Before you undergo surgical treatment to remove the skin around the primary melanoma, sentinel lymph node biopsy (SLNB) is recommended for all patients with Stage II melanoma. The purpose of SLNB is to determine whether any cancer cells have spread to the sentinel node, the first lymph node to receive drainage from the primary tumor. The results of the biopsy will guide the course of treatment. Sentinel node biopsy is most accurate when it is performed before surgery to remove the tumor and the surrounding skin. (See Lymph Node Evaluation for more information.)

• Surgery is the most common treatment for Stage II melanoma. The goal of surgery is to remove any cancer remaining after the biopsy. The procedure is called wide local excision. The surgeon removes the tumor, including the biopsy site, as well as a surgical margin, a surrounding area of normal-appearing skin and underlying subcutaneous tissue. The width of the margin taken depends upon the thickness of the primary tumor. Recent advances in surgery allow surgeons to take narrower margins than before, so a much greater amount of normal skin is preserved. (See Surgery for more information.)
• Adjuvant therapy, a treatment given in addition to a primary cancer treatment, is recommended following surgery for Stage IIB and Stage IIC melanoma. Systemic therapies use substances that travel through the bloodstream to reach and affect cancer cells throughout the body. Established treatments include interferons, natural proteins produced by the normal cells of most body tissues in response to viral infections and disease. Interferon therapies have been shown to help the body's immune system fight disease more effectively. Studies indicate that low-dose interferon alfa-2a, a manufactured form of interferon, consistently delays relapse in patients with Stage II melanoma and higher-risk Stage IIB disease, but does not extend overall survival. High-dose interferon alfa-2b has been shown to significantly prolong disease-free and overall survival in patients with high-risk Stage IIB and Stage III melanoma.
• A variety of experimental vaccines are under evaluation. Like interferons, they may help boost the immune system to fight the return of melanoma. Clinical trials for Stage II melanoma are investigating how vaccines work to produce immune responses. Vaccine therapy is also being investigated as a therapy for patients who cannot tolerate the side effects of immunotherapies, such as interferon. Vaccines have not yet been shown to extend overall survival in any randomized, controlled trials for any stage of melanoma. (See Biological Therapy for more information on immunotherapy and vaccine therapy.)

See also Follow-Up Management: Stage II.

About Clinical Trials

Clinical trials are research studies to evaluate new therapies and improve cancer care. These studies are responsible for most of the advances in cancer prevention, diagnosis, and treatment. If you have melanoma, you may be eligible to participate in a clinical trial.

See Clinical Trials to learn more about these studies, or go directly to the Stage II Clinical Trials list.