Surgery for melanoma

Introduction

Melanoma is a skin cancer which originates from melanocytes. Melanocytes are present in the skin and mucous membranes. They are even found in brain membranes and in the eye.

The best and the only way to treat this severe disease is surgical removal of the tumor and surrounding tissue.

The mortality rate for malignant melanoma is very high. Still there are new treatment options apart from the surgery that may help people who are suffering from this horrible disease.

Surgery for Melanoma

Complete excision of the tumor is required in all cases. In advanced stages even lymph nodes need to be resected. If there are metastatic formations they can be resected as well.

The most successful way is to remove the tumor with the defined margin around the tumor. Even though the surrounding skin may appear normal metastases may be present near the primary tumor. In case that melanoma occurs in the eye the surgery usually includes the entire removal of the eyeball.

Fortunately, the surgery in general has advanced. This also refers to surgery in case of malignant melanoma. Sentinel node biopsy which is commonly used in surgery of breast cancer can now be successfully used even in case of malignant melanoma.

Namely, the first thing surgeon thinks about is the thickness of the tumor. The thickness of malignant melanoma determines whether the tumor has spread to the regional lymph nodes. The tumors that are thicker are more prone to give regional metastases. Doctors need to know if lymph nodes are affected as only then they can stage the disease properly and conduct the proper treatment. The prognosis of the disease also depends if the lymph nodes are affected or free of tumor cells.

Sentinel node biopsy can identify the first lymph node in a row that is in charge of drainage of the lymph of the affected area. If the tumor spreads into this lymph node the further surgery and excision of regional lymph nodes is necessary. This method is highly effective and is rather reliable.

In some patents a large portions of skin and the underlying tissue have to be removed. This is rather radical procedure and is done in advanced stages of the disease. The skin that is removed has to be somehow compensated. So additional surgery called skin grafting is necessary. The skin grafts require special care as they need time to heal properly.

The bottom line is that sentinel node needs to be performed in each an every case of melanoma. This way the surgeon will not have to remove those lymph nodes that are not affected by the tumor.