TREATMENT BY STAGE

Stage

Treatment 41,46

Stage 0

• Surgery / excision biopsy to remove the melanoma and a small area of surrounding skin is the main treatment.
• If your doctors are sure they removed enough skin around the melanoma, this is all the treatment you need.
• As an alternative to surgery, depending on where the melanoma is and your overall health for surgery, your doctor might recommend treatment with a cream called imiquimod which you apply on the affected area.

Stage 1

• Surgery / excision biopsy to remove the melanoma and a small area of surrounding skin
• Sometimes, a second operation may be recommended to remove a larger area of skin around the melanoma site. This is known as a wide local excision.
• For stage 1A melanoma, if your doctors are sure that they removed enough skin around the melanoma, this is all the treatment you need.
• For stage 1B melanoma, your doctor might discuss with you the option to have a lymph node biopsy.

Stage 2

• Surgery to remove the abnormal mole and a small area of surrounding skin
• Usually, a second operation is recommended to remove a larger area of skin around the melanoma site. This is known as a wide local excision.
• Your doctor is likely to discuss with you the option to have a lymph node biopsy.

Stage 3

• Surgery to remove the abnormal mole and a larger area of surrounding skin. This is known as a wide local excision.
• A lymph node biopsy.
• Your doctor may advise adjuvant treatment following surgery, to reduce the risk of melanoma returning, this could include: - Targeted therapy (dabrafenib and trametinib combination treatment) 47 - Radiotherapy (uncommon)
• Your doctor may also discuss a lymph node dissection (removal of all the lymph nodes in that area) with you. This is carried out under general anaesthetic.

Stage 4

You might have one or more of the following treatments:

• Targeted therapy (including dabrafenib on its own or in combination with trametinib, vemurafenib)
• Immunotherapy (including ipilimumab, nivolumab, pembrolizumab and talimogene laherparepvec)
• Chemotherapy
• Radiotherapy
• Surgery