NCCN Guidelines for Patients
Melanoma, Version 1.2014
Making treatment decisions
Have a treatment plan
in treating cancer with drugs. A surgeon is an
expert in operations to remove or repair a part
of the body. A radiation oncologist is an expert at
treating cancer with radiation. A dermatologist is an
expert in diseases of the skin. A pathologist is an
expert in testing cells and tissue to find disease. A
dermatopathologist is a doctor who’s an expert in
testing skin cells and tissues for disease.
Your primary care doctor can also be part of your
team. He or she can help you express your feelings
about treatments to the team. Treatment of other
medical problems may be improved if he or she is
informed of your cancer care. Besides doctors, you
may receive care from nurses, social workers, and
other health experts. Ask to have the names and
contact information of your health care providers
included in the treatment plan.
There is no single treatment practice that is best for
all patients. There is often more than one treatment
option, including clinical trials. Clinical trials study
how well a treatment works and its safety. Treatment
planning for melanoma takes into account many
factors, such as:
• The cancer stage,
• Location(s) of the cancer,
• Your general health,
• Treatment side effects,
• Costs of treatment,
• Changes to your life,
• What you want from treatment, and
• Your feelings about side effects.
A guide to melanoma treatment options can be found
in Part 5. The cancer treatment that you and your
doctors agree on should be reported in the treatment
plan. It is also important to note the goal of treatment
and the chance of a good treatment outcome. In
addition, all known side effects should be listed and
the time required to treat them should be noted. See
Part 4 for a list of some of the possible side effects of
Your treatment plan may change because of new
information. You may change your mind about
treatment. Tests may find new results. How well
the treatment is working may change. Any of these
changes may require a new treatment plan.
Stress and symptom control
Cancer and its treatments can cause bothersome
symptoms. The stress of having cancer can also
cause symptoms. Such symptoms may include pain,
sleep loss, and anxiety. Helping you to be comfortable
and stay active are key goals of the treatment plan.
There are ways to treat many symptoms, so tell your
treatment team about any symptoms you have. Some
of the challenges you may face are discussed next.
You may lose sleep before, during, and after
treatment. Getting less sleep can affect your
mood, conversations, and ability to do daily tasks.
If possible, allow yourself to rest, let people do
things for you, and talk with your doctor about sleep
medication. Behavioral sleep medicine—a type of talk
therapy—may also help.
Feelings of anxiety and depression are common
among people with cancer. You may feel anxious
before testing and while waiting for the results.
Likewise, you may have a passing depression during
a hard part of treatment. Feeling distressed may be a
minor problem or it may be more serious. Serious or
not, tell your treatment team so that you can get help
if needed. At your cancer center, cancer navigators,
social workers, and other experts can help. Help can
include support groups, talk therapy, or medication.
Some people also feel better by exercising, talking
with loved ones, or relaxing.