Surgery involves removing all or part of the cancer with an operation. A wide local excision is the most common operation for anorectal melanoma.

About surgery for anorectal melanoma

There are two types of operation used to treat anorectal melanoma. The aim is to remove all of the cancer, or as much of it as possible. The operation you have will depend on the stage of the cancer. We have more information about having your operation.

Wide local excision

This is the most common operation for anorectal melanoma. The surgeon removes the tumour and a small area (margin) of normal-looking tissue all around the tumour. This reduces the risk of cancer cells being left behind.

The anal muscles are not usually affected. This means you should still be able to control your bowel in the normal way after treatment.

Abdominoperineal resection (APR)

Some people need a bigger operation to remove the cancer. Your doctor may suggest this operation if:

  • you had a local excision but some cancer could not be removed or has come back
  • the tumour is in a difficult area to remove with a local excision
  • the tumour cannot be completely removed by a local excision, and involves structures in the anus or rectum that may cause a loss of bowel control (incontinence).

In an APR, the surgeon removes all of the anus and rectum. They may also remove nearby lymph nodes if the cancer has spread there.

Abdominal perineal resection 

The surgeon closes the hole where the anus was. They make a cut on your tummy (abdomen) and join the end of your bowel to this opening. This is called a colostomy. After the operation, your bowel motions come through this opening (stoma) instead of your back passage. You wear a bag over the stoma to collect the bowel motions.A stoma and colostomy bag 

Being told you need a stoma can be distressing, but most people find they get used to the stoma over time. You will get support and advice from a stoma nurse in your hospital. We have more information about living with a colostomy.

Lymph node dissection

If an ultrasound scan suggests that melanoma has spread to lymph nodes, the surgeon may remove them as part of the operation. This is called lymph node dissection. There is a risk of leg swelling after lymph nodes are removed from the groin. This is called lymphoedema.

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