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  • Surgery for melanoma

    Last reviewed October 2012


    Treatment for localised melanoma

    Although melanoma is the most serious type of skin cancer it can be treated successfully if caught early.

    Your medical team will discuss the best treatment for you based on how far the melanoma has spread. The most common treatment for localised (early stage) melanoma is surgery. Most of the time this is the only treatment required.

    Some people with metastatic disease may also need other types of treatment such as radiotherapy or chemotherapy.

    Surgery for localised melanoma

    Primary melanomas are always removed by surgery. Sometimes a part of the melanoma will have been removed in the initial diagnostic biopsy.

    The surgeon will do a wide local excision. This means that the melanoma will be completely cut out plus enough of the normal skin around it to make sure all the cancer cells have been removed. This is called a safety margin. The size of the safety margin is usually between five millimetres and two centimetres, depending on the thickness of the melanoma.

    A wide local excision is sometimes performed as a day procedure using local anaesthetic. However many people with melanomas thicker than 1mm also have a sentinel node biopsy.

    A pathologist will check the tissue around the melanoma for cancer cells. If the sample doesn’t have any cancer cells, it is called a clear margin. If the margins aren’t clear, you may need further treatment.

    Skin flaps and grafts

    If the surgery wound is too big to close by drawing the edges together with stitches, the surgeon may cover the wound using some skin from another part of your body.

    The surgeon may use a skin flap. This means nearby skin is pulled over the wound and stitched.

    If a skin flap isn’t possible a skin graft will be used to cover the wound. This means a shaving of skin is taken from another part of your body and placed over the area where the melanoma was removed. The skin graft is usually taken from the thigh.

    In either case the melanoma wound will be covered with a dressing and left for several days. It will then be checked to see if it is healing properly. You will also have dressings on any area from which skin was taken for a graft.

    After the operation

    You may be uncomfortable for a few days after a wide local excision. Your doctor will prescribe pain-killers if necessary. If you have a skin graft, the area on which the skin is grafted may look unattractive after the operation. Eventually this area will heal and the redness will fade. Your medical team will tell you how to keep the wound clean to prevent it from becoming infected.

    Your doctor can give you information about any bruising or scarring that you may have after surgery.

    In rare cases the original skin graft fails and a new skin graft is required.

    Your total recovery time varies depending on the thickness of the tumour and the extent of the surgery required. Your health care team will advise you when you can resume your usual activities.

    Treatment for metastatic melanoma

    Metastatic melanoma (also called advanced melanoma) means the cancer has spread to distant skin sites, lymph nodes or internal organs. Treatment may include surgery, radiotherapy and chemotherapy.

    Surgery for metastatic melanoma

    In most cases the surgeon will be able to do a wide local excision to treat metastatic melanoma. This is usually possible if the cancer involves other parts of the skin. The surgeon will also remove nearby lymph nodes if they are cancerous. This procedure is called a lymphadenectomy or lymph node dissection.

    If the melanoma has spread to internal organs, surgery may still be possible. The type of operation you will have depends on the part of your body that is affected. Talk to your medical team for more information or call Cancer Council 13 11 20.

    Information reviewed by: : Prof Grant McArthur, Consultant Medical Oncologist, Head of the Translational Research Group and Head of the Molecular Oncology Laboratory, Peter MacCallum Cancer Centre, VIC; Jay Allen, Consumer and Community Coordinator, Melanoma Institute Australia, NSW; Annie Angle, Cancer Council Helpline Nurse, Cancer Council Victoria; Prof Michael P Brown, Director, Cancer Clinical Trials Unit, Senior Medical Oncologist, Royal Adelaide Cancer Centre, SA; Dr Vanessa Estall, Head Radiation Oncologist, Melanoma and Skin Service, Peter MacCallum Cancer Centre, VIC; Clinton Heal, Consumer and CEO and Founder of Melanoma WA; Prof John Thompson, Professor of Melanoma and Surgical Oncology at the University of Sydney and Director, Melanoma Institute Australia, NSW; and members of the SunSmart Victoria team. 


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