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SKIN CANCER SERIES: PART 3 - MELANOMA SURGERY

Melanoma

Melanoma is the most serious form of skin cancer. Left untreated there is a high risk of melanoma spreading around the body, and this can be fatal. At the Skin Centre this cancer is treated with the highest priority. Surgery may well be fitted in out of hours to expedite your treatment.

Surgery

Surgery is done under a local anaesthetic. Often the surgery is done as a staged procedure. In some areas, for example the face, the melanoma will be removed and you may be left with a wound which is dressed and not repaired for several days until it is certain that the skin cancer is removed with a large enough margin so that all the roots have gone. In other areas the surgery may be staged in a different way; the melanoma is removed, the skin is sutured and further surgery is performed once the degree of severity is known. The more severe the melanoma, the larger the second excision that is required. You may be surprised at the size of the scar that is necessary to ensure that the melanoma has been fully removed.

After your surgery

You should expect to have a very big dressing after your surgery, even if the wound is small. The large, bulky dressing to apply even, firm pressure, will ensure the wound heals well. This dressing is removed at follow up.

Sentinel Node Biopsy

Some melanomas may require a sentinel node biopsy. Typically this is a melanoma with a Breslow thickness of between 1-4mm. This technique of surgery involves sampling of the lymph gland closest to the melanoma. If the melanoma spreads, the first place it will go to is the gland. This procedure will determine whether or not this has occurred. This procedure tells us whether or not the melanoma has spread and will give you a better idea as to the prognosis of the tumour. Not everyone requires a sentinel node biopsy and if you feel, on reflection, you prefer not to have this done, it is not essential.

Lymph Node Dissection

This procedure is not indicated routinely. You may be referred for lymph node dissection if the sentinel node biopsy is positive.

Follow up

You have an increased risk of developing another unrelated melanoma as well as other less dangerous types of skin cancer. If your melanoma is low risk, follow up care is often shared with your GP. If your melanoma is more serious, you may require a 3 monthly skin check for the year after your surgery and 6-monthly thereafter.

Sun Exposure

The only thing we know you can do to reduce your risk of further skin cancer is to reduce your sun exposure. Covering up all year round with long sleeves, long skirts/trousers and hats, provides your best protection from the sun. Sunscreen is a useful adjunct to clothing in areas not able to be covered with clothing.