• Surgical Procedures for Melanoma

    Surgical removal of melanoma is the most common treatment. In some cases, it may be combined with other treatments to prevent the spread or recurrence of more advanced cancer.

    Surgery for Early Stage and Advanced Melanoma

    Excision
    The entire tumor is cut away along with a wide margin of healthy tissue to make sure no cancer cells remain in the skin. The area affected will depend on the size and depth of the cancer. The remaining skin will need to be stitched together. If the area is too big, skin from another area of the body may be needed to cover the area. Skin scarring may be permanent.
    Mohs Surgery
    In Mohs surgery, the visible part of the tumor is removed. The surrounding tissue is then removed in layers and examined under a microscope for the presence of cancer cells. This process is repeated until the most recent removed layer are free of cancer cells. This helps preserve as much tissue as possible.
    Mohs surgery is used less often for melanoma. It is generally only used for stage 0—melanoma in situ.
    Amputation
    If melanoma is found on a finger or toe, amputation of the part of all of digit may be necessary. This is not a common procedure.
    Lymph Node Dissection
    Cancer can spread to the lymph nodes near the main tumor. Once there, it can travel to other parts of the body through the lymphatic system. During surgery, some or all of the lymph nodes suspected of having cancer will be removed and examined under a microscope. Removing lymph nodes may create permanent problems with the drainage of lymph fluid from the limbs called lymphedema. Talk to your doctor about the risks and benefits of having lymph node dissection.

    Surgery for Metastatic Melanoma

    Surgery is not generally used for metastatic melanoma except in cases where it may relieve symptoms, prolong life, or improve quality of life.

    References

    Dawn ME, Dawn AG, Miller SJ. Mohs surgery for the treatment of melanoma in situ: a review. Dermatol Surg. 2007;33(4):395-402.

    Melanoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115302/Melanoma. Updated August 26, 2016. Accessed October 18, 2016.

    Melanoma. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dermatologic-disorders/cancers-of-the-skin/melanoma. Updated July 2015. Accessed October 18, 2016.

    Melanoma skin cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003120-pdf.pdf. Accessed October 18, 2016.

    Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq#section/%5F135. Updated July 22, 2016. Accessed October 18, 2016.

    Walling HW, Scupham RK, Bean AK, Ceilley RI. Staged excision versus Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma. J Am Acad Dermatol. 2007;57(4):659-664.

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