Melanoma: Diagnosis, Treatment and Support Programs

Melanoma Diagnosis Treatment and Support
This page was originally published May 1, 2023 and updated April 24, 2024.

If you or someone you know has been diagnosed with melanoma, you’re probably feeling a mix of emotions – fear, confusion, and uncertainty about what comes next. This article aims to help guide you through this challenging time. Here, you’ll find comprehensive information about melanoma, including its diagnosis, treatment options, and several support programs available for patients and their families. For more help, please visit our national directory of no-cost programs, products, and services for melanoma patients in the USA.

You’re not alone on this journey, and with the right knowledge and resources, you can navigate this situation more effectively. ❤️

Melanoma and Other Skin Cancers

Skin cancer, a malignant condition characterized by uncontrolled growth of skin cells, is a major health concern worldwide. The frequency of this disease has been on the rise, making it an urgent topic to be addressed and understood. The National Cancer Institute describes skins cancer types, diagnosis and treatment options here. Read on for an overview.

As the NCI reports, there are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma, with melanoma being the most dangerous type.

Basal Cell Carcinoma (BCC)

BCC is the most common type of skin cancer, often appearing as a red or pink lump, though it can also resemble a pearly white or waxy bump. It is primarily caused by long-term exposure to the sun or the usage of tanning beds. BCC grows slowly over time and rarely spreads to other parts of the body, but it can cause significant local destruction and disfigurement if left untreated.

Squamous Cell Carcinoma (SCC)

SCC is the second most common type of skin cancer. It is commonly seen as a firm red nodule or a flat lesion with a scaly, crusted surface. Like BCC, it is also primarily triggered by cumulative UV exposure over time. While SCC is generally more aggressive than BCC, it is still typically slow-growing. However, if neglected, it has a greater potential to spread to other body parts.


Melanoma is the most dangerous type of skin cancer. It often appears as a dark spot or mole on the skin that changes in size, shape, or color. Melanoma is particularly associated with intense, intermittent exposure to the sun’s harsh UV rays, especially episodes causing sunburn. Unlike BCC and SCC, melanoma possesses a high risk of spreading rapidly, making it much more lethal if not caught and treated early. It’s crucial to seek medical attention if any signs or changes indicative of melanoma are observed.

Melanoma Self Checks

Recognizing the early signs of melanoma can potentially save lives, as early detection allows for more effective treatment. According to the American Academy of Dermatology Association, the ABCDE rule is a guide commonly used to identify suspicious moles or spots that may be melanoma:

A – Asymmetry: Normal moles or freckles are usually symmetrical. If you draw a line through a mole and the two halves do not match, it indicates asymmetry. This is a hallmark of melanomas.

B – Border: A benign mole has smooth, even borders, unlike melanomas which typically have irregular borders that are hard to define.

C – Color: A variety of colors is another warning signal. While benign moles are usually a single shade of brown, a melanoma may have different shades of brown, tan or black. As it grows, the colors red, white or blue may also appear.

D – Diameter or Dark: Melanomas usually are larger in diameter than the size of the eraser on your pencil (1/4 inch or 6mm), but they may sometimes be smaller when first detected. Also, consider any dark moles.

E – Evolution: The evolution of your mole(s) has become the most important factor to consider when it comes to melanoma. Knowing what is normal for YOU could save your life. If a mole has gone through recent changes in color and/or size, bring it to the attention of a professional immediately.

Remember, some melanoma may not fit these rules, so it’s important to tell your doctor about any changes or new spots on the skin, or growths that look different from the rest of your moles. Skin self-exams can help find melanoma early when it is most treatable.

Diagnosing Melanoma

The diagnosis of melanoma often starts with a thorough examination of your skin. If a suspicious spot is identified, your doctor will likely perform a biopsy to remove a small sample of skin for lab testing. It’s important that you are proactive and vigilant in checking your skin for any changes, as early detection can significantly improve your prognosis.

Diagnostic Tests for Melanoma

Beyond a preliminary biopsy, several other tests may be performed to confirm a diagnosis of melanoma and understand its stage.

Dermoscopy: This non-invasive procedure involves using a tool called a dermatoscope to examine the skin. The dermatoscope illuminates the skin’s structure, allowing the healthcare provider to see features that aren’t visible to the naked eye. This can help distinguish melanoma from benign skin lesions.

