Melanoma, from the CureRays guide library.

Melanoma is a serious skin cancer that begins in pigment-making cells; found early it is almost always curable, and new medicines have transformed advanced disease.

What it is.

Melanoma starts in melanocytes, the cells that give skin its color. It can appear as a new spot or a change in an existing mole, and unlike more common skin cancers it can spread to other parts of the body if not caught early. The encouraging news is twofold: most melanomas are found early and cured by simply removing them, and for the minority that spread, immunotherapy and targeted drugs have dramatically improved survival over the past decade. Sun exposure and tanning beds are major, preventable risk factors.

How radiation treats it.

Radiation uses focused high-energy x-rays to damage cancer-cell DNA so the cells can no longer divide. While surgery is the mainstay for most melanoma, radiation is a valuable tool for specific situations, delivered with image guidance that concentrates the dose on the target and protects surrounding tissue. For melanoma in the brain, stereotactic radiosurgery treats spots with millimeter precision. Treatments are painless and brief; side effects depend on the area treated and are usually localized and temporary.

The ways we can treat it.

Adjuvant nodal radiation. Targeted radiation to a lymph-node region after surgery can reduce the chance the melanoma returns there when the risk is high.

Stereotactic radiosurgery (SRS). Highly focused radiation precisely treats melanoma that has spread to the brain in one or a few sessions, often combined with immunotherapy.

Radiation for lentigo maligna / non-surgical cases. When surgery is difficult — for example, large facial lentigo maligna in older patients — focused radiation can be an effective alternative.

Questions we hear often.

How do I spot melanoma early? Watch for the ABCDEs of a mole: Asymmetry, Border irregularity, Color variation, Diameter larger than a pencil eraser, and Evolving or changing over time. Show any new or changing spot to a clinician.

Does melanoma get treated with radiation like other skin cancers? Usually not first — melanoma is mainly removed surgically. Radiation is reserved for specific situations, such as high-risk lymph nodes, brain spread, or tumors that are hard to remove.

Is advanced melanoma still a death sentence? No. Immunotherapy and targeted drugs have dramatically improved outcomes, and many people with advanced melanoma now live for years, some with no detectable disease.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.