Surgery for lymph node removal

If melanoma has spread to nearby lymph nodes, you will be offered surgery to remove them. This is called lymph node dissection.

The operation you have and its side effects will depend on the lymph nodes being removed. Usually, only the lymph nodes closest to where your melanoma was found will be removed. For example, if the melanoma was in your leg, the lymph nodes in your groin will be removed.

You will be in hospital for 3 to 5 days to have the operation. It is normal to feel pain around the wound, but this will get better in time. The nurses will give you regular painkillers until this eases.

You will be told how to reduce your chances of getting lymphoedema (swelling in the arms or legs).

You may not need any further treatment after your operation.

Sometimes, if it was not possible to remove all the affected lymph nodes, you may have radiotherapy after surgery. Your specialist might also talk to you about taking part in a research trial.

Surgery to remove the lymph nodes

You will only have this surgery if:

  • your specialist thinks your melanoma has spread to nearby lymph nodes 
  • tests show that they are affected.

You will have your lymph nodes removed under a general anaesthetic. You are likely to be in hospital for three to five 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 is in your leg, a cut (incision) will be made in the groin on the affected side to remove the lymph nodes. If the melanoma is 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 have a melanoma anywhere on your face, head or in the neck area.

I had to have full groin clearance surgery to remove as many lymph nodes as possible. They would all be checked for cancer.

Kathryn


After your operation

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 will be removed when most of the excess fluid has been drained away. This is usually within a few days. The wound will be covered with a dressing and your stitches or staples will be removed 10 to 14 days later, unless they are the self-dissolving type.

You may also have a drip (infusion) to give you fluids until you are drinking properly again.

You will probably have some discomfort or pain in the area afterwards, but you will be given regular painkillers until this eases. Occasionally, people continue to have pain after this kind of operation. But, 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 is a risk of developing swelling in an arm or leg or other part of your body, depending on where in the body the lymph nodes were removed. This swelling is called lymphoedema.

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. Sometimes your surgeon may need to drain off the fluid with a needle and syringe.


Further treatment

After you have had your lymph nodes removed, you may not need any further treatment.

Radiotherapy may sometimes be offered after surgery to help reduce the risk of the melanoma coming back. Radiotherapy 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 doctor will give you more information about the treatment and any possible side effects.

If your doctor thinks you will benefit from any drug treatments after your lymph node dissection, they will discuss this with you. These are called adjuvant treatments They 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.

Back to Surgery explained

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.