Booklet: What You Need to Know about Melanoma

Side Effects of Treatment

Doctors plan treatment to keep side effects to a minimum. For example, to avoid causing large scars, they remove as little tissue as they can without increasing the chance of recurrence. In general, the scar from surgery to remove an early stage melanoma is a small line (often 1 to 2 inches long), and it fades with time. How noticeable the scar is depends on where the melanoma was located, how well the person heals, and whether the person develops raised scars called keloids. When a tumor is large and thick, more surrounding skin and tissue (including muscle) are removed. Although skin grafts reduce scarring from the removal of large growths, these scars will still be quite noticeable.

Surgery to remove the lymph nodes from the underarm or groin may damage the lymphatic system and slow the flow of lymph in the arm or leg. Lymph may build up in a limb and cause swelling (lymphedema). The doctor or nurse can suggest exercises or other ways to reduce swelling if it becomes a problem. Also, it is harder for the body to fight infection in a limb after nearby lymph nodes have been removed, so the patient will need to protect the arm or leg from cuts, scratches, bruises, or burns that may lead to infection. If an infection does develop, the patient should see the doctor right away.

Although doctors plan chemotherapy, biological therapy, and radiation therapy very carefully, it is hard to limit the effects of these treatments so that only cancer cells are destroyed. Because healthy cells also may be damaged, cancer treatment often causes unwanted side effects.

The side effects of cancer treatment depend mainly on the type and extent of the treatment. Also, they may not be the same for each person, and they may even change from one treatment to the next. Doctors and nurses can explain the possible side effects of treatment, and they can help relieve symptoms that may occur during and after treatment.

The side effects of chemotherapy depend mainly on the drugs and the doses received. In addition, as with other types of treatment, side effects vary from person to person. Generally, anticancer drugs affect cells that divide rapidly. These include blood cells, which fight infection, help the blood to clot, or carry oxygen to all parts of the body. When blood cells are affected, people are more likely to get infections, may bruise or bleed easily, and may have shortness of breath and less energy. Cells in hair roots and cells that line the digestive tract also divide rapidly. As a result, people may lose their hair and may have other side effects, such as poor appetite, nausea and vomiting, or mouth sores.

Usually, these side effects go away gradually during the recovery periods between treatments or after treatment is over. However, some side effects may continue even after chemotherapy is over. The National Cancer Institute booklet Chemotherapy and You has helpful information about chemotherapy and coping with side effects.

The side effects caused by biological therapy vary with the type of treatment. These treatments may cause flu-like symptoms, such as chills, fever, muscle aches, weakness, loss of appetite, nausea, vomiting, and diarrhea. Patients may also have bruising, skin rashes, swelling, or shortness of breath. These problems can be severe, but they go away after the treatment stops.

The side effects of radiation therapy depend on the amount of radiation given and the area being treated. Side effects that may occur during treatment include fatigue and hair loss in the treated area. Although the side effects of radiation therapy can be unpleasant, the doctor can usually treat or control them. It also helps to know that, in most cases, side effects are not permanent. The National Cancer Institute booklet Radiation Therapy and You has helpful information about radiation therapy and managing its side effects

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