39 NCCN Guidelines for Patients ® : Melanoma, 2018 4 Overview of melanoma treatments Surgery Order of treatments Most people with melanoma will receive more than one type of treatment. When and why treatments are given can be hard to understand. Part 5 gives full details. Here, the terms that describe the order of treatments are explained. Neoadjuvant treatment Treatment given to shrink the tumor before surgery. This may be used for metastatic melanoma to shrink the tumor before surgery. This treatment is mostly given in clinical trials. Primary treatment The main treatment given to rid the body of cancer. Surgery is most often used as the primary treatment for melanoma. Adjuvant treatment Treatment given after primary treatment to kill any remaining cancer cells.