The management of metastatic melanoma

Surgery is of significant benefit in regional metastases and in selected cases of solitary visceral metastasis. The chief use of radiotherapy is in central nervous system and osseous metastases. Chemotherapy and immunotherapy have, to date, been disappointing but perhaps have more hope for the future. It is important, however, that management is balanced, and that patients are not submitted to toxic and distressing regimes on the basis of unrealistic hopes.