The short answer
Early melanoma is usually treated with surgery to remove it. For melanoma that has spread, immunotherapy and targeted therapy are important treatments.
Surgery to remove the melanoma is the main treatment for early disease.
For melanoma that has spread, immunotherapy is an important treatment.
Targeted therapy helps melanomas with certain gene changes, such as BRAF.
Radiation and other treatments are used in some situations.
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The simple version
This page is for people with melanoma and those who care for them. It explains treatment by stage.
Melanoma treatment generally starts with surgery. For stage 0 and stage I disease, NCI describes surgery as the treatment.
What changes as the stage goes up is what gets added. Immunotherapy and targeted therapy are now part of treatment for higher stages.
Surgery
Doctors call the main surgery a wide local excision. It removes the melanoma, plus a margin of normal skin around it. The width of the margin depends on how thick the melanoma is. Thicker melanomas need a wider margin. For larger removals, you may need a skin graft to close the wound.
Some melanomas need one more step: a sentinel lymph node biopsy, done at the same time as the excision. This finds and removes the first lymph node that drains fluid from the tumor area. That's the node cancer would reach first if it spread. Doctors use a radioactive tracer or dye to find it.
Cancer cells in that node change the stage and the plan. A clear node is reassuring. It's not an absolute guarantee, though.
Stage 0 and I
Doctors also call stage 0 melanoma "melanoma in situ." It stays in the outer layer of skin. Treatment is surgery: removing the abnormal cells, plus a margin of normal tissue. Ask your team whether anything more is planned.
Stage I melanoma gets similar treatment. Surgeons excise it with a margin. Some tumors also need a sentinel lymph node biopsy, depending on thickness and other features.
Stage II
Doctors treat stage II melanoma with excision, usually with a sentinel lymph node biopsy too. Some stage II melanomas carry higher risk. These are thicker or more concerning tumors, even with a clear node. For those, doctors may add immunotherapy with pembrolizumab after surgery. Doctors call this "adjuvant" treatment: added after the main treatment, to lower the odds the cancer comes back.
Stage III
"Resectable" stage III melanoma means the cancer reached nearby lymph nodes, but surgeons can still remove it. Treatment combines several steps. Sometimes doctors give immunotherapy with pembrolizumab first, before surgery. Then comes the excision and lymph node surgery. After that, you may get more immunotherapy — nivolumab, pembrolizumab, or ipilimumab. Some melanomas carry a BRAF gene mutation instead. For those, doctors may give targeted therapy after surgery: dabrafenib plus trametinib, to lower the risk of recurrence.
Advanced or unresectable disease
Sometimes surgeons can't remove stage III melanoma. The same is true for stage IV melanoma, or melanoma that came back. Here, treatment centers on drugs that travel through your whole body, not surgery. Two kinds of drugs lead the way.
Immunotherapy uses checkpoint inhibitors: nivolumab, pembrolizumab, and ipilimumab. Doctors give these alone or combined. They work by releasing the brakes on your immune system's T cells. That lets your T cells attack melanoma cells better. These drugs have clearly improved long-term survival for advanced melanoma.
Targeted therapy works for about half of melanomas: the ones with a BRAF gene mutation. Doctors often call it BRAF V600. A biomarker test on tumor tissue finds this mutation. BRAF inhibitors — dabrafenib, encorafenib, or vemurafenib — usually get paired with a second drug, called a MEK inhibitor. Trametinib, binimetinib, and cobimetinib are the MEK inhibitors in use. NCI reports that the combination improves outcomes over a BRAF inhibitor alone. Side effects differ between the two approaches rather than simply being fewer. Ask your team what to expect from the pairing you are offered. This only applies to BRAF-mutated melanoma. That's why testing for the mutation comes first.
For BRAF-mutated advanced melanoma, ask your oncologist how they are choosing between immunotherapy and targeted therapy for you, and what side effects to expect.
What to ask your team
- Is a sentinel lymph node biopsy right for my tumor?
- Has my melanoma been tested for a BRAF mutation?
- For stage II or III disease: do you recommend treatment after surgery, and why?
- For advanced disease: how are you choosing between immunotherapy and targeted therapy for my case?
Sources
Common questions
How is early melanoma treated?
Early melanoma is usually treated with surgery to remove it along with a margin of normal skin. Ask your team what your stage means for your plan.
How is advanced melanoma treated?
Melanoma that has spread is often treated with immunotherapy, which helps the immune system fight the cancer, and targeted therapy for melanomas with certain gene changes.
What is targeted therapy for melanoma?
Some melanomas have a change in the BRAF gene. Targeted therapy drugs can attack melanomas with these changes, so the tumor may be tested for them.
Is melanoma curable?
Early melanoma is treated with surgery. NCI says immunotherapy has significantly improved survival for advanced melanoma. Ask your team what to expect for your stage.
Questions to ask your doctor
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Last updated: 2026-10-16Next planned review: 2027-07-07
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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