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Surgery for early and medium stage melanoma

Surgery is the main treatment for early and medium stage melanoma. Once a melanoma has been diagnosed, you have an operation called a wide local excision. The surgeon removes the area of skin and tissue around the melanoma. You may have this operation under local anaesthetic. Sometimes the surgeon will do a test called a sentinel node biopsy at the same time. This test checks whether melanoma cells have spread into the nearby lymph nodes. If you have a sentinel node biopsy you have a general anaesthetic

Surgery to nearby lymph nodes

If melanoma has spread into the lymph nodes close to the melanoma your doctor will recommend removing all the lymph nodes in that area. This can be a big operation. It is called lymph node dissection. The surgery will depend on which part of the body the lymph nodes are in.

Surgery for melanoma that has spread

Surgeons can sometimes remove melanomas that have spread to other areas of the body. This is called metastasectomy. If all the metastases can be removed it is called a complete metastasectomy. After this type of surgery people can sometimes stay well for months or perhaps years afterwards.

 

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Types of surgery for melanoma

Surgery is the main treatment for melanoma. You usually have the melanoma removed and doctors check how deeply it has gone into the skin. Most early melanomas are cured with surgery. 

If melanoma has spread into the lymph nodes close to the melanoma you will have the lymph nodes removed. If the melanoma comes back some time after the surgery, you may have a further operation to remove it.

Surgery is also sometimes used to remove melanoma that has spread to other parts of the body but this is not common.

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Surgery for early and medium stage melanoma

Doctors diagnose melanoma by removing a mole or abnormal area of skin. Most melanomas are only in the upper layers of the skin when they are diagnosed and most of them are cured with surgery. 

When you are diagnosed with melanoma, your doctor will ask you to go into hospital for another operation to take away more of the tissue in the area where the melanoma was. This aims to remove any abnormal cells that may have been left behind in the area close to the melanoma. It reduces the chance of the melanoma coming back in the future and is called a wide local excision.

Wide local excision

Your doctor will remove skin and tissue from the area around the melanoma, usually down to the level of the muscle. How much tissue they take will depend on

  • Whether any of the melanoma cells were left behind in the surrounding skin
  • How deeply the melanoma has grown into the tissue beneath the skin
  • The position of the melanoma on the body
  • Whether the surgery will affect your movement afterwards (for example, if the melanoma is close to a joint)

Generally, this is a small operation. The doctor will put in stitches to close up the area where they remove the tissue. This will feel a little tight at first. But as it heals, the surrounding skin will stretch and the tightness should ease.

We have detailed information about surgery for early stage melanoma and surgery for medium stage melanoma in this section.

You usually have a wide local excision under local anaesthetic. But sometimes your surgeon will want to check the nearby lymph nodes at the same time using a test called sentinel lymph node biopsy. Then you will have a general anaesthetic. Sentinel lymph node biopsy is described on the page about further tests for melanoma.

Skin graft

Occasionally, doctors need to remove a large area of skin. If this is the case, you may need to have a skin graft to repair it. This means taking a thin sheet of skin from somewhere else on your body (the donor site) and placing it over the area that has been removed. The donor skin is usually taken from somewhere where it will not be too obvious, such as your inner thigh. At first it looks like a large graze. The skin will grow back quite quickly, usually over a couple of weeks.

The skin graft will be very delicate while it heals. It is vital that the graft is not damaged during this time. You must be very careful not to knock it. And your doctor and nurses will be very careful that your wound does not become infected. You may have antibiotics to take, to help prevent this. Most people having a wide local excision do not need a skin graft. The area heals up perfectly well without one.

 

Surgery to remove lymph nodes

If melanoma has spread into the lymph nodes close to the melanoma your doctor will recommend removing all the lymph nodes in that area. This can be a big operation. It is called lymph node dissection. The surgery will depend on which part of the body the lymph nodes are in.

 

Surgery to remove melanoma that has spread to other parts of the body

Surgery may sometimes be used to remove tumours that have spread to other areas of the body. This is called metastasectomy. It is most commonly used when people have a secondary melanoma tumour in the skin. If all the metastases can be removed it is called a complete metastasectomy. It can't cure the melanoma but after this type of surgery some people can stay well for months or sometimes years afterwards. 

There is information about surgery for advanced melanoma on the treatment for advanced melanoma page.

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Updated: 23 January 2014