Melanoma Surgery
Surgery is the standard treatment for melanoma, a common type of skin cancer. If performed early enough, surgery for melanoma is often completely curative.
Types of Melanoma Surgery
The extent of surgery depends on if the cancer has spread and how deeply the cancer has invaded the skin.
Wide Local Excision
Malignant melanoma of the skin requires removal by a procedure called Wide Local Excision (WLE). In this procedure, the surgeon removes the tumor with a margin of normal skin around it. The amount of margin required is based largely on the depth of the lesion (determined by biopsy beforehand). In general, the thicker the tumor, the larger the margin.
Sentinel Lymph Node Biopsy
Cancer Care Northwest’s surgical oncologists perform sentinel lymph node biopsy, a fairly new surgical procedure used to determine if melanoma has spread to the lymph nodes.
With sentinel lymph node biopsy, the surgeon uses a radioactive substance or dye to find the first (sentinel) lymph node that is most likely to be invaded by cancer. This lymph node is removed and checked for cancerous cells. The results help your doctors predict if cancer has spread to other lymph nodes.
Prior to sentinel lymph node biopsy, all of the lymph nodes in question had to be removed to determine if the cancer had spread. Because melanoma often does not involve the lymph nodes, many patients, prior to sentinel lymph node biopsy, had to undergo an operation that was ultimately found to be unnecessary.
Surgeons at Cancer Care Northwest have been actively involved in clinical research aimed at better defining which melanoma patients, particularly those with thinner lesions (< 1mm in depth), need to undergo this procedure as part of their surgical treatment. These findings have been presented at recent regional/national surgical meetings and published in peer-reviewed surgical journals.
Skin Graft
Occasionally, Wide Local Excision creates a defect in the skin that can only be closed with the use of a skin graft (transfer of skin from one area of the body to another). Most of the time, however, the skin can be closed without a skin graft.