KEYTRUDA for advanced melanoma

How is melanoma diagnosed?

It is possible to detect the early signs of melanoma by self-examination; checking regularly for changes in spots, freckles and moles. If anything irregular stands out (a variation in colour, size, shape or sensitivity) the next step is to see a doctor.

The doctor will conduct a physical examination, and possibly a biopsy. They will also ask about any personal or family history with melanoma. They may use a dermascope (a magnifying device) to examine the skin, and feel the lymph nodes near the suspicious spot or mole.

Having a biopsy

If the doctor suspects it is melanoma, they'll take a biopsy to remove the mole, so it can be sent to a pathology laboratory to be examined under a microscope. This is usually a straightforward procedure, and the waiting period is usually about a week before the results come back. If the tests show it is melanoma, surgery may be required to remove a wider margin of surrounding skin.

Other tests

If it is melanoma, the doctor may recommend other tests, such as:

  • blood tests: to check general health
  • a chest X-ray: to see if it's spread to the lungs
  • scans: to see if it's spread to other parts of the body
  • fine needle aspiration: inserted into the lymph nodes, to see if they contain melanoma cells.

The stages of melanoma

  • Stage 0 — (melanoma in situ) abnormal cells are found in the epidermis
  • Stage 1 — the melanoma is not more than 2mm thick
  • Stage 2 — more than 2 to 4mm thick with no spread to the lymph vessels or nodes
  • Stage 3 — any thickness that has spread to lymph vessels or lymph nodes
  • Stage 4 — the melanoma has spread to other parts of the body

Knowing the stage helps doctors plan suitable treatment.

What is the prognosis?

If treated in its early stages, melanoma is more likely to be cured. Over 85% of people diagnosed with early stage melanoma 15 years ago are alive today with no sign of the disease. This percentage has grown steadily over the years with early detection and treatment.

Each patient should talk to their doctor about their own prognosis, as each medical history is unique. As a rule - melanomas on the limbs have a better prognosis than those on the trunk, head or neck.

Treating melanoma

Questions to ask your doctor about melanoma

Who can I talk to?


KEYTRUDA (pembrolizumab) 50mg powder for infusion
KEYTRUDA is a Prescription Only Medicine Use: KEYTRUDA is used:
  • in the treatment of melanoma which cannot be removed by surgery alone or when it has spread to multiple sites in the body.
  • in the treatment of a kind of lung cancer called non-small cell lung cancer (NSCLC).
  • in the treatment of classical Hodgkin Lymphoma (cHL)
  • in the treatment of urothelial carcinoma, including bladder cancer
  • in the treatment of a kind of head and neck cancer called head and neck squamous cell carcinoma (HNSCC)

Side effects: Immune-mediated side effects including inflammation of the lungs, colon, liver, kidneys, pituitary gland, brain, eye, muscles, nervous system, pancreas, and heart, thyroid disorders, type 1 diabetes mellitus. Severe skin reactions including Steven-Johnson syndrome and toxic epidermal necrolysis. Severe infusion reactions including hypersensitivity and anaphylaxis. Transplant recipients: rejection of a transplanted organ, graft-versus-host-disease (in people with a bone marrow transplant using donor cells). Very common side effects include diarrhea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of discoloured skin, stomach pain, decreased levels of sodium in blood. Tiredness, nausea, vomiting, diarrhea, constipation, shortness of breath, rash, itching, headache, hair loss, and, infections of the upper respiratory tract were reported when given in combination with chemotherapy. You may experience more than one side effect at the same time.

All medicines have risks and benefits. Talk to your doctor to see if KEYTRUDA is right for you. KEYTRUDA is a funded medicine for melanoma patients– restrictions apply. KEYTRUDA is an unfunded medicine for NSCLC, HNSCC, cHL and urothelial carcinoma patients. Ask your health professional the cost of the medicine and any other medical fees that may apply. Use only as directed and if symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

Based on data sheet prepared 17 July 2018. Marketed by: Merck Sharp & Dohme (New Zealand) Limited, Newmarket, Auckland. . For additional product information, consult the Consumer Medicine Information (CMI), available on request, phone 0800 500 673 or refer to the Medsafe website

This site is intended for New Zealand residents.

References to support this are available on request.

MSD recommends people always seek the medical advice of their healthcare professional.

Copyright © 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey, USA. All rights reserved.

Copyright © 2018 Merck Sharp & Dohme (New Zealand) Limited. Level 3, 123 Carlton Gore Road, Newmarket, Auckland. All rights reserved.

ONCO-1273154-0000 First Issued November 2017 TAPS NA10076 essence MSD8360

Updated: October 2018