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Chemotherapy (chemo) is the use of drugs to treat cancer. The drugs can be injected into a certain part of the body (such as the liver), or they can be injected into a vein (through an IV line) or taken by mouth (as a pill) to reach most of the body, making this treatment very useful for many types of cancer that have spread. Unfortunately, chemo is usually not as helpful for melanoma as it is for some other types of cancer, but it can shrink tumors in some people.

Chemo might be an option if uveal (eye) melanoma has spread to other parts of the body, although other treatments such as immunotherapy or targeted drugs might be tried first. If chemo is an option, the drugs used are generally the same as for melanoma of the skin. For more information, see Chemotherapy for Melanoma Skin Cancer.

For uveal melanoma that has spread to the liver and can't be removed with surgery, your doctor may suggest that you get chemo directly into your liver through a main artery in the liver, called the hepatic artery. An example of chemo that can be given this way is melphalan. This type of treatment, called “liver-directed” treatment, is usually only an option if the cancer affects less than half of the liver and there are no other places of cancer in the body (or if there are, those areas can be treated with either surgery or radiation).

Possible side effects of chemo

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are likely to be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given, how they are given, and the length of time they are taken. The side effects of systemic chemo can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation
• Increased chance of infections (from having too few white blood cells)
• Easy bruising or bleeding (from having too few blood platelets)
• Fatigue (from having too few red blood cells)

These side effects usually go away after treatment is finished. There are often ways to lessen these side effects. For example, there are drugs to help prevent or reduce nausea and vomiting. Some drugs may also have specific side effects not listed above. Be sure to ask your doctor or nurse about medicines to help reduce side effects, and let them know when you do have side effects so they can be managed.