Lymph node biopsy: If your doctor believes the cancer may have spread, they might perform a lymph node biopsy. This involves removing a small tissue sample from the lymph node closest to the cancerous mole, then examining it for cancer cells.

Imaging tests: To check if the melanoma has spread to other parts of your body, your doctor may recommend imaging tests. These could include X-rays, CT scans, MRI scans, or PET scans. These tests can provide detailed images of your internal organs and help detect any metastasis.

Molecular testing: This test is done to examine the genes in the melanoma cells. Certain changes in these genes may suggest that targeted therapy may be a good treatment option.

Remember, an early diagnosis of melanoma can significantly improve your prognosis. Therefore, it’s imperative to consult with a healthcare professional if you observe any changes to your skin that may be indicative of melanoma.

Treatment Options for Melanoma

A variety of treatments are available for melanoma, and the choice of treatment often depends on the stage and location of the melanoma, as well as your overall health. These treatments may include surgery, immunotherapy, targeted therapy, chemotherapy, radiation therapy, or a combination of these. It’s essential that you discuss with your doctor to understand the benefits and risks of each treatment option.


Surgery is often the first line of treatment for melanoma. The type of surgery will depend on the size and stage of the cancer. For early-stage melanoma, a wide local excision—removal of the melanoma along with some normal skin around it—may be performed. For larger or more advanced melanomas, lymph nodes may also be removed.

For advanced melanomas, or those that have spread beyond the skin, more extensive surgical procedures may be required. These can include lymphadenectomy, a procedure to remove one or more lymph nodes for examination and to prevent the spread of cancer. In specific cases where melanoma has spread to organs, metastasectomy, the surgical removal of metastases, can be performed.

When surgery itself is not feasible due to the location or extent of the cancer, doctors may opt for isolated limb perfusion. This technique delivers high doses of chemotherapy to the affected arm or leg, without exposing the rest of the body to the drugs.

In certain cases, Mohs surgery is an option. This precise surgical technique removes the cancer layer-by-layer, examining each layer until no abnormal cells remain. This method allows surgeons to conserve as much healthy skin as possible, making it a preferred option for melanomas located in areas where preserving cosmetic appearance is important.

Remember, surgical options are dependent on the individual’s condition, and a thorough discussion with your healthcare provider is crucial to choosing the best treatment strategy.


Immunotherapy is a treatment option that helps your immune system fight cancer. Cancer can weaken the immune response, and immunotherapy aims to strengthen this response. Medications like immune checkpoint inhibitors, cytokines, and treatment vaccines fall under this category.

Immunotherapy is a groundbreaking field that has shown considerable promise in the treatment of melanoma. This innovative approach harnesses the power of the body’s own immune system to recognize and combat cancer cells. The primary goal of immunotherapy is to stimulate the patient’s immune response, enabling it to more effectively attack melanoma cells.

One of the key therapies in this domain is the use of Immune Checkpoint Inhibitors. These drugs function by inhibiting the checkpoints on immune cells, effectively ‘taking the brakes off’ the immune system, and allowing it to respond more aggressively to cancer cells.

Another form of immunotherapy is Cytokine Therapy, which involves the administration of proteins such as Interferons and Interleukins to boost the immune response. These substances can enhance the ability of the immune cells to infiltrate tumors and induce cancer cell death.

Treatment Vaccines, another form of immunotherapy, aim to stimulate the immune system by introducing antigens that the immune system recognizes as foreign. This helps the immune system to identify and destroy cancer cells.

Immunotherapies can be used alone, but they are often most effective when used in combination with other treatments. Side effects can vary and may be severe, as the activation of the immune system can inadvertently lead to it attacking normal cells as well. Regular monitoring and reporting of any side effects to your healthcare provider is crucial. Despite the potential for side effects, immunotherapy offers a new avenue for the treatment of melanoma, and ongoing research is exploring new and more effective ways to harness the power of the immune system in the fight against cancer.

Targeted Therapy

Targeted therapy uses drugs or other substances to attack specific cancer cells with less harm to normal cells. These treatments target the changes in cancer cells that help them grow, divide, and spread. Some targeted therapies for melanoma focus on specific gene mutations such as BRAF and MEK.

