The cancerous skin cells and a portion of the normal surrounding skin usually need to be surgically removed. A procedure called surgical lymph node biopsy may be necessary to see if the cancer has spread to nearby lymph nodes, which also may need to be removed. A skin graft may be necessary after the surgery if a large area of skin is affected. Only the smallest and most shallow melanomas can be cured by surgery alone, so early diagnosis is very important. Radiation therapy, chemotherapy, or immunotherapy (use of medications that stimulate the immune system, such as interferon) may be recommended in addition to surgery. If the skin cancer is deeper than 4 mm or the lymph nodes have cancer, there is a high risk of the cancer spreading to other tissues and organs. Using interferon after surgery may be useful for these patients. Studies have suggested that interferon improves the overall chance of cure by approximately 10%. However, interferon has many side effects and is sometimes difficult to tolerate. Patients with high-risk melanomas should consider enrolling in clinical trials (research studies of new medications or other treatments). For patients with melanoma that has spread beyond the skin and lymph nodes to other organs, treatment is more difficult. At this point, melanoma is usually not curable. Treatment is usually directed at shrinking the tumor and improving symptoms. Both chemotherapy and use of interferon or interleukin may be tried. These patients also should consider participating in clinical trials.
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