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Melanoma: Chemotherapy

What is chemotherapy?


When might chemotherapy be used for melanoma?

Chemotherapy is sometimes used to treat advanced melanomas. But it is not used as often as it was in the past because newer types of medicines seem to be more helpful. Examples are immunotherapy and targeted therapy. Chemotherapy is most often used to treat advanced melanomas if other treatments are no longer working.

How is chemotherapy given for melanoma?




  • Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of the mouth and intestines. This causes side effects, such as sores and nausea. Between cycles, your body can get a rest from the chemotherapy.


What types of medicines are used to treat melanoma?

Chemotherapy medicines used to treat melanoma include:

  • Dacarbazine (DTIC)

  • Nab-paclitaxel

  • Carboplatin

  • Cisplatin

  • Paclitaxel

  • Docetaxel

  • Temozolomide

  • Vinblastine

  • Fotemustine

  • Lomustine

For melanoma, you may get just one medicine or more than one medicine. This is called combination therapy. The schedule of treatment varies for each person. Which medicines you take and how often you take them depend on many factors, such as your general health.


What are common side effects of chemotherapy?

Side effects of chemotherapy depend on the type and amount of medicines you’re taking. They vary from person to person. Some common temporary side effects from chemotherapy include:

  • Loss of appetite, nausea, and vomiting

  • Infections from low white blood cell counts

  • Easy bruising or bleeding from low blood platelet counts

  • Fatigue from low red blood cell counts


  • Constipation or diarrhea

  • Hair loss

  • Mouth sores 

  • Skin changes



Chemotherapy through isolated limb perfusion (ILP)

If the melanoma is on a leg or arm, you may also get the chemotherapy medicine by isolated limb perfusion (ILP). This procedure may shrink the tumor and help prevent amputation. It may also relieve symptoms, such as pain and swelling.

How ILP is done

ILP combines surgery and medicine. First the surgeon temporarily stops the blood circulation to the affected arm or leg. Keeping the blood in the limb stops high doses of chemotherapy medicine from traveling around the body and affecting other organs.

Then 2 small tubes called catheters are put into the limb. One is put in an artery and one is put in a vein. Blood from the vein goes into a machine called a pump-oxygenator. This machine is like the one used in heart bypass surgery. There the blood is mixed with oxygen and chemotherapy medicine. Melphalan is the most common medicine used for this. The blood is then sent to the limb through the artery. 


How ILP may help

The main advantage of ILP is that it lets high doses of chemotherapy medicine be given to the affected limb. But it spares the rest of the body from the medicine’s side effects. Side effects are mostly limited to the limb, such as limb swelling.

But ILP also has a few drawbacks. For one, it is a major procedure. Also it does not affect any cancer that has spread beyond the limb. And while this procedure can often shrink tumors, it may not improve long-term survival better than other treatments.

Working with your healthcare provider




Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Lu Cunningham
Online Medical Reviewer: Michael Lehrer MD
Date Last Reviewed: 3/1/2019
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