Surgical Procedures for Melanoma

This page discusses the use of surgical procedures for the treatment of melanoma. For a thorough review of surgical procedures, please see the ]]>surgical procedures treatment monograph]]> .

Surgery is the initial procedure in the treatment of many cancers. Surgery and other invasive procedures work by removing cancerous tissues.

Surgical removal of the cancerous tissue is the primary treatment for melanoma. While the doctor may remove the entire suspicious lesion during a biopsy, it is very important to return for additional surgery if melanoma is found. Failing to follow up to remove surrounding tissue has resulted in the cancer returning in as many as 40% of patients.

Melanoma Removal

The extent of the procedure depends on the stage of the cancer. Types of surgery include the following:

Simple excision – thin melanomas can usually be completely cured with this relatively minor surgery. The tumor is cut out, along with a small amount of normal, noncancerous skin at the edges. The wound is stitched back together and usually leaves a scar.

Wide excision – this procedure is usually done when a melanoma diagnosis has already been made by a biopsy. More skin is cut away from the site to make sure no more cancer cells remain in the skin.

Amputation – if melanoma is present on a finger or toe, it may be necessary to amputate the cancerous part of that digit.

Therapeutic lymph node dissection – if the cancer is found to have spread to nearby lymph nodes, the nodes in that area usually will be surgically removed.

Depending on how extensive the melanoma removal proves to be, the area may be closed with stitches, or may require a skin graft for repair. A skin graft is the removal and transplantation of healthy skin from one area of the body (source area or donor site) to another area (recipient area) where the skin has been damaged. Stitches are usually removed about 10 days after surgery.

Effectiveness

Surgery offers the best chance of a cure for melanoma. If caught at an early stage, more than 90% of patients survive five or more years. Surgery is not effective if the cancer has already spread to other parts of the body.

Possible Complications:

Surgical wound infection
Incomplete removal of all cancerous cells
Lymphedema (fluid accumulation, usually in an arm or a leg); a possible complication of removal of lymph nodes under the arm or in the groin.
Recurrence or spread of cancer can occur despite surgical removal of the melanoma, but surgery is not thought to cause spread or recurrence.
Nerve damage
Scarring

Postoperative Care:

Keep the surgical area clean, dry, and protected by bandages; you can wash it gently with mild soap
Your doctor may recommend applying a non-prescription antibiotic ointment to the wound before applying bandages
Your doctor may prescribe medication for pain or antibiotics to prevent infection
Avoid vigorous exercise according to your doctor's recommendations

Call Your Doctor if Any of the Following Occurs:

Signs of an infection, including fever and chills
Redness, swelling, increased pain, excessive bleeding, or discharge from the incision site
A new lump or discoloration in your skin, or a change (such as color, bleeding, itching, growth) in an already-existing mole, either at the surgical site or in a new location

Sources:

American Cancer Society

American Society for Dermatologic Surgery

National Cancer Institute

Last reviewed February 2003 by ]]>Donald Lawrence, MD]]>

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.