Surgery to remove lymph nodes to treat melanoma
If tests show that the lymph nodes are affected, further surgery will be carried out to remove the lymph nodes.
You will need to be in hospital to have your lymph nodes removed. You’ll usually need to stay in for 3–5 days. The surgery is carried out under a general anaesthetic.
The operation you have and its side effects will depend on the lymph nodes being removed. For example, if the melanoma was in your leg, a cut (incision) is made in the groin on the affected side to remove the lymph nodes. If the melanoma was in your arm, the lymph nodes in your armpit on the affected side will be removed. The nodes in your neck will be removed if you had a melanoma anywhere on your face or head or in the neck area. Your specialist doctor or nurse will tell you more about what to expect.
After the operation, you may have a small tube in place (a drain) to remove any fluid that builds up around the wound. The drain is connected to a small suction bottle. It’ll be removed when most of the excess fluid has been drained away, usually within a few days. The wound will be covered with a dressing and your stitches or staples will be removed 10–14 days later, unless they’re the self-dissolving type.
You may also have a drip (infusion) to give you fluids until you’re drinking properly again.
You’ll probably have some discomfort or pain in the area afterwards, but you’ll be given regular painkillers until this eases.
Occasionally, people continue to have pain following this kind of operation. However, most people can begin to do the things they normally do after a couple of weeks.
After your operation, you may see a physiotherapist who will show you some exercises to help you move normally again.
You will also be told about what you can do to help reduce your chances of getting lymphoedema. This can sometimes happen weeks, months or even years after surgery.
A small number of people may get a wound infection after this type of surgery. This can be treated with antibiotics. Some people may get a small collection of fluid around the wound scar. This is known as a seroma. It usually goes away within a few weeks but sometimes your surgeon may need to drain off the fluid with a needle and syringe.
Benefits and disadvantages of treatment
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It’s important to be aware of the benefits and disadvantages of surgery to remove your lymph nodes and to discuss these with your doctors before your treatment.
In many cases surgery to remove affected lymph nodes helps control the local spread and growth of the melanoma.
The surgery will leave a scar on your skin, which will become less noticeable with time. You may want to discuss with your doctor and nurse what the scar may look like after surgery.
Removing the lymph nodes can sometimes lead to lymphoedema. This is a swelling of an arm, leg or other part of your body, depending on which lymph nodes were removed. There are ways you can help lower your risk of lymphoedema or reduce its severity if it does develop. There’s still a risk that the melanoma may come back again after removing the lymph nodes.
After you’ve had your lymph nodes removed, you may not need any further treatment.
Occasionally, if it hasn’t been possible to remove all the affected lymph nodes, you may have radiotherapy after surgery. This is treatment with high-energy x-rays. Radiotherapy to the lymph nodes may sometimes cause long-term side effects, depending on the area being treated. It may also increase your risk of developing lymphoedema. If you need radiotherapy, your specialist will give you more information about the treatment and any possible side effects.
If your doctor thinks you’ll benefit from having any drug treatments (called adjuvant treatments) after your lymph node dissection, they’ll discuss this with you. Adjuvant drug treatments are given to reduce the risk of a cancer coming back. You usually have them as part of a research trial. This is because doctors are still trying to find out how effective they are. Your specialist may ask you to think about joining a trial.