Adjuvant Treatment

What is it?

Adjuvant treatment is any additional treatment that is given after your melanoma has been surgically removed and no visible melanoma has been left behind or can be seen on a scan. The aim of adjuvant treatment is to try to stop the melanoma from returning after your operation. It may be, however, that your melanoma will not return without further adjuvant treatment, however, there is always a risk that your stage III melanoma could return. Currently, we can’t predict which patients require adjuvant treatment to ensure they are given the best chance of an overall cure. You and the oncologist will need to consider the possibility of preventing the melanoma from returning against the potential side effects of the adjuvant treatment.

In order to know whether an adjuvant treatment will increase the chance of patients being ‘cured’ of their melanoma, it is important to follow-up patients for some years after their treatment. We currently don’t have such a long follow-up of all patients, however, we do have evidence that there is a reduction in the local and distant recurrence of the melanoma returning and some early evidence of an improvement in cure rates. It is very much thought that the reduction in local recurrence is linked to cure. There are three treatment options that have been assessed and are approved in the UK.

  • Dabrafenib and Trametinib
  • Pembrolizumab
  • Nivolumab

The effect of adjuvant treatment on your day-to-day life will depend on the type of treatment you are receiving and a number of other factors, including your general health and any side effects or complications you might experience. Treatment is for a year for all of the treatment options; one treatment is an oral regimen and the other two are given intravenously (via a drip) usually in hospital. Some people may carry on almost as normal, whilst others may feel quite unwell and unable to work or socialise during their treatment. It is important that you discuss the balance of the side-effects with the benefits of treatment with your oncologist.

For further information, please see individual treatment options below:

Values you may wish to consider during treatment

    • Is the most important thing to you having treatment that gives you the best chance of curing your melanoma?
    • How prepared are you to have a treatment that has a potential risk of causing serious side effects or complications?
    • How prepared are you to have a year of treatment?
    • Is it important to you whether you have oral treatment or treatment in hospital?
    • How much time are you prepared to spend in hospital having treatment?
    • How much do you want to avoid having a visible scar after treatment?
    • How important is it to you to know everything about your risk of future melanoma?
    • How important is it to you to maintain living an active lifestyle, taking into account your daily activities and hobbies?
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