requires a general anaesthetic, after the procedure patients usually stay in the hospital for a few days.52

Talimogene laherparepvec (Imlygic® or T-vec) is recommended for certain types of stage 3 or 4 melanoma that have spread, cannot be removed by surgery and are not suitable for treatment with other immunotherapy options. It is injected directly into the melanoma on the skin once every two and then three weeks

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