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’ll only have this surgery if your specialist thinks your melanoma has spread to nearby lymph nodes or if tests show that they are affected.
You’ll have your lymph nodes removed under a general anaesthetic and are likely to be in hospital for a few days. The surgery you have and its side effects will depend on the group of lymph nodes being removed. Your specialist doctor or nurse will tell you more about what to expect in your situation. 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, head or in the neck area.
After the operation, you may have a small tube in place (called 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. It’s likely that you’ll 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. If your lymph nodes have been removed, there’s a risk of developing swelling in an arm or leg or other part of your body (depending on which lymph nodes were removed). This is called lymphoedema.
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, radiotherapy (treatment with high energy x-rays) may be given after surgery.
If your doctor thinks you’ll benefit from having any other treatments (adjuvant treatments) after your lymph node dissection, they’ll discuss this with you. Adjuvant treatments are usually given to reduce the risk of a cancer coming back. There are no standard treatments for people with melanoma to reduce the risk of it coming back. However, there may be a research trial going on to find an effective adjuvant treatment. Your specialist may ask you to think about joining a research trial.
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 will help control the spread and growth of the cancer in the affected lymph node areas. It will also reduce the risk of the cancer spreading to other parts of the body.
Surgery to remove the lymph nodes will leave a scar on your skin, which will fade 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. But there are ways you can help lower your risk of getting lymphoedema or reduce its severity if it does develop.