Melanoma Removal

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Melanoma Removal

Definition

Melanoma removal is a surgery to remove cancer in skin tissue. The cancer is called melanoma.

Melanoma

Reasons for Procedure

A melanoma removal is done to treat melanoma. For some it may be a cure for melanoma.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a melanoma removal, your doctor will review a list of possible complications, which may include:

Infection
Bleeding
Nerve damage
Scarring
Incomplete removal of all cancerous cells
Recurrence or spread of cancer

Smoking may increase the risk of complications.

What to Expect

Prior to Procedure

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

Physical exam of skin
Biopsy of any suspicious lesion
Blood tests
Image tests such as Chest x-ray, CT scan, MRI, or PET scan

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—The tumor is cut out, along with a small amount of normal skin at the edges. The wound is stitched back together. This type of surgery may leave a scar.
Wide excision—The tumor is cut out along with a larger area of normal skin. This will help make sure there are no cancer cells left behind.
Amputation—A finger or toe may be removed if the cancer is on the digit.
Lymph node dissection—Nearby lymph nodes may be removed if there is concern that the cancer spread. The removed lymph nodes will be sent to a lab for study.

The area may be closed with stitches. A larger area may need to be covered with a skin graft from another area of your body.

After Procedure

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

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. Medicine will help manage pain.

Postoperative Care

Keep the surgical area clean, dry, and protected by bandages.
If recommended by your doctor, apply a nonprescription antibiotic ointment to the wound before applying bandages.
Take any medications as prescribed.
Avoid vigorous exercise according to your doctor's recommendations.
Return to have any stitches or staples removed when instructed.
Ask your doctor about when it is safe to shower, bathe, or soak in water.

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. Do self-exams to look for any new or changing moles. Your doctor can show you how to do a self-exam.

Call Your Doctor

After arriving home, contact your doctor if any of the following occur:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
Pain that you can't control with the medications you've been given
A new lump or discoloration in your skin
A change such as color, bleeding, itching, or growth in an already-existing mole, either at the surgical site or in a new location
Any other new or concerning symptoms

In case of an emergency, call for medical help right away.

RESOURCES

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

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

Bichakjian CK, Halpern AC, Johnson TM, et al. Guidelines of care for the management of primary cutaneous melanoma. American Academy of Dermatology. J Am Acad Dermatol. 2011;65(5):1032-1047.

Lens MB, Nathan P, Bataille V. Excision margins for primary cutaneous melanoma: updated pooled analysis of randomized controlled trials. Arch Surg. 2007;142(9):885-891.

Melanoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 3, 2013. Accessed April 9, 2013.

Melanoma: diagnosis, treatment, and outcome. American Academy of Dermatology website.Available at: http://www.aad.org/skin-conditions/dermatology-a-to-z/melanoma/diagnosis-treatment/melanoma-diagnosis-treatment-and-outcome. Accessed April 9, 2013.

Melanoma skin cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003120-pdf.pdf. Updated January 17, 2013. Accessed April 9, 2013.

Physician quality reporting system quality measures. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 5, 2013. Accessed April 9, 2013.

6/2/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Revision Information

Reviewer: Brian Randall, MD
Review Date: 04/2013 -
Update Date: 04/09/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Cartersville Medical Center