What’s the Best Approach to Treating Stage IV Melanoma?

Lilit Karapetyan, MD, MS, FACP Moffitt Cancer Center With stage IV metastatic melanoma, the cancer has spread to distant body regions, mostly the liver, lungs, bones, gastrointestinal tract, and brain. Your doctor will examine two factors to determine how advanced stage IV melanoma has become. One is the location of the distant tumors. The second factor is an elevated serum lactate dehydrogenase (LDH) level, an enzyme responsible for turning sugar into energy. The higher the LDH level in body fluids, the more damage the cancer has done. Treatments for Stage IV Metastatic Melanoma The primary tumor and any enlarged lymph nodes to which the cancer has spread may be surgically removed or treated with radiation to treat stage IV melanoma. Cancer that has metastasized to internal organs may also be surgically removed, depending on whether the tumors are causing symptoms, where the tumors are located, and how many tumors have formed. Treatment options for metastases that cannot be removed include radiation therapy, chemotherapy, immunotherapy, or targeted therapies.