Targeted therapies have revolutionized the treatment of melanoma, particularly for patients with advanced or metastatic disease. They work by specifically interfering with the genetic changes that drive the growth and spread of melanoma cells.

BRAF inhibitors are a type of targeted therapy that blocks the activity of the BRAF protein, which is mutated in about half of all melanomas. By inhibiting this protein, these drugs can slow or stop tumor growth. Examples of BRAF inhibitors include vemurafenib and dabrafenib.

MEK inhibitors are another class of targeted therapy used in the treatment of melanoma. These drugs block the MEK protein, which works along the same signaling pathway as BRAF. MEK inhibitors, such as trametinib and cobimetinib, are often used in combination with BRAF inhibitors to enhance their effectiveness.

In addition to BRAF and MEK inhibitors, there are targeted therapies that focus on other genetic changes in melanoma. For instance, KIT inhibitors target mutations in the KIT gene, which are found in a small percentage of melanomas, particularly those arising in certain parts of the body like the palms, soles, and under the nails.

Despite the effectiveness of targeted therapies, not all patients respond, and some who do respond later develop resistance. For this reason, ongoing research is critical to developing new targeted therapies and combinations of therapies to improve outcomes for those with melanoma. It is essential for patients to discuss with their healthcare providers whether targeted therapy might be a suitable treatment option for them.


Chemotherapy uses drugs to kill cancer cells or to stop them from dividing, which may slow the growth of melanoma. Chemotherapy can be administered orally or directly into the bloodstream, depending on the stage and severity of the disease.

While chemotherapy is not as commonly used for melanoma as some of the other treatments due to the effectiveness of newer targeted therapies and immunotherapies, it still has a place in the treatment plan for some patients. This treatment works by circulating throughout the body in the bloodstream, and can therefore reach cancer cells that have spread to distant organs.

The most commonly used chemotherapy drug for melanoma is dacarbazine. Other drugs, such as cisplatin, carboplatin, paclitaxel, and vinblastine may also be used, typically in combination with each other or with other types of treatment.

Chemotherapy is typically administered in cycles, with each period of treatment followed by a rest period to allow the body time to recover. The side effects of chemotherapy can be significant and may include fatigue, nausea, hair loss, and an increased risk of infection due to lowered white blood cell counts. However, many of these side effects can be managed effectively with the right supportive care and medications.

Notably, scientists are also investigating the use of chemotherapy in a strategy known as biochemotherapy, which combines chemotherapy with immunotherapy drugs. This approach aims to increase the overall effectiveness of the treatment, although it often comes with increased side effects.

As with all treatment decisions, the potential benefits of chemotherapy should be weighed against the potential risks and side effects. It is important for patients to have a thorough discussion with their healthcare provider about the possible benefits and drawbacks before deciding on the best treatment approach.

Radiation Therapy

Radiation therapy uses high-energy rays to kill melanoma cells. This treatment may be used after surgery to kill any remaining cancer cells, or in later stages of melanoma to relieve symptoms caused by the spread of cancer.

External Beam Radiation Therapy

External beam radiation therapy is the most common form of radiation used to treat melanoma. In this process, a machine directs high-energy rays at the cancer from outside the body. The procedure itself is painless and much like getting an X-ray, though the setup time usually takes longer as everything must be carefully arranged to aim the radiation precisely.

Before starting treatment, your healthcare provider will use imaging tests, such as CT scans, to determine the exact location of the cancer. This information is then used to plan the radiation treatment, ensuring that the maximum dose is delivered to the cancer while minimizing exposure to healthy tissues.

Treatment is typically given five days a week for several weeks. Each treatment session lasts only a few minutes, but the entire process, including setup time, often takes 15 to 30 minutes.

Side Effects of Radiation Therapy

As with any cancer treatment, radiation therapy can have side effects. These may include fatigue, mild skin reactions, upset stomach, or loose bowel movements. Most side effects go away a few weeks after treatment ends.

Remember, your healthcare team is there to help manage any side effects you may experience. They can provide strategies for coping and, if necessary, prescribe medications to help relieve symptoms.

Ongoing Research and Development

Research is ongoing to improve the effectiveness of radiation therapy for melanoma and to reduce its side effects. This includes the development of new techniques to deliver radiation, like intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), which allow for more precise targeting of cancer cells, thereby sparing more normal tissue.

