NCCN Guidelines for Patients® | Melanoma - page 79

NCCN Guidelines for Patients
Melanoma, Version 1.2014
observation with follow-up tests. If all of the cancer
wasn’t removed by surgery, then you will receive
treatment for widespread metastatic disease, which is
described next.
For widespread metastatic disease,
the first step
is to assess for metastases in your brain. If you
have brain metastases, then you will likely receive
treatment for the cancer in your brain first to try to
prevent other serious medical conditions. This may
include surgery and/or radiation therapy. (For more
information on treating cancer in the brain and spinal
cord, see the NCCN Guidelines for Central Nervous
System Cancers. These guidelines are online at They were written for your doctor, so he or
she will likely be able to answer your questions about
After treating the brain metastases, you can move
on to the main treatment options for widespread
metastatic disease. These options are the same
regardless of brain metastases.
There are four main options for treating widespread
metastatic disease. Options include systemic therapy,
treatment within a clinical trial, or best supportive
care. Systemic therapy options are listed in Chart 6
on page 81. Your doctor may also consider surgery
or radiation therapy to treat any symptoms caused by
the cancer. Treatment for symptoms—called palliative
treatment—can be given alone or in addition to the
other options.
For more treatment details, read Part 4 on page
Principles of radiation therapy
on page 79, or
Principles of systemic therapy
on page 80.
Next steps:
For recommended follow-up tests after
completing treatment for metastatic
melanoma, see Chart 5.5.3. 
Treatment guide
Metastatic melanoma
1...,69,70,71,72,73,74,75,76,77,78 80,81,82,83,84,85,86,87,88,89,...108
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