Melanoma

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Duke melanoma experts use the latest advances to diagnose and treat melanoma, the most aggressive type of skin cancer. Melanoma is curable if caught early and treated effectively but can spread quickly to lymph nodes and other parts of the body. Our melanoma specialists use novel treatments to control the spread and minimize the risk that it will return.

We are the first in North Carolina and among the few hospitals in the country offering a new, FDA-approved cell therapy called Lifileucel (Amtagvi) to treat metastatic melanoma that has not responded to other treatments.

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Melanoma Tests

Duke melanoma experts use the latest diagnostic tools to detect melanoma at the earliest stage possible. These tests provide important information about your melanoma and help determine the best approach to your treatment.

Physical Exam

Melanoma is typically first identified during a physical exam. A dermatologist may use a high-powered microscope called a dermatoscope to closely examine a suspicious area.

Total Body Photography

If you have several moles on your body or a family history of melanoma, our dermatologists may use mole-mapping technology to take sequential photographs of your body from multiple angles over time. The photographs allow your dermatologist to track changes in your skin and evaluate your risk for melanoma.

Biopsy

If melanoma is suspected, a sample of skin will be removed and examined for cancer. The type of biopsy you have will be determined by how deep your doctor believes the melanoma has penetrated. A shave biopsy takes less skin, while a punch biopsy goes deeper into the skin.

Surgical Biopsy

This biopsy removes a much larger section of skin, the melanoma, and surrounding tissue to confirm the diagnosis and stage the cancer. This procedure can also be used to ensure that the cancer has been completely eliminated. Your doctor may also perform a sentinel node biopsy, in which the lymph node closest to the tumor is removed and examined for cancer. If it's cancer-free, it means the tumor has not spread to your lymph nodes.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

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Melanoma Treatments

Your doctor will develop your treatment plan based on the location of your melanoma, how deeply it has penetrated your skin, and whether it has spread to other parts of your body.

Surgery

Surgery to remove the tumor and surrounding normal tissue may be the only treatment necessary for small melanomas that are detected early.

Lymph Node Removal

If a sentinel node biopsy reveals the presence of tumors, surgery may include removal of lymph nodes or tumors that have spread.

Immunotherapy

This type of therapy is given intravenously to boost the body’s immune system and help it identify and destroy melanoma. We use a variety of immunotherapies to prevent cancer from recurring. They are also used to treat advanced melanoma in people who are not candidates for surgery. You may be eligible to participate in clinical trials that evaluate if combinations of these therapies with other medications may extend survival or boost the drugs’ ability to attack melanoma.

Medication for Targeted Gene Therapy

Your tumor’s genetic makeup will determine if you are eligible for targeted therapies that focus on genes known to affect melanoma cancer growth. These genes include the BRAF gene, which is linked to nearly half of all melanoma. Treatment is a daily pill. You may also be eligible to participate in clinical trials investigating new targeted therapies that are not yet widely available.

Tumor Infiltrating Lymphocyte (TIL) Therapy

Immune cells from patient’s own tumor are isolated and then infused back into the patient. This therapy can be effective in advanced melanoma that has not responded to other therapies.

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Treating Locally Advanced Melanoma

Some forms of melanoma return as multiple lesions on the skin that cannot be removed. This condition is called satellite or in-transit disease and is treated with medications often used to treat skin cancer. Duke specializes in this kind of treatment, which may also include immunotherapy or targeted gene therapy.

Intralesional Therapy

During outpatient visits to our clinic, your doctor will use a needle to inject a high concentration of medication directly into your tumor to kill tumor cells. Depending on the severity of your melanoma, you'll receive an injection every two to three weeks until the tumor is gone.

Regional Chemotherapy

A high dose of chemotherapy is delivered only to the affected area through a catheter placed in a vein or under your skin. This is an outpatient, one-time treatment and is used with other therapies.

Radiation Therapy

Precision X-rays destroy cancer cells or shrink tumors. This outpatient procedure can reduce pain. It may be used with surgery to prevent cancer from recurring or to treat cancer that has spread.

Skin Grafting and Reconstructive Surgery

After a cancer is surgically removed, you may need a skin graft or rotational flap procedure. Healthy skin is taken from another part of your body and used to cover wounds, promote healing, and restore your skin’s appearance. The site may take three weeks to heal.

Leaders in Melanoma Treatment and Research

The Duke Cancer Institute
The Duke Cancer Institute brings together the extensive resources of Duke University, Duke Health, and the Duke Comprehensive Cancer Center. We are committed to making innovative discoveries, developing new ways to prevent, diagnose, and treat cancer, and delivering those therapies in a patient- and family-centric way.

Your Melanoma Team
Your team of doctors may include dermatologists, medical oncologists, surgical oncologists, radiation oncologists, otolaryngologists (ear, nose and throat doctors), plastic and reconstructive surgeons, and oculoplastic facial surgeons. They work together to identify the most effective treatment to ensure you experience the best possible outcome.

Expertise in Head and Neck Melanoma
Our experienced ear, nose, and throat surgeons are specially trained in removing melanoma on the head and neck.

Ocular Melanoma Treatment Options
Our ophthalmologists are experts in detecting and treating melanoma that occurs around or near the eye. For metastatic ocular melanoma, we offer the most up-to-date therapies, including immune-mobilizing monoclonal T-cell receptors against cancer (ImmTAC), and clinical trials. We also have extensive expertise in performing percutaneous liver perfusions and other liver directed therapies for ocular melanoma which has spread to the liver.

Compassionate Care for Pediatric Melanoma
If your child is diagnosed with melanoma, we make the treatment process as easy as possible. Appointments with your oncologist and dermatologist can be conveniently scheduled at the same time and location, and a child life specialist will be present to ensure your child feels comfortable.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2025–2026.

You May Be Eligible to Participate in Clinical Trials
Our involvement in clinical trials offers hope to people with advanced melanoma as well as people at high risk for recurrent melanoma. You may be eligible to participate in these trials, which may give you access to therapies that are not widely available.

Top-Ranked Care
We are part of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers dedicated to improving care for people with cancer.

Treatment of Secondary Melanoma
When melanoma has spread to the bone, brain, or spine, Duke experts use advanced medical and surgical treatments to extend and enhance the lives of people who need specialized care.

Comprehensive Support
You’ll have access to our many cancer support services including education and resources that help you understand your diagnosis, make decisions about treatment, and manage any side effects. We also help you and your family cope with the emotional impacts of your diagnosis and treatment.

Patient Resources

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This page was medically reviewed on 10/16/2025 by

Georgia M. Beasley, MD, MHSc | Surgical Oncologist