Adjuvant treatment after melanoma surgery

It is considered when melanoma has been removed but clinical and pathology features suggest that microscopic cancer cells could remain elsewhere. Treatment is directed at this unseen risk rather than at a visible tumour. The decision is individual and balances the expected benefit against side effects and the option of close surveillance.

The oncology team reviews the original melanoma, surgical pathology, lymph-node findings, imaging when relevant, general health and any molecular test results that may guide therapy. Adjuvant immunotherapy helps the immune system recognise and attack melanoma cells. Some melanomas with a specific molecular change may have an additional targeted-treatment option.

A recommendation for adjuvant therapy does not mean a scan has found active cancer. It means the team considers recurrence risk high enough to discuss treatment after complete removal. Observation with structured follow-up can also be a reasoned choice in some circumstances.

Bring your pathology and operation details to the oncology visit if they are not already available. Tell the team about autoimmune disease, organ transplantation, pregnancy plans, regular medicines and previous reactions to cancer treatment. Ask which treatment is proposed, how it is given, what monitoring is planned and how side effects would be managed.

Keep appointments for clinical examinations, blood tests and imaging arranged by the team. Record new symptoms and when they began instead of waiting for the next routine visit. Do not start supplements or immune-altering medicines without checking whether they could interfere with treatment or mask a side effect.

Contact the oncology service promptly for new or worsening diarrhoea, severe abdominal pain, yellowing of the eyes or skin, persistent cough, shortness of breath, marked weakness, severe headache, confusion, vision change or a widespread blistering rash. Immunotherapy can inflame healthy organs, and early assessment can prevent a problem from becoming more serious.

Use emergency services for severe breathing difficulty, collapse, a seizure, sudden weakness on one side, or rapidly worsening confusion. Between visits, also report a new lump, unexplained persistent pain or a changing skin lesion so the team can decide whether earlier examination is needed.

Ask how your pathology and lymph-node findings affect the recommendation, what alternatives exist, and what would happen if you chose surveillance. Clarify which side effects require a same-day call, whether an emergency information card is provided, how treatment may affect fertility or other medical conditions, and who coordinates skin checks with oncology follow-up.