Clinical trials are also being conducted to evaluate the combination of radiation therapy with other treatments, such as immunotherapy and targeted therapy, in hopes of enhancing the overall effectiveness of treatment. Always remember to discuss with your healthcare provider about the option of participating in a clinical trial.

Clinical Trials

Clinical trials offer opportunities to try new treatments that are not yet available to the public. Participating in a clinical trial could give you access to cutting-edge treatments and will contribute to research that could help future melanoma patients. Be sure to discuss with your doctor the potential benefits and risks of participating in a clinical trial.

It is crucial to discuss all possible treatment options, along with their potential side effects, with your healthcare provider to determine the best approach for your individual case. It’s also a good idea to consider getting a second opinion before starting treatment. Your needs and preferences, along with the nature and stage of your melanoma, will all play a key role in determining the right path.

Free Support After a Melanoma Diagnosis

Managing melanoma is not just about medical treatment. Emotional and financial support can be just as crucial. There are several programs available that offer support for those diagnosed with metastatic melanoma.

Good Days Metastatic Melanoma Fund

The Good Days Metastatic Melanoma Fund is a charitable foundation that aims to alleviate the financial burden associated with managing metastatic melanoma. The fund provides financial assistance to eligible patients who are unable to afford the cost of their medication. By offering co-pay assistance, the fund helps patients access life-saving treatments that can significantly improve their quality of life. It’s important to note that eligibility is dependent on several factors such as income, insurance coverage, and the patient’s specific diagnosis. Applications can be made online through the Good Days website, where one can also find a wealth of resources related to melanoma, including educational materials and support networks.

PAF Melanoma Fund

The Patient Advocate Foundation (PAF) Melanoma Fund is another avenue of support for patients diagnosed with melanoma. This fund provides co-pay relief to patients who have health insurance and are grappling with the high costs associated with their treatments. Like the Good Days Fund, the PAF Melanoma Fund’s goal is to reduce the financial stress for patients, allowing them to focus more on their health and recovery. The fund covers a variety of melanoma-related expenses, including prescribed medications, medical consultations, and specific treatments. Eligibility for this fund is determined based on a set of criteria, which includes the patient’s financial status, insurance coverage, and residency. Applications can be submitted online via the PAF’s Co-Pay Relief website.

Merck Helps Program

The Merck Helps Program is a significant resource for patients prescribed Keytruda, a medication commonly used in the treatment of melanoma. This program is committed to helping eligible patients access Keytruda, particularly those who lack insurance coverage or have financial constraints. The Merck Helps Program provides Keytruda at no cost for patients who meet specific criteria, easing the financial burden and enabling the continuation of crucial treatment. The application process is initiated by the healthcare provider, who submits a Patient Assistance Program Enrollment Form on behalf of the patient. The program distinctly demonstrates Merck’s commitment to patient care, ensuring that financial barriers do not prevent patients from receiving the treatment they need.

A Cure in Sight Expenses Grant

A Cure In Sight Expenses Grant offers financial assistance to support those who have been diagnosed with ocular melanoma – a rare and aggressive eye cancer. Recognizing the financial implications of dealing with this form of melanoma, the grant helps to alleviate the financial stress associated with the cost of treatments and related expenses that may not be covered by insurance. This includes travel expenses for medical appointments, lodging, meals, parking, tolls, and medical copays. The program aims to ensure that individuals can access the necessary treatments and care without the added strain of financial difficulty. The grant is available to ocular melanoma patients who are US residents and are actively undergoing treatment. The grant amount varies depending on the individual’s need and available funding. The application process is straightforward and involves an online form through which applicants can submit their request. A Cure in Sight organization is dedicated to providing not just financial aid but also essential information, education, and support to those suffering from ocular melanoma.

More Help for Melanoma Patients and Families

For more assistance, please visit our national directory with many free and low-cost programs, products and services for melanoma patients in the USA. Remember, you are not alone in this journey, and there are resources and support systems available to help you through. Don’t hesitate to reach out and ask for help when you need it. You deserve all the support you can get as you navigate through this difficult time. So, if you or someone you know has been diagnosed with melanoma, remember that help is available. From financial assistance to emotional support and resources, visit our resource for organizations across the nation that dedicated to helping those affected by this form of cancer. ❤️

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