Systemic Therapy for Metastatic Melanoma

If melanoma spreads to vital organs outside the nearby lymph nodes, and if it is visible on scans or on exam, this is called stage 4 melanoma and is very serious. Some patients can be cured at this stage, but unfortunately not many. The aim of treatment for metastatic melanoma is usually to give you the best quality of life for as long as possible.

Metastatic melanoma is usually treated with systemic therapy, with the goal to shrink, control, and contain the cancer for as long as possible. Systemic therapy means cancer medications that go to all parts of the body’s systems; there the medications combat the cancer.

Common systemic therapy used to treat metastatic melanoma are the chemotherapy medications dacarbazine (given intravenously) and temozolomide (given orally). Sometimes young people with only a few areas of cancer are given high doses of an immune-stimulating systemic therapy called interleukin-2. Occasionally other types of systemic therapy are given. Most systemic therapy is given in the medical oncologist’s office by a treatment team supervised by the medical oncologist, and including a nurse practitioner, oncology nurse, medical assistant and office staff. High dose interleukin-2 is given in the hospital.

All patients develop some side effects from systemic therapy. Your treatment team will work closely with you to help minimize side effects. It is always important for you and your physicians to think carefully about the balance of the benefits of systemic treatment and the side effects. It is important to keep in mind that quality of life is often as important as length of life.

Your oncologist in the North Bay Melanoma Program participates in national clinical trials of promising new systemic therapies for melanoma. You will learn about these treatments during your appointments, and you may be eligible for one or more of these trials.