Surgery for lymph node removal

If your melanoma has spread to nearby lymph nodes you will have 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. Only the lymph nodes closest to where your melanoma was found will be removed. If the melanoma was in your leg, the lymph nodes in your groin will be removed.

You will be in hospital for 3–5 days to have the operation. After your surgery, the nurses on the ward will look after you. It’s normal to have some 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.

Occasionally, 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

If your melanoma has spread to nearby lymph nodes you will have further surgery to remove them. This is called lymph node dissection.

You will need to be in hospital to have your lymph nodes removed. You’ll usually need to stay in hospital 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 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, 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 are 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.

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 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.


Further treatment

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. There are no standard treatments for people with melanoma 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 research 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.