Melanoma Removal Overview

Melanoma removal is a surgery to remove skin tissue that has cancerous cells. The cancer is called melanoma .

Melanoma © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Depending on the stage of the disease, your doctor will likely do the following:

• Physical exam of skin
• Biopsy of any suspicious lesion
• Chest x-ray —uses radiation to take a picture of the chest
• Blood tests
• Imaging studies with CT scan , MRI , or PET scan
• Sentinel lymph node biopsy —to find out if the cancer has spread

Anesthesia

Local anesthesia is often used to numb the area where the cancer is removed. General anesthesia may need to be used if the area is large. In this case, you will be asleep.

Description of the Procedure

Surgical removal of the cancerous cells is the primary treatment for melanoma. Types of surgery include:

• 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—More skin is cut away from the site to make sure no cancer cells remain in the skin.
• Amputation—If melanoma is present on a finger or toe, it may be necessary to cut off the cancerous part of that digit.
• Lymph node dissection—If the cancer has spread to nearby lymph nodes, some of those nodes will be surgically removed for laboratory exam.

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. Stitches will be removed about 7-14 days after surgery, depending on the site and extent of excision.

After Procedure

The removed tissue will be examined by a laboratory.

In more advanced cases of melanoma, other treatments may be necessary. These include:

• Chemotherapy (using drugs to kill cancer cells)
• Radiation therapy (using radiation to kill cancer cells)
• Immunotherapy (which uses the body's immune system to kill cancer cells)
• Biological therapy (eg, gene therapy, tumor vaccines, monoclonal antibodies)

How Long Will It Take?

This depends on the extent of the melanoma and the type of surgery. Simple excision can take less than one hour.

Will It Hurt?

Anesthesia prevents pain during the procedure. You may have some pain around the wound during recovery. You will be given medicine to help manage pain.

Postoperative Care

• Keep the surgical area clean, dry, and protected by bandages. Wash it gently with mild soap.

• If recommended by your doctor, apply a nonprescription antibiotic ointment to the wound before applying bandages.

• If prescribed, take pain medicine and antibiotics.

• Avoid vigorous exercise according to your doctor's recommendations .

• Return to have any stitches or staples removed when instructed.

Talk to your doctor about appropriate ways to protect your skin against sun damage. These may include using sun block and wearing protective clothing. You will also need to have regular skin exams to look for the return of cancer cells.

RESOURCES:

American Academy of Dermatology
http://www.aad.org/default.htm/

American Cancer Society
http://www.cancer.org/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/

Canadian Society of Plastic Surgery
http://www.plasticsurgery.ca/

References:

American Cancer Society website. Available at: http://www.cancer.org .

American Society for Dermatologic Surgery website. Available at: http://www.asds-net.org .

Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. Guidelines from the American Joint Committee on Cancer. J Clin Oncol. 2001;19:3635-48.

Lens MB, Dawes M, Goodacre T, Bishop JA. Excision margins in the treatment of primary cutaneous melanoma: a systematic review of randomized controlled trials comparing narrow vs wide excision. Arch Surg. 2002;137:1101-5.

National Cancer Institute website. Available at: http://www.cancer.gov .