Surgery to remove the lymph nodes for melanoma

If melanoma has spread to nearby lymph nodes they can be removed with an operation.

About surgery to remove the lymph nodes

You might have surgery to remove your lymph nodes if:

  • your cancer doctor thinks the melanoma has spread to nearby lymph nodes
  • tests show that your lymph nodes are affected.

Your surgeon will remove your lymph nodes under a general anaesthetic. You are likely to be in hospital overnight, and may need to stay in for 3 to 5 days.

The surgery and side effects you have will depend on the group of lymph nodes being removed. Your surgeon or specialist nurse will tell you more about what to expect in your situation. You may have one of the following operations:

  • If the melanoma was on your leg, a cut (incision) is made in the groin on the affected side to remove the lymph nodes.
  • If the melanoma was on your arm, the lymph nodes in your armpit on the affected side are removed.
  • If the melanoma was on your face or neck area, the lymph nodes in your neck are removed.

After your operation

After the operation, you may have a small tube (drain) in place to remove any fluid that builds up around the wound. The drain is connected to a small bottle. It will be removed when most of the fluid has drained away. This is usually within a few days. You might 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 10 to 14 days later. If you have dissolvable stitches, these will not need to be removed.

You will probably have some discomfort or pain afterwards, but you will have regular painkillers to help with this. Most people feel able to do their normal activities after two weeks.

After your operation, you may see a physiotherapist. They will show you some exercises to help you move normally again.

If your lymph nodes have been removed, you have a higher risk of developing lymphoedema. Lymphoedema is a chronic swelling in an arm, leg or other part of your body. Where the swelling is depends on where in the body the lymph nodes were removed.

A small number of people may get a wound infection after this operation. This can be treated with antibiotics.

Some people get a small collection of fluid around the wound scar. This is called a seroma. It usually goes away within a few weeks. Sometimes your surgeon may need to drain the fluid with a needle and syringe.

Further treatment

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

Your cancer doctor may offer you radiotherapy 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 can 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 cancer doctor will give you more information about the treatment and any possible side effects.

They will also talk to you about whether any drug treatments, such as targeted therapies or immunotherapies, will help after your operation. These are called adjuvant treatments. They help to reduce the risk of a cancer coming back.