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Most people with melanoma have chemotherapy in an outpatient part of the hospital, at the doctor's office, or at home. You might go to a special chemotherapy-only clinic. Depending on which drugs you receive and your general health, you might stay in the hospital during treatment. You can take chemotherapy in pill form, by injection, or in more than one way. For melanoma, intravenous (IV) injection is most common.
You get chemotherapy in cycles over a period of time. That means you may take the drugs for a set amount of time and then you have a rest period. Each period of treatment and rest is one cycle. And you may have several cycles. Having chemotherapy in cycles helps in these ways:
The drugs kill more cancer cells because all cells aren't all dividing at the same time.
Your body gets a rest from the chemotherapy. Treatment damages quickly dividing normal cells, too, such as those in the lining of your mouth or stomach.
You get an emotional break between treatments.
These are chemotherapy drugs that doctors often use for melanoma:
Temodar, Temodal (temozolomide)
It's important for you to know which drugs you're taking. Write your drugs down, ask your doctor how they work and what side effects they might have, and keep a written diary of your regimen.
For melanoma, you may get more than one drug, which is called combination therapy. This may lower the chance that the cancer will develop a resistance to one drug, although for melanoma it's not clear if this is better than using just one drug. Combination therapy can include several days of treatment given every three to four weeks. But the schedule varies for each person. Which drugs you get and how often you get them depend on many factors, including your general health.
If you are having chemotherapy, you may have it combined with immunotherapy. Doctors sometimes call this biochemotherapy.
If the melanoma is located on a leg or arm, you may also get the chemotherapy drugs by isolated limb perfusion. This procedure involves surgery and injection of a high dose of chemotherapy in the limb where the cancer has recurred. The doctor temporarily cuts off the circulation to the affected arm or leg while anticancer drugs go directly into the bloodstream of that limb. The doctor inserts a catheter to withdraw blood from the limb. Then the doctor transfers the blood to a machine, where it mixes with oxygen and chemotherapy drugs. The drugs can be given at higher doses because they do not reach the rest of the body. The temperature of the blood goes up as well to improve the success of the treatment. The doctor uses another catheter to return the treated blood to your limb. The whole procedure takes about two to three hours.