Surgery for advanced melanoma
Surgery is used to help control advanced melanoma and relieve symptoms. It is usually only possible if the melanoma has spread to:
- areas of skin distant from the original melanoma
- lymph nodes distant from the original melanoma.
Surgery can sometimes be used to remove melanoma that has spread to the:
- liver (but only if the melanoma is in one place in the liver)
- lungs (but only if the melanoma is in one place in the lungs).
Surgery can remove a melanoma that has spread to the skin. Melanoma that spreads to the skin can cause new lumps. Sometimes these lumps bleed or cause discomfort. Lumps can be removed under local or general anaesthetic, depending on the amount of skin being removed.
You may have the operation as an outpatient or you may stay in hospital overnight. Some people need to have skin taken from somewhere else on the body to replace the skin that is removed. This is called a skin graft. Your surgeon or specialist nurse will explain more about this.
Your stitches will be removed about a week after surgery. If you have dissolvable stitches, they will not need to be removed. You may need to have your wound cleaned and dressed until it has healed. The hospital nurses can show you how to do this, or they can arrange for a district nurse to do it for you at home.
Melanoma can spread to lymph nodes far away from the melanoma. They may become enlarged or feel hard. If this is uncomfortable or painful, you may have an operation to remove the lymph nodes.
You will have the operation under general anaesthetic, and you will probably be in hospital for a few days. The type of operation you have will depend on where the lymph nodes are. Your surgeon or specialist nurse will tell you more about what to expect.
After the operation, you may have a small tube (a drain) to remove any fluid that builds up around your wound. The drain is connected to a small bottle. The drain is removed when most of the extra fluid has drained away, usually within a few days. Some people may go home with the drain in place. It can be removed by a practice nurse at your GP surgery or a district nurse at home.
The wound will be covered with a dressing and your stitches or staples will be removed 7 to 10 days later. If you have dissolvable stitches, they will not need to be removed. The hospital nurses can show you how to take care of your wound. Or they can arrange for a district nurse to do it for you at home.
If your lymph nodes have been removed, there is a risk of developing swelling in an arm, leg or other part of the body. It will depend on where in the body the lymph nodes were removed. This is called lymphoedema.
We have more information about how to reduce your risk of lymphoedema.
Surgery to remove melanoma that has spread to the brain may be possible if there is only one tumour. It will only be offered if melanoma has not spread anywhere else in the body. A specialist surgeon (a neurosurgeon) can talk to you about whether an operation is possible. Your melanoma specialist will refer you if they think surgery could help.
This type of surgery is done in a specialist centre. Your neurosurgeon and specialist nurse will tell you what to expect before and after your operation. You will probably be in hospital for at least a week.
You usually have steroid drugs to help reduce any swelling around the tumour and improve your symptoms. These are usually prescribed before your operation and for a few weeks afterwards. Some people may have radiotherapy after surgery to the brain.
If the melanoma has spread to the liver or lungs, it may be possible to remove the tumour with surgery if:
- it is only a single tumour or area of the liver or lungs
- melanoma has not spread anywhere else in the body.
Surgery to remove tumours from the lungs or liver is a big operation. It is unlikely to cure the cancer. Your specialist will talk with you about the risks and possible benefits of the operation. They will usually refer you to a specialist surgeon. The surgeon will do some checks to find out whether an operation is suitable